By Rabbi Yair Hoffman for 5tjt.com

As people are coming back from camp and vacation, everyone should be checking themselves and their children for ticks. If a tick is found on achild (or adult) he or she should also be treated for it in the manner that is recommended by expert medical opinion.  It should be taken very seriously.

There is an issue, however, in regard to ticks and Lyme Disease of which some people are entirely unaware.  But first, a side digression that will help us understand the concept.

There is a word in the English language called, “taxonomy” – which deals with the branch of knowledge involving the classification of things.   This article will address a great debate about Lyme Disease and those who believe that it is far more pernicious a disease than what 99% of expert doctors believe it to be. In fact, there is even a debate regarding terminology.  Those who believe it to be far more pernicious use the term “Chronic Lyme Disease.” When most conventional doctors hear that term they think “Uh Oh, red flag for quack” (although they don’t necessarily express it per se).  They also have a term for those doctors who believe in Chronic Lyme Disease – Lyme Literate MD’s. This article will also address some possible halachic repercussions of this great debate.

THE CONVENTIONAL WISDOM

Generally speaking, Lyme Disease responds to a short course of antibiotic treatment.  All agree that if Lyme Disease is left untreated, neurologic, cardiac, or musculoskeletal problems may develop.  But there are often people who, for one reason or another, have medically unexplained symptoms,  What are these symptoms?  Often, they are continual fatigue, musculoskeletal pains, and some sort of neurocognitive dysfunctionality.

One thing perhaps that every side will agree upon is that there are three types of Lyme Disease believers.   There are those who do not believe that Lyme  Disease plays such a major role in illness and that it is easy to treat and easy to cure.  We will call them Type 1 LD believers.

THE TYPE 1 LYME DISEASE BELIEVERS

Most of the medical establishment and the insurance world are of the Type 1 variety.  They believe that the doctors who believe in Chronic Lyme Disease incorrectly prescribe (to quote an NIH article on the matter), “prolonged antimicrobial therapies, in a belief that this eradicates suspected infection. Perhaps due to the lack of supportive data, proponents of this theory have developed their own meetings, literature, activist groups, and substantial internet activities to advance their views. Forces motivating this movement are explored, as are tactics used to advance non-scientific ideas that have included legal action and garnering legislative endorsement. While neither logical nor evidence-based, “chronic Lyme disease” harnesses corrosive energies that taint modern medicine and society.”

Conventional doctors, in an effort to find out whether additional antimicrobial treatment even helps such patients, had four National Institutes of Health (NIH) studies sponsored, randomized, placebo-controlled trials have examined whether long-term antibiotic therapy benefits previously treated patients who have had authentic Lyme disease followed by persistent subjective complaints (5–7). All the studies concluded that “No study found any evidence of chronic infection, and none showed significant or durable benefit in the antibiotic arms.”  They even pointed out that “Post-Lyme disease syndrome (PLDS) has been advanced as a descriptive term for these non-specific complaints in patients who have no evidence of an active infection or an alternative explanation at least 6 months after symptom onset.

THE EXTREME BELIEVERS

We will skip to Type 3 for now. Type 3ers believe that virtually every disease, physical and psychiatric, can be attributed in total or in part to Lyme Disease or its associate illnesses.  Type 3ers believe that information about Lyme Disease is being suppressed by the medical world as well.

THE IN-BETWEEN VIEW

How do we describe the third group of Type 2ers?  They believe that the Type 1ers are wrong in not attributing enough illness and its possible repercussions to Lyme Disease and that the Type 3ers are all wrong as well.  (It is interesting to note that virtually all Type 3ers consider themselves to be Type 2ers.)

There is one local nurse that this author knows who took off a tick from the face of a young girl this past July, who exhibited some of these symptoms but the doctor said that she tested negatively for Lyme.  She later had the test results re-examined and said that the official criterion for Lyme Disease is 5 bands, but the girls results did show two bands.  (This author is not exactly sure what that means, but maybe it is significant to put out there.)

MORE TAXONOMY

In terms of our aforementioned taxonomy, it is possible to be a Type 1.5 or a Type 2.5 as well.  And by the way, it is not just Lyme Disease in which this taxonomy applies.  It applies to Polio vaccines, MMR vaccines, COVID vaccines, whether the Disease known as AIDS exists or not, and a whole slew of other areas as well.  It is also possible to be 3er or a 2er in one area and not in another.

PARENTHETIC NOTE

Before we get into the Halachic repercussions, notwithstanding the author’s personal sentiment of probably being categorized in between a 1.2 and a 1.4 in regard to Lyme Disease – a non-scientific anecdotal observation reveals the following:  People that lay between 2 and 3 generally have far better midos and ethical qualities than those that are between 1 and 1.4.  There may be a rational scientific reason for this that some future study may bear out – but that is beyond the scope of this article.

THE HALACHIC REPERCUSSIONS

There are various halachic areas in which this debate impacts.  The first is that of seeking a cure for it on Shabbos if it is deemed pikuach nefesh by the Lyme Literate medical doctors.   In terms of Hilchos Shabbos, when we have a sick person who presents with a matter of controversy and two doctors saying that Shabbos should not be violated, and two doctors saying that we should violate Shabbos – we rule (SA OC 618:2) in accordance with those who say to violate -because when there is a doubt about a life-saving matter – we do not take chances.  However, when one doctor is more expert than the others and he says that there is no need to violate Shabbos – then we have a debate.

THE MISHNA BRURAH’S VIEW

The predominant view is that we follow the expert opinion.  This is the ruling of The Mogain Avrohom (OC 618:4), the Eliyahu Rabbah (618:7) and the Chofetz Chaim as expressed in the Mishna Brurah (618:8) and in his Biur Halacha (“V’Im”).   Generally speaking, we follow the view of the Mishna Brurah regarding all such halachic matters. [Heard from Rav Chaim Kanievsky zt”l].

THE DISSENTING VIEW

However, there is a dissenting view – where, since it is a question of a threat to life – we do not follow the view of the experts – that of the Maamar Mordechai (618:1).  This view is cited by the Kaf HaChaim (618:21).  The Maamar Mordechai, however, concludes with the words – this needs further examination.  Likewise, if the doctors are not equal in number and the majority state not to violate Shabbos – we do not violate it (SA OC 618:3). If we have 2 against 100, however, and the two say to violate it – we would do so (ibid 618:4).

There is a fascinating Ramah in 618:10 that the views of non-doctors in this regard do not count.  Finally, the language of the Rambam is illuminating.  He employs the term “rofeh uman” an expert doctor indicating that a regular doctor’s view does not carry weight against the view of the majority, and in those situations it may be preferable to employ a gentile to violate the Shabbos.

OTHER AREAS OF HALACHA

There are two other areas in halacha where we can perhaps extrapolate as to where to go from the views mentioned above.  When there are two ways in which to pursue remedying a suffering patient – one involving the seeking of Lyme Disease remedies and the other in seeking that of conventional medicine – it seems from the view of the Mishna Brurah cited above that the conventional method is preferred.  We all know that we have limited time and resources.   Given that reality, it is this author’s view that the Mishna Brurah’s view should be followed over that of the Maamar Mordechai.

There is a second area as well.  Insurance companies do not cover or reimburse Lyme Disease expenses.  Neither they, nor the medical establishment, even recognize the blood tests or the laboratories that the Type 2 or Type 3 doctors recommend for testing.  The four NIH studies also showed that the treatments of prolonged anti-biotic are ineffective and the other treatments have not been shown to be effective.

There is an obligation of which many people are unaware and that is to be “chas al mammon chaveiro” – to be concerned about other people’s money and certainly one’s own funds as well.  It is a fulfillment of the Torah Mitzvah of “v’ahavata larayacha kamocha.”

SHROUD SOURCE

The Gemorah in Moed Katan 27b tells us that when Klal Yisroel were burying their dead in the finest clothing, Rabban Gamliel HaZakain arose and declared that enough was enough. The rising pressures, the “keeping up with the Joneses” in how to dress the deceased was causing enormous economic pressure on the living. “It must stop,” declared the rabbi, and the tachrichim, burial shrouds, we now use became the norm.

BOYCOTTING FISH SOURCE

The great Tzemach Tzedek (of 17th century Poland), cited by the Mogain Avrohom in the beginning of hilchos Shabbos, once ruled (responsa #28) that when local fishermen collude and lift up the price of fish excessively, a prohibition can be levied upon the consumption of fish on Shabbos. It may take a week or two or even three, but eventually the collective buying power of ordinary people would force the price back down.

OBLIGATION UPON EVERYONE

We will see, however, that it is not just great Torah leaders who have saved and are concerned for the financial well-being of others. It seems that this is what is expected by the Torah of everyone.

The Gemorah (Menachos 76a) tells us that Hashem commanded Moshe to also feed the nation’s livestock from the water that He had caused to come out from the rock at Mei Merivah. Also, Rashi (Rosh Hashanah 27a) points out that the kohain first removes the vessels from the house before declaring a house impure. We thus see a number of examples of how the Torah is concerned with the financial well-being of the nation.

FOR THE PUBLIC AND FOR PRIVATE INDIVIDUALS

The difference between the two cases is that the former is for the entire nation, while the latter demonstrates that the Torah is concerned even for the individual’s finances.

SOCIAL NORM AND TORAH OBLIGATION

The Chasam Sofer on Bava Basra (54b) states that, generally speaking, one can make the assumption that fellow Jews are concerned with the monetary well-being of their fellow man, and that this assumption has legal ramifications. We see then that it is the normal behavior expected of all of Klal Yisroel.

Rabbi Yaakov ben Asher, author of the Tur, discusses (in the Choshen Mishpat section of Shulchan Aruch, chapter 35) a person who does not care about the money of others.  He writes that such a person will, in the future, surely answer for it. The Minchas Chinuch writes that one who is concerned about the preservation of the money of others fulfills the Biblical commandment of v’ahavta l’rei’acha kamocha (see his commentary on that mitzvah).

CONCLUSIONS

It is unclear to many as to whether or not there is anything to Chronic Lyme Disease.  But the treatments seem to be pretty much ineffective.  Those of whom this author has spoken to are still seeking treatments for themselves or their children to address it.  Perhaps future research will bear out that there is something to it and will perhaps find a cure for the symptoms that are manifest.  But at this point it is difficult to see people spending time and money on things that do not yet work.

The author can be reached at [email protected]