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Tuesday, August 3, 2010

Some Thoughts on Metzitzah

[Note from 4/30/11 - see here for more on this subject]
Metzitzah is the ancient practice of drawing blood from the wound after the excision of the foreskin. There is much debate amongst rabbinic authorities as to how this is to be done. Sadly, much of it has become a politicized debate to the point that the different sides of the aisle often cannot see or recognize the validity of a differing opinion.

In the Talmud, the main reason for removing a mohel from his position, ie not allowing him to continue to practice as a mohel, was if he did not perform metzitzah. (Babylonian Talmud Shabbat 133b, Maimonides Laws of Milah 2:2, Shulchan Arukh Y”D 264:3) Bear in mind, the lack of metzitzah does not a non-kosher bris make. (Avnei Nezer Y”D 338, especially letter “י”, mishneh Halakhot (Menashe klein))

Only the mohel who does not do metzitzah has questioned legitimacy. The baby and his bris are deemed kosher, with no further procedure necessary to rectify the flaws of the practices of the mohel.

The Talmud is not clear how metzitzah is to be done. As long as a mohel does metzitzah (many call it "Metzitzah B'Peh" or "Metzitzah B'feh" - drawing blood with the mouth, or the power of the mouth), be it orally or with a tube, he is Talmudically fit to be a mohel (assuming of course, his character is otherwise exemplary).


Much ink has been spilled over metzitzah. The only Jews who require metzitzah are the Orthodox and some Conservative communities.

How metzitzah is done is the subject of debate, though just about everyone who does it has the mouth involved, in some way performing suction of blood from the wound.
  • Some have the mouth directly touching the open wound.
  • Others have a sterile tube directly touching the open wound, while the mouth provides the suction to draw the blood.

Both methods have rabbinic authorities backing them, and either one is acceptable to most Jews. While I did not poll either community, I imagine that if someone from either camp discovered a bris had been done using the method of metzitzah to which they do not subscribe, they would be unlikely to declare the bris invalid or the mohel who did it invalid.
They certainly would not require the baby to have a wound reopened so metzitzah could be done the other way. Also, metzitzah is never done on an adult circumcision or for hatafat dam brit.

While I do advocate metzitzah be done, with a tube, it is worth noting that if for some reason the metzitzah is not done at all, whether by choice or by oversight, no one questions the validity of the bris itself.

The reason I recommend the tube is because I value the cause of sterility and good hygienic practice in the bris procedure. While Jews circumcise their sons because of the inherent spiritual value, I feel there is no excuse for subjecting the baby to the possibility of any infection - which can so obviously come to a baby through the direct contact of a stranger's saliva with the baby's open wound and the baby's blood which is truly "his life" (see Deuteronomy 12:23)

Final, and perhaps most important note: What sometimes is lost in translation is that the advocates for using a tube are not arguing or declaring a ban on metzitzah or even metzitzah b’peh! They are actually suggesting metzitzah b’peh be accomplished using a tube which can achieve the same result as the mouth, using the strength of the mouth.

I added to this topic in a different posting (as linked at the top of this page)

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