Bechorot 37-38: Trephination

Once again, I find myself taking issue with a Talmudology post. Trephination might be mentioned in the Mishna / Talmud, but why did the ancients practice this art?

Let us start by establishing the meaning of the word מקדח. It literally means a drill or borer, rather than the hole made by a drill. To cite Jastrow:

Talmudology writes:

בכורות לז,ב

ובגולגולת ב"ש אומרים כמלא מקדח וב"ה אומרים כדי שינטל מן החי וימות

Concerning the deficiency in the skull: Beit Shammai say that it must be missing a piece like the size of a drilled hole, and Beit Hillel say: It must be missing an amount that if removed from a living person, he would die.

But just how big is Bet Shammai’s “size of a drilled hole?” In tomorrow’s daf (38a) we learn that it is the size of “the small drill hole, used by physicians” (בקטן של רופאים). So around the first century BCE there were physicians going around drilling holes (of various sizes) into the skulls of the living. Why on earth would they do such a thing, and just how common was this practice?

I believe that this is a mistaken translation. It is not that the physicians were drilling holes of various sizes, large and small. Rather, there were drills of various sizes. The Mishna in Ohalot, cited by our gemara, contrasts Rabbi Meir's position that it was a hole made by a small drill, that of doctors, to the chachamim who say it is the hole made by a larger drill, used in the Temple:

דתנן באיזה מקדח אמרו בקטן של רופאים דברי רבי מאיר וחכ"א בגדול של לשכה

As we learned in a mishna (Oholot 2:3): With regard to which drill did Beit Shammai state their opinion concerning an incomplete skull? It was with regard to a small drill of doctors, used for drilling bones. This is the statement of Rabbi Meir. And the Rabbis say: It was with regard to a largedrill, such as that used in the Temple chamber. According to the mishna concerning a window that imparts impurity, the size of this drill is like that of a sela coin, and the opinions of Beit Shammai and Beit Hillel would still be identical.

So it is not a small vs. large hole that doctors make, but rather a smaller hole, made by the smaller drill, which is the standard drill doctors use. Nothing in the Mishna or gemara itself states that doctors use this to drill a hole in a skull - trephination -  rather than in other bone, but Rashi does in fact make the leap and state that the doctor drilled a hole in the skull:

באיזה מקדח אמרו - ב"ש בגולגולת כמלא מקדח כקטן של רופאים שקודרין בו את הראש לתקן את המכה:

Along the way, Rashi also gives an explicit reason the doctors would drill such a hole - to fix a head injury.

This is also where I think Talmudology missed the boat. Why did the doctors drill into the skull? He should mention Rashi. Instead, the only scientific discussion is why it was practiced in rather ancient cultures, as a result of superstition:

“..an opening in the head, trephination, could be “the activating element,” the act that could allow the demon to leave the body or the good spirit to enter it, for the necessary “undying” process to take place. If deities had to enter or leave the head, the opening had to be sufficiently large…The head was chosen for the procedure, not because of any particular intrinsic importance or because of magic or religious reasons, but because of the unique and universally accumulated experience observed by primitive man in the Stone Age with ubiquitous head injuries during altercations and hunting. Otherwise, the pelvic bone or femur could have served the same purpose. We must recall that even the much more advanced ancient Egyptian, Mesopotamian, Hindu, and even Hellenic civilizations believed the heart to be the center of thought and emotions, not the brain. In fact, the association of the heart with emotions lingered to the present age.

And so it was that the procedure came to be practiced across the world. This may also explain how it also ended up being used in ancient Israel, and trickled down into a teaching about ritual impurity cited by Bet Shammai.

If the purpose was to discuss the science of the Talmud, it seems that here would be a place to discuss trephination as contemporary science, as practiced by Galen, or by Hippocrates. For instance, here is Hippocrates:

That is just a taste. It is utterly confounding that he doesn't present this from a medical perspective.

Bechorot 36: The Truth Will Come Out!

The Talmudology blog is an excellent Daf Yomi blog. Its author, a doctor, looks at the modern scientific evidence for or against ideas presented in the Talmud. On today's post, about milta de'avida li'igluyei, I would have to say that he is off the mark.

In evaluating the veracity of a scientific claim in the Talmud, there are two steps. The first is establishing the content of the scientific claim. The second is checking whether the content matches the modern observable facts. I think the blogpost fails on the first step, by misidentifying the content of the claim. The disproof in the second step then misses its mark.

The claim, as put forth by Talmudology:

בכורות לו, א

מילתא דעבידא לאיגלויי לא משקרי בה אינשי

People do not lie about something that may later be revealed [as having been false]

Can a Cohen may be relied upon to testify that first-born animal in his possession has been declared by an expert to have a blemish (which would widen its permitted uses)? Rav Yehuda ruled (in the name of Rav) that the Cohen should indeed be believed. Since that expert could come forward and state that he issued no such ruling, the Cohen would not risk being discovered as having lied. In a small village or town of a few dozen to a few hundred families, this ruling is reasonable. To lie would expose the Cohen to the risk that his fraud might be exposed. But does Rav Yehuda’s no-lying rule make sense in today’s society?

The full quote is actually כל מילתא דעבידא לאיגלויי לא משקרי בה אינשי, but the omission of the word kol is not relevant. What is relevant is the English word I bolded in red above, "may".

As a contrast, this is how the Koren Talmud translated it (from Sefaria):

With regard to any matter that is likely to be revealed, people do not lie about it.

This is a major distinction. If Rav Yehuda, citing Rav, or even the setama degamara explaining him, asserts that one will not lie about anything which may / might be revealed, that means that where there is any level of risk in the matter, the person will not lie. And that is easily falsifiable. Students regularly cheat on tests, and are caught. People regularly lie, and they are caught in the lie, so there was obviously some risk. This assertion is easy to falsify.

If Rav Yehuda citing Rav asserts that this holds only when the truth is likely to come out, then that is more difficult to falsify. One would need to present studies where people lied even though there was a good likelihood that the truth would eventually come out.

The word דעבידא in the Aramaic strongly suggests the latter interpretation. That we can somewhat expect it to be revealed. The cases in which this is applied in the gemara also lends support to this interpretation. A woman claims her husband died, and we allow her to remarry. Because people know other people, the husband walking around when he is reported dead can be expected to eventually come to light. In terms of blemishes of bechorot declared by an expert, a bechor is big news, and the expert circulates. A local expert is somewhat likely to hear, and the lie will be found out.

Meanwhile, all of Talmudology's studies have to do with people who lie, either with no risk, or some risk, of being caught. This is "may", not "likely". Therefore, it is irrelevant.

Talmudology's blogpost concludes:

People will lie even if there is a risk of being discovered, and will do so brazenly and without concern for others. Just ask Elizabeth Holmes. Actually, don’t ask her, since she’d probably lie you. Rav Yehuda’s rule that people will not lie if there is a risk of their lie being uncovered is at best aspirational. Sadly, it is no-longer an accurate description of social norms. (Perhaps it never really was.) But wouldn’t it be wonderful if it were so?

Perhaps Elizabeth Holmes is somewhat who lied while knowing that she would eventually be caught out. Perhaps she dug herself into a hole and then lied in order to push off the inevitable fallout. Regardless, an anecdote is not data, and the plural of anecdote is not data. Indeed, the gemara in Bechorot itself pointed out a counterexample and dismissed this anecdotal evidence:

רפרם בפומבדיתא הוה ליה בוכרא ויהביה ליה לכהן בלא מומא אזל שדא ביה מומא יומא חד חלש בעיניה אייתיה לקמיה א"ל בכור זה נתן לי ישראל במומו ארפסיניה לעיניה חזייה בשקריה א"ל לאו אנא דיהיבתיה לך

In this regard, the Gemara relates that Rafram, who resided in Pumbedita, had a firstborn animal and he gave it to a priest in an unblemished state. The priest went and caused a blemish in it. One day, Rafram had an affliction in his eyes, which rendered it difficult for him to open them. The priest to whom Rafram had given the firstborn animal brought it before him,as an expert examiner, for him to deem the animal permitted. The priest said to him: An Israelite gave me this firstborn animal with its blemish upon it. Rafram forced his eyes open and saw the animal and recognized it [bashkerei] as the one he himself had given the priest. Rafram said to the priest: Is it not I who gave this firstborn animal to you?

ואפ"ה לא חש לה למילתא האי הוא דחציף כ"ע לא חציפי

The Gemara notes: And even so, Rafram was unconcerned by the matter of the priest’s attempted chicanery, as he maintained that it is only this priest who is impudent, but all other priests are not impudent. This scenario did not cause Rafram to discredit any other priest’s claim that he received a blemished firstborn animal from an Israelite, as this was an exceptional case. This priest demonstrated extreme impudence by bringing it to be examined by Rafram himself, and therefore one cannot draw conclusions about the behavior of other priests from this incident.

In sum, the Rav Yehuda's assertion was not disproved and shown to be merely "aspirational". Rather, the assertion was misunderstood (IMHO) and what was disproved was an assertion prime.