Pt1 Bodily Afflictions and Illnesses as Signs of Sin: Wounds, Edema (Hidrokan), and Diphtheria (Askara) (Shabbat 33a-b)

This is the first part of a two-part series. The outline of the series is below.¹

Outline

1. The Physical Toll of Sin: Wounds, Bruises, and Edema (Hidrokan) as Manifestations of Divine Punishment (Proverbs 20:30)

2. Distinguishing the Possible Causes of Edema: Sin, Starvation, and Witchcraft

3. Edema and Its Causes Among the Babylonian Sages: Sin, Starvation, and Physical Strain

   1. Shmuel

   2. Abaye

   3. Rava

4. Physical Afflictions as Signs of Moral Failings: Edema, Jaundice, Poverty, and Diptheria (Askara) as signs of sin, baseless hatred, arrogance, and Lashon Hara (respectively)

5. Diphtheria is divine punishment for neglecting to separate tithes (ma’aser) or due to speaking Lashon Hara (Psalms 63:12)

6. Why does Diphtheria start in the intestines and end in the mouth?

   1. R' Yehuda: The disease follows the path of speech formation, from internal organs to the mouth, as a punishment for slander (Lashon Hara)

   2. R' Elazar ben Yosei: Diphtheria ends in the mouth because one eats non-kosher food

   3. R' Shimon: The disease is a punishment for neglecting Torah study (Bitul Torah)

Appendix 1 - Organ Functions: A List of Thirteen Organs and Their Functions (Berakhot 61a-b)

1. A List of Thirteen Organs and Their Functions

2. The Principle of Bodily Harmony: When Sleep- and Wake-Regulating Organs Misfunction, the Body Declines and Perishes

Appendix 2 - Extreme Poverty, Intestinal Illness, and Other Causes of Distress and Their Implications: Perspectives on Overwhelming Forces, Exemption from Gehenna, and Sudden Death (Eruvin 41b)

1. Three Forces That Overwhelm a Person: Non-Jews, Evil Spirit, and Extreme Poverty

2. Exemption from Gehenna Due to Intense Earthly Hardships: Extreme Poverty, Intestinal Illness, Government Persecution, and a Bad Wife

3. Three Conditions That Lead to Sudden Death: Intestinal Disease, Childbirth Complications, and Severe Edema

The Passage

Shabbat.33a.10-33b.3

The Physical Toll of Sin: Wounds, Bruises, and Edema (Hidrokan) as Manifestations of Divine Punishment (Proverbs 20:30)

Rav Oshaya states that someone who prepares (ממרק עצמו) to commit a sin will develop wounds (חבורות) and bruises (פצעין), citing Proverbs 20:30 as support.

Additionally, he states that such a person is punished with edema,² as indicated by the verse’s mention of afflictions (מכות) reaching the "inward parts" (חדרי בטן).

Rav Naḥman bar Yitzḥak states that edema serves as a visible sign³ of sin.

אמר רב אושעיא:

כל הממרק עצמו לעבירה —

חבורות ופצעין יוצאין בו,

שנאמר: ״חבורות פצע תמרוק ברע״.

ולא עוד אלא שנדון בהדרוקן

שנאמר: ״ומכות חדרי בטן״.

אמר רב נחמן בר יצחק: סימן לעבירה הדרוקן.

Rav Oshaya said:

Anyone who prepares himself to commit a sin,

wounds and bruises emerge on him,

as it is stated: “Sharp wounds for one devoted to evil; so do stripes that reach the inward parts” (Proverbs 20:30).

And not only that, but he is sentenced to suffer from the disease of edema [hidrokan],

as it is stated: “So do stripes that reach the inward parts”.

Rav Naḥman bar Yitzḥak said: A sign indicating one who committed a sin is the disease hidrokan, which afflicts the inner parts.

Distinguishing the Possible Causes of Edema: Sin, Starvation, and Witchcraft

A baraita identifies three types of edema (hidrokan) with distinct causes and characteristics:

1. Sin-related edema, which is thick (עבה)

2. Starvation (רעב)-induced edema,⁴ which is swollen (תפוח)

3. Witchcraft (כשפים)-induced edema, which is thin (דק).

תנו רבנן:

שלשה מיני הדרוקן הן:

1. של עבירה -- עבה,

2. ושל רעב -- תפוח,

3. ושל כשפים -- דק.

The Sages taught in a baraita:

There are three types of hidrokan:

1. The one that comes as punishment for sin is thick;

2. and that which is the result of hunger is swollen, but not as thick;

3. and the one caused by witchcraft is thin, and the flesh of the sick person becomes thin in other places.

Edema and Its Causes Among the Babylonian Sages: Sin, Starvation, and Physical Strain

The Talmud now recounts three cases of prominent sages afflicted with edema (hidrokan) and the efforts to determine its cause.

Shmuel

Shmuel (in the printed edition he has surname “HaKatan”, but this seems likely to be a scribal error) fell ill (חש) and questioned who could confirm that his condition was not due to sin. He was later cured.

שמואל הקטן חש ביה.

אמר:

רבונו של עולם!

מי מפיס?

איתסי.

The Gemara relates: Shmuel HaKatan fell ill with hidrokan.

He said:

Master of the Universe!

who will draw lots, meaning, who will be able to determine that this hidrokan is not the consequence of sin?

He was cured.

Abaye

Abaye also suffered from hidrokan, but Rava testified that it was caused by starvation, as Abaye often fasted.⁵

אביי חש ביה.

אמר רבא:

ידענא ביה בנחמני,

דמכפין נפשיה.

Abaye also fell ill with hidrokan.

Rava testified and said about him:

I know about Naḥmani, Abaye,

that he starves himself and that his hidrokan is the result of hunger.

Rava

Rava himself later developed hidrokan (prompting talmudic questioning, since he neither fasted excessively nor was suspected of sin).

A relevant statement of Rava is cited: “Greater in number are those killed [due to the chamber] pot,⁶ than those swollen (נפיחי) [due to] starvation (כפן)”.⁷

The explanation given by the Talmud is that his condition resulted from being forced by his rabbinic duties to go long periods without relieving himself.⁸

רבא חש ביה.

והא רבא הוא דאמר:

נפישי קטילי קדר,

מנפיחי כפן?

שאני רבא,

דאנסי ליה רבנן בעידניה בעל כורחיה.

The Gemara relates that Rava fell ill with hidrokan,

and they asked: But Rava did not starve himself, and there is no reason to suspect him of sin, and we cannot say that he contracted hidrokan because he did not relieve himself on time. Rava knew to relieve himself, as it is he who said:

More have been killed due to the chamber pot, because they were not careful about relieving themselves in a timely manner,

than those swollen due to starvation.

The Gemara answers: Rava is different

because the Sages compel him to remain in place against his will while he lectures. Since he could not relieve himself, he became sick with hidrokan.

Physical Afflictions as Signs of Moral Failings: Edema (Hidrokan), Jaundice, Poverty, and Diptheria (Askara) as signs of sin, baseless hatred, arrogance, and Lashon Hara (respectively)

1. Edema (הדרוקן) → Punishment for sin⁹

2. Jaundice (ירקון) → Sign of baseless hatred (שנאת חנם)

3. Poverty (עניות) → Sign of arrogance (גסות הרוח)

4. Askara¹⁰ → Sign of lashon hara¹¹

תנו רבנן:

ארבעה סימנין הן:

1. סימן לעבירה — הדרוקן,

2. סימן לשנאת חנם — ירקון,

3. סימן לגסות הרוח — עניות,

4. סימן ללשון הרע — אסכרה.

On a related note, the Sages taught in a baraita that

there are four signs:

1. A sign of sin is hidrokan,

2. a sign of gratuitous hatred is jaundice,

3. a sign of arrogance is poverty,

4. and a sign of slander is askara.

1. See my recent three-part series, on the beginning and main part of this sugya: “ ‘Due to Sin [X], Occurs [Y]’: Divine Justice and Human Responsibility for Suffering and Death (Shabbat 32b-33a)”, final part here.

2. הדרוקן - hidrokan - from Greek, see my note on this word and disease in my piece here, section “Types of People With Notable Physical Appearances and Disabilites (Berakhot 58b)”, first list, item # 6 - דרניקוס - dranikos.

3. סימן - from Greek.

4. See Wikipedia, “Edema“ section “Diagnosis“:

Edema caused by malnutrition defines kwashiorkor […]

For more on malnutrition/starvation and kwashiorkor, see later in the sugya, with my notes.

5. מכפין - literally: “starved himself”.

6. קדר - i.e. because they weren’t careful about relieving themselves in a timely manner. Compare my previous piece on the Babylonian sages who became infertile due to Rav Huna’s long lectures.

7. On bloated stomach caused by starvation, see Wikipedia, “Starvation“:

The bloated stomach represents a form of malnutrition called kwashiorkor.

The exact pathogenesis of kwashiorkor is not clear […]

And Wikipedia, “Kwashiorkor“:

Kwashiorkor […] is a form of severe protein malnutrition characterized by edema […]

Conditions analogous to kwashiorkor were well documented around the world throughout history.

8. אנסי ליה רבנן בעידניה בעל כורחיה - literally “the rabbis force him ‘in his time’ against his will” - notably, terms for “forcing” appear twice in the phrase, both אנסי and בעל כורחיה.

Presumably the rabbinic duties referred to here are such duties as lecturing, judging, answering questions, etc.

9. עבירה - as stated earlier.

10. אסכרה - diphtheria, a throat disease, see my extended note in next section.

11. לשון הרע - slander.