סוגיה 22- תנאי כתובה: ריפוי

לָקְתָה,

חַיָּב לְרַפֹּאתָהּ.

אָמַר, הֲרֵי גִטָּהּ וּכְתֻבָּתָהּ, תְּרַפֵּא אֶת עַצְמָהּ- רַשָּׁאי.

(9) If she was taken captive, he is obligated to ransom her. And if he says, "Here is her document of divorce, and [the amount of] her ketubah, let her ransom herself [at her own expense]," he is not allowed [to do so]. If she gets injured, he is obligated to [pay for] her [to be] healed. [However, if] he says, "Here is her document of divorce, and [the amount of] her ketubah, let her heal herself [at her own expense]," he is allowed [to do so].

'לקתה - חייב לרפאותה':

תנו רבנן

אלמנה ניזונת מנכסי יתומין

וצריכה רפואה, הרי היא כמזונות

רבן שמעון בן גמליאל אומר:

רפואה שיש לה קצבה- נתרפאת מכתובתה

שאין לה קצבה- הרי היא כמזונות

אמר רבי יוחנן:

עשו הקזת דם בארץ ישראל

כרפואה שאין לה קצבה

קריביה דרבי יוחנן,

הוה להו איתת אבא

דהות צריכה רפואה כל יומא

אתו לקמיה דרבי יוחנן .

אמר להו: איזילו קוצו ליה מידי לרופא

אמר רבי יוחנן:

עשינו עצמינו כעורכי הדיינין

מעיקרא מאי סבר ולבסוף מאי סבר?

מעיקרא סבר: ומבשרך לא תתעלם (ישעיהו נח ז)

ולבסוף סבר: אדם חשוב שאני:

One does not redeem captives at more than their value. This policy is for the betterment of the world, because if captives are ransomed at exorbitant prices, this will encourage their captors to kidnap more people. The Gemara notes: This implies that if the captors seek a ransom in accordance with their actual value one does redeem captives, even though this includes a case where a woman’s redemption is more than her marriage contract. And the Gemara raises a contradiction from a different baraita, which states: If she was taken captive and the captors were seeking from her husband a ransom of up to ten times the value of her marriage contract, on the first occasion he must redeem her. From this point forward, if he wants to he redeems her, but if he does not want to redeem her, he does not have to redeem her. Rabban Shimon ben Gamliel says: If the price of her ransom was equal to her marriage contract he redeems her. If not, i.e., the price of her ransom was greater than the sum of money guaranteed to her in her marriage contract upon divorce or the death of her husband, he does not have to redeem her. He can suffice with paying her marriage contract. The Gemara answers: Rabban Shimon ben Gamliel is of the opinion that there are two leniencies with regard to the halakhot of redemption. First, he maintains that one does not pay more than the general ransom given for such a captive, and second, a husband does not have to pay more than the sum of his wife’s marriage contract. § The mishna taught (51a) that if a woman was struck with illness, her husband is obligated to heal her, i.e., to pay for her medical expenses. The Sages taught in a baraita: In the case of a widow who is sustained from the property of the orphans and who requires medical treatment, her medical needs are like her sustenance, and the orphans must bear the costs. Rabban Shimon ben Gamliel disagrees and says: With regard to treatment that has a fixed cost, she is healed from her marriage contract, i.e., the amount is subtracted from her marriage contract. If it is a treatment that does not have a fixed cost, it is considered like sustenance. Rabbi Yoḥanan said: The Sages established that in Eretz Yisrael, bloodletting is considered like a treatment that does not have a fixed cost, and therefore the heirs must pay for that treatment. The Gemara relates: The relatives of Rabbi Yoḥanan had to take care of the wife of their father, who required treatment every day, and therefore her medical expenses were high. They came before Rabbi Yoḥanan to ask him what to do. He said to them: Go and fix a lump sum with the doctor for his services. The treatment would then be considered as having a fixed cost, which is deducted from the marriage contract. Later Rabbi Yoḥanan said in regret: We have made ourselves like legal advisors, who help people with their legal claims. The Gemara asks: At the outset, what did he hold and ultimately, what did he hold? The Gemara explains: At the outset he held that one should act in accordance with the verse “and that you do not hide yourself from your own flesh” (Isaiah 58:7), which indicates that one must help his relatives. And ultimately he held that an important person is different. If a man of stature offers assistance to his family in a manner that causes a loss to another individual, it appears as though he were unfairly favoring his relatives. MISHNA: If the husband did not write for her in her marriage contract: Any male children you will have from me will inherit the money of your marriage contract in addition to their portion of the inheritance that they receive together with their brothers, he is nevertheless obligated as though he had written it, as it is a stipulation of the court and therefore takes effect even if it is not explicitly stated. Likewise, if he omitted from the marriage contract the sentence: Any female children you will have from me will sit in my house and be sustained from my property until they are taken by men, i.e., until they are married, he is nevertheless obligated as though he had written it, as it too is a stipulation of the court. Similarly, if he omitted from the marriage contract the clause: You will sit in my house and be sustained from my property all the days you live as a widow in my house, he is nevertheless obligated as though he had written it, as it is a stipulation of the court. The mishna comments: The residents of Jerusalem would write in this manner, that a widow may remain in her husband’s house throughout her widowhood, and the residents of the Galilee would write in this manner as well, like the inhabitants of Jerusalem. In contrast, the residents of Judea would write: Until the heirs want to give you your marriage contract. Consequently, if the heirs wish, they may give her marriage contract to her and release her, and she must find her own living arrangements and provide for herself. GEMARA: Rabbi Yoḥanan said in the name of Rabbi Shimon ben Yoḥai: For what reason did the Sages enact the marriage document concerning male children? It was enacted so that a man will be willing to take the initiative and write an agreement to give his daughter a dowry as large as the portion of his possessions that his son will receive as an inheritance. The marriage document concerning male children ensures that even if one’s daughter dies and her husband inherits her possessions, the dowry will eventually be inherited by her sons when her husband dies. Since the father of the bride knows that his grandchildren will inherit the dowry, he will give a larger dowry. The Gemara asks: And is there anything that justifies a situation where the Merciful One says that the son inherits and the daughter does not inherit, and yet the Sages came and enacted that the daughter should inherit? The practical effect of their decree is that daughters receive a significant portion of their father’s estate, just like sons. The Gemara answers: This also applies by Torah law, as it is written: “Take wives for yourselves and bear sons and daughters, and take wives for your sons, and give your daughters to husbands” (Jeremiah 29:6). This verse requires clarification. Granted, sons are in his hands, i.e., a father can select wives for them, but daughters, are they in his power that he can select husbands for them? It is not the manner of a woman or her family to court a man. Rather, the verse teaches us this, that the father should dress her and cover her and give her something, i.e., property, so that men will take the initiative with her and come to marry her. When the verse instructs fathers to marry off their daughters, it means that they must make efforts to ensure this outcome, including bestowing a dowry. The Gemara asks: And up to how much must a father give his daughters? Abaye and Rava both say: Up to one-tenth of one’s property should be handed over to his daughter for her dowry. The Gemara asks: But if this is the reason for the institution of the marriage document concerning male children, say that it is only the portion the bride’s father gave as a dowry that her sons should inherit, but the money the husband guarantees to pay his wife, they should not inherit. The Gemara answers: If so, the bride’s father will also refrain from writing a large dowry. If his daughter’s sons will not inherit the husband’s portion of the marriage contract, her father will be reluctant to give generously himself. The Gemara continues to ask: But if the concern is that the father will not give, say that in a case where the father wrote a large dowry for his daughter, let the husband also write the stipulation in the marriage document concerning male children, and when the father did not write a large dowry, let the husband not write this stipulation. The Gemara replies: The Sages did not distinguish between these cases. Although the main purpose of their enactment was to encourage fathers to provide their daughters with generous dowries, the Sages applied their decree equally to all women, even when the father failed to do so. The Gemara poses another question: If the aim is to ensure that the money of the marriage contract will remain with the woman’s descendants, in a case when one has a daughter from one woman among his sons from another woman, the daughter should likewise inherit her mother’s dowry. Why do only male children inherit their mother’s dowry? The Gemara responds: The Sages established this enactment as similar to the halakha of inheritance: Just as a regular inheritance belongs to sons and not daughters, the same applies to the marriage document concerning male children. The Gemara continues to inquire: Why shouldn’t one at least say that a daughter among daughters should inherit? If he had a daughter from this wife, and his other children are also daughters, in which case all the daughters divide the inheritance, the daughters of each wife should receive the portion her maternal grandfather gave to her mother. The Gemara again answers: The Sages did not distinguish between these cases when establishing their decree. The Gemara further asks: And let the marriage document concerning male children be collected even from movable property, if that is all the father possesses. The Gemara replies: The Sages established this enactment as similar to a regular marriage contract, which can be collected only from land. The Gemara poses yet another question: Let it be collected even from liened property, i.e., property the father sold after he wrote the marriage contract. The Gemara answers that we learned in the mishna: Will inherit, and one’s heirs do not inherit property that he has sold. The Gemara asks: But if this is the reason for this enactment, say that it should apply even though there is no more than a dinar beyond the value of the marriage contract that the father left over in his estate. The Sages stated that if no property is left for the inheritance, all the sons share the inheritance equally, in accordance with Torah law. The Gemara answers: In a case where their decree would entirely uproot the halakha of inheritance by Torah law, the Sages did not enact the marriage document concerning male children. The Gemara relates: Rav Pappa, having arranged for his son to marry into the family of Abba of Sura, went to supervise the writing of the bride’s marriage contract. Yehuda bar Mareimar heard that Rav Pappa was coming, and came out to present himself before him, in honor of his arrival. When they came to the entrance of Abba of Sura’s house, Yehuda bar Mareimar took his leave of him, as he did not wish to enter. Rav Pappa said to him: Let the Master enter inside with me.

ביאור:

שנינו במשנה שאם לקתה [חלתה] - חייב לרפאותה.

תנו רבנן [שנו חכמים]: אלמנה שהיתה ניזונת מנכסי יתומין וצריכה רפואה - הרי הרפואה היא כמזונות ומוטל עליהם גם לשלם עבור רפואתה.

רבן שמעון בן גמליאל מחלק ואומר: רפואה שיש לה קצבה, כלומר, שיש סכום קבוע בשביל לרפא אותה

נתרפאת מכתובתה ומנכים מסכום הכתובה. רפואה שאין לה קצבה - הרי היא כמזונות, ונותנים לה כפי צורכה.

אמר ר' יוחנן: עשו דין הקזת דם בארץ ישראל כרפואה שאין לה קצבה, והיא כמזונות, והיורשים משלמים.

מסופר: קריביה [קרוביו] של ר' יוחנן הוה להו איתת אבא [היתה להם אשת אב] דהות [שהיתה] צריכה רפואה כל יומא [יום] והיו להם הוצאות מרובות לרפואתה.

אתו לקמיה [באו לפני] ר' יוחנן לשאול.

אמר להו [להם]: איזילו קוצו ליה מידי [לכו וקיצבו לו דבר, סכום מסויים] לרופא עבור כלל הוצאות רפואתה לתמיד, ואז יהיה זה בגדר של רפואה שיש לה קיצבה, ותוכלו לנכות אותה מן הכתובה.

אחר כך אמר ר' יוחנן בצער: עשינו עצמינו כעורכי הדיינין המסייעים לאדם לטעון בדינו, שהצטער על שנתן עצה בהלכה לבעל דין.

ושואלים: מעיקרא מאי סבר ולבסוף מאי סבר [מתחילה כאשר נתן להם עצה זו מה חשב, ולבסוף שהתחרט מה חשב?] ומסבירים: מעיקרא [מתחילה] סבר הלא נאמר:" ומבשרך לא תתעלם" (ישעיה נח, ז) שצריך אדם לסייע לקרוביו,

ולבסוף סבר: אדם חשוב שאני [שונה], שאם עושה הוא דבר כזה, הריהו נראה כעורכי הדיינים, ולא היה צריך לעשות זאת.

רבן שמעון בן גמליאל – תנא, נשיא הסנהדרין באושא שבגליל, במאה השנייה לספירה , אחרי מרד בר כוכבא . אביו של רבי יהודה הנשיא.

רבי יוחנן (בר נפחא)- גדול אמוראי ארץ ישראל (דור שני, מאה שלישית) . ראש ישיבת טבריה במשך מעל לשישים שנה! דבריו- הן בתחום ההלכה והן בתחום האגדה- השפיעו רבות על שני התלמודים: הבבלי והירושלמי.

עיון ודיון:

1. הסיפא של המשנה קובעת: "אמר: הרי גיטה וכתובתה-תרפא את עצמה, רשאי" –

הסבירו.

2. במה שונה הדין שבסיפא מדין הרישא של המשנה (לגבי פדיון מהשבי, בסוגיה 23)?

הסבירו!

3. הסוגיה בתלמוד מביאה ברייתא הנוגעת לרפואת האלמנה.

מהי עמדת תנא קמא בברייתא? האם היורשים (יתומין) חייבים לממן את רפואת

האלמנה?

רבן שמעון בן גמליאל מבחין בין שני סוגי מחלות. הסבירו את ההבחנה שלו.

4. הסבירו את עצתו של רבי יוחנן לקרוביו. מדוע ייעץ להם כך?

5. רבי יוחנן הצטער על עצתו. מדוע?

פותחים סוגריים

הרמב"ם (משנה תורה, הלכות אישות פרק י"ד הלכה י"ז) ובעקבותיו ה"שולחן ערוך" שלהלן ,

מחדדים את ההבדל בין החובה המשפטית לבין החובה המוסרית.

חיוב רפואתה ובו ג סעיפים:

(א) רפואתה כיצד?

לקתה חייב לרפאותה בין רפואה שיש לה קצבה בין רפואה שאין לה קצבה

אבל אלמנתו אינה מתרפאת מנכסיו אלא ברפואה שאין לה קצבה שהוא דומה למזונות:

(ב) רצו היורשין לקצוב עם הרופא כדי שיהיה לה קצבה ויפטרו ממנה הרשות בידם:

(ג) אם ראה הבעל שהחולי ארוך

יכול לומר לה הרי כתובתיך מונחת או רפאי עצמך מכתובתיך או הריני מגרשך ונותן כתובה

ואין ראוי לעשות כן מפני דרך ארץ:

(1) How is he required to pay for her healing? If she became ill, he must heal her (pay her medical costs), whether healing that has a determinate cost or an indeterminate cost. But his widow is not healed from his estate except for healing which has no determinate cost, which is similar to food [payments].

(2) If the heirs wish to specify a cost with the doctor, such that [her healing] will have a determinate cost and they will be relieved of payment, they are permitted to do so.

(3) If a woman contracts a lasting disease, he is able to say to her that the ketuba can be assumed if she heals herself or the ketuba can be absolved and give her the ketuba , but this is not proper behavior because it is not derech eretz .

הקזת דם: חיתוך ורידים ועורקים של החולה באמצעות כלים חדים והוצאת דם מגופו. לצורך כך היה מקובל גם שימוש בעלוקות למציצת דם. הקזת דם הייתה נפוצה בקרב עמים קדומים רבים- ביוון, במצרים ובמסופוטמיה – שסברו כי בדרך זאת ניתן לרפא מחלות ואף למנוע אותן. האמונה המקובלת בעת העתיקה הייתה, שדמו של החולה נחשב למזוהם, לכן הורדת ריכוז הדם "הרע" והעלאת ריכוז הדם ה"טוב" עשויה הייתה לעזור לו.

מבַצע ההקזה לא היה רופא, אלא "אוּמַן" -אדם שעיסוקו היה בכך.

רופאי ימי הביניים ובראשם הרמב"ם, נקטו גישה זהירה והגבלות שונות בביצוע הקזת הדם. הם סברו שפעולת ההקזה מסוכנת ולא התירו אותה, אלא להצלה מסכנות גדולות יותר.

הקזת דם: ציור יווני עתיק על כד

http://psychology.wikia.com/wiki/Iatrogenesis