י״א בתשרי ה׳תשע״ג (September 27, 2012)

Berakhot 57a-b: Seeing Bloodletting in a Dream

The Gemara on today’s daf continues with its discussion of dreams and their significance. Many of the examples of dreams involve everyday objects or activities. Thus we find a discussion of the meaning of seeing different Biblical books in a dream, or metal objects, or farm animals. Similarly we find discussions of the significance of seeing oneself climbing onto a roof, entering a forest or having his clothing torn.

Another common practice during Talmudic times was bloodletting. The Gemara concludes that if a person sees himself undergoing that procedure it is an indication that his transgressions have been forgiven, based on a passage in Sefer Yeshayahu (1:18) “Though your sins be as scarlet, they shall be as white as snow; though they be red like crimson, they shall be as wool.”

Bloodletting involves spilling small quantities of blood. It was used both as a cure and as a general preventive therapy that was believed to keep a person healthy. Bloodletting was based on an ancient system of medicine in which blood and other bodily fluid were considered to be humors, the proper balance of which was believed to maintain health. It was the most common medical practice performed by doctors on both humans and animals from antiquity through the late 19th century, a period of almost two millennia. Today it is well established that bloodletting is not effective for most diseases. One of the only remaining conditions for which it is used is Polycythemia vera, a disease in which the body produces too many red blood cells. A classic symptom of this illness is erythromelalgia. This is a sudden, severe burning pain in the hands or feet, usually accompanied by a reddish or bluish coloration of the skin. Erythromelalgia is caused by an increased platelet count or increased platelet “stickiness” (aggregation), resulting in the formation of tiny blood clots in the vessels of the extremity. Patients with polycythemia vera are prone to the development of blood clots (thrombosis). A major thrombotic complication (e.g. stroke or heart attack) may sometimes be the first symptom or indication that a person has polycythemia vera.

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