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There is a lot of talk in the news, etc., about Metzitzah B'peh that employs direct oral contact being dangerous.

First: If it is dangerous, shouldn't pikuach nefesh push it off?

Second: How important is it to a Bris in the first place?

Isaac Moses
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Mendy
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    Hello Mendy, welcome to Mi Yodeya, and thank you for this question! Please consider registering your account, which will give you access to more of the site's features. I hope to see you around! – HodofHod Jul 27 '12 at 01:03
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    See this article in Yated, which claims that there is a vendetta against Metzitzah B'peh and that (at least some of) the cases of herpes related fatalities have nothing to do with Metzitzah B'peh: http://www.yated.com/content.asp?categoryid=0&contentid=686 – Menachem Jul 27 '12 at 02:04
  • It is brought in a Mishnah in Shabbas it is also brought in the Rambam and later in halacha. It seems that if one does not do it, it causes a danger for the baby. The achronim bring different ways of doing a sponge, glass tube but it seems that milah and priah must be done and metzitzah is for sakanah but I am almost sure some hold it is a must. see sefer Otzar Habrit very good sources. – sam Jul 27 '12 at 02:33
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    @Menachem, given what everyone knows about germs nowadays, how could anyone possibly, in the name of health, introduce saliva into a cut on the infant's genitals? It doesn't take a vendetta to know that's a bad idea. – Isaac Moses Jul 27 '12 at 02:56
  • @IsaacMoses, if m'tzitza vape is done via a tube, no saliva is introduced. – msh210 Jul 27 '12 at 05:26
  • @msh210 And the complaints aren't about that. IsaacMoses is still right about the lack of need for a vendetta to complain about 'classical' metzitza vefeh. – Double AA Jul 27 '12 at 05:33
  • @msh210, I think the main controversy is about the method that does not use a tube or any intermediary. In fact, the NYC Health Dept. post that Mendy linked to mentions the use of a tube among the apparently-safe alternatives to direct contact. – Isaac Moses Jul 27 '12 at 05:33
  • @Menachem I don't know about what it claims, but that article is a vendetta! – Double AA Jul 27 '12 at 05:35
  • @IsaacMoses, DoubleAA, Mendy, then the question should clarify what sort of m'tzitza vape it's asking about. – msh210 Jul 27 '12 at 05:36
  • @DoubleAA: I don't disagree (although I'd say Yeted has an agenda), and I'd love to see some independent verification, here is a response from the city: http://www.thejewishweek.com/news/short-takes/city-countering-inaccurate-bris-story -- Here is an article from Dr Berman (mentioned in the Yated piece about Metzitza B'Peh) from a publication called Dialogue: http://www.matziv.com/pictures/drbermanarticlemetzitzah – Menachem Jul 27 '12 at 06:06
  • You may like this link: http://www.hakirah.org/Vol%203%20Sprecher.pdf Note: I have not read it yet. Note2: I think some of the above comments should have been answers instead. – Ariel Jul 27 '12 at 08:34
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    @msh210, I think Mendy's intent is pretty clear, since he linked to that NYC DoH post and because he's asking about pikuach nefesh, which AFAIK, has not been raised as an issue with non-direct-contact methods. I've edited the question to more clearly express that intent. – Isaac Moses Jul 27 '12 at 14:04
  • @IsaacMoses It was I that linked to the NYC DoH, FWIW. – HodofHod Jul 27 '12 at 15:57
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    The Avnei Neizer 1:338 discusses this issue at length and it seems like it should be done b'peh(the Maram Schick held like this as well,http://www.hebrewbooks.org/pdfpager.aspx?req=1345&st=&pgnum=369 . Rav Tzvi Frank (Har Tzvi 214) held one can use a glass tube and mentions the Chasam Sofer who held a sponge is good ,but said one needs to learn how to do it properly ,http://hebrewbooks.org/pdfpager.aspx?req=22460&st=&pgnum=217 – sam Jul 27 '12 at 20:04
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    @sam, why don't you write this up into an answer? – HodofHod Jul 27 '12 at 20:49
  • The S'dei Chemed has a couple chapters on this issue. It was also published as a separate pamphlet called, "A Collection of Laws - S'dei Chemed, Pamphlet Metzitza and Miluim", subtitled "Which talks about the laws of Metzitza, which must be done for the Mitzvah to be performed properly, and specifically with the mouth." I haven't read it, but it looks like it addresses the question. – Menachem Aug 22 '12 at 21:31
  • While the question itself is quite valid, I believe it is erroneous to apply the concept of pikuach nefesh to this issue. Statistically, the risk to life from MBP is minuscule. The child is in far more danger during the car trip to and from the synagogue than from MBP. Pikuach nefesh assumes a clear danger to life, and under normal circumstances MBP certainly does not rise to that level. – LazerA Dec 20 '12 at 01:46
  • http://en.tvunah.org/2014/02/18/metzitza-bpeh/ – Double AA Apr 28 '16 at 06:42

2 Answers2

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The gemara strongly implies that metzitzah is done for health reasons. Nowadays, we can follow that tradition safely by doing it with a tube. It seems ironic to to follow the gemara's health-suggestions in a way (b'peh) that we know to cause health-risks. However, some groups feel that there are other reasons for doing Metzitzah and that it should still be done since the health risks are small. If so, they should make strong safeguards to lessen the risk of transmitting disease.

Hakirah has an article from 2006 available online about metzitzah b’peh (pdf), which I summarize below (from my previous summary).

In the article he explains the historical medical background to metzitzah. In ancient times, people didn't know that blood circulated or that pathoegns cause disease. The hellenic system of medicine thought blood was attracted to cuts and could decay and form pus, so it was necessary to get the blood to flow from a cut to prevent disease. (The author cites R’ Nachum Rabinovitch who compares the Rambam’s requirement for metzitzah to the Rambam’s suggestion to suck the blood out after a snake bite). He discusses some modern-day rationals for doing MBP, but then refutes them.

The next part shows that metzitzah b’peh is a danger and many cases are cited where it has unfortunately caused harm to infants. He also tells the the history of MBP, and quotes some of the discussions about it from the 19th century. He then discusses the p’sak of the chasam sofer who didn’t even consider metzitzah b’peh to be a minhag. He concludes that if most of the litvishe gedolim accepted that MBP was a danger, surely now, when we know much more about transmission of diseases, we should not risk it.

Ariel K
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  • You seem to be addressing only question 1 of the two questions above, and doing so by quoting Hakirah as saying "It should". Right? – msh210 Jul 31 '12 at 21:51
  • also by mentioning that they should do it in a safer manner. – Ariel K Jul 31 '12 at 23:24
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    and that the gemara implies its not so important for the bris itself, its just a safety measure. – Ariel K Jul 31 '12 at 23:26
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    Frankly I don't see any other way of reading that Gemara. – Double AA Apr 11 '13 at 18:26
  • According to the Chatam Sofer, shouldn't it be prohibited to do on Shabbat? We don't allow heating water on the third day after the Milah anymore (OC 331:9), even though in the days of the Gemara they thought that was Pikuach Nefesh. This is the same thing; it just took people longer to realize the science was bogus. – Double AA Aug 17 '17 at 20:34
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Back in September (2012) there was well written article by Rabbi Moshe Zuriel (from Bnei Brak) posted on the Parsha Blog about this topic. Much of the mareh makomos that are brought in the article have already been mentioned here. However I'd like to contribute the article as it answers the question and I find it to be well-written and posing very good points

See here: PROPER PERFORMANCE OF MITZVAS BRIS MILAH

Yehoshua
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  • I strongly disagree. The article is extremely one-sided and does not really cover both sides of the debate. – Shraga Dec 19 '12 at 23:16
  • @Phil I said it's well-written and posing very good points. I didn't say anything about being fair. A One- sided article might not be fair but can still be well-written and pose good points (for his side at least.) He points out that there is no makor in Shas, Rambam, or Shulchan Aruch. Now I would certainly say there is a strong reason to do it with the mouth since seemingly that's how it was always done (I certainly don't plan on taking a mohel who doesn't do it this way.) Where is the makor then that it has to be done with the mouth davka? – Yehoshua Feb 03 '13 at 11:11
  • Why the down vote? – Yehoshua Apr 11 '13 at 18:14
  • @Shraga Don't know what you mean. It covers all sides. – Double AA Apr 29 '15 at 15:42
  • @Shraga reading it again it's a brilliant, well-written article. – Yehoshua Mar 31 '16 at 01:16
  • Seems like a link-only answer. – mevaqesh Dec 05 '16 at 02:33