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Thought for the Day: Ingesting Non-Kosher Ingredients for Medicinal Purposes

Today's TftD is rated ITYB (Irresistible to Twelve Year Old Boys), and the men in whose psyche they live.

The Shulchan Aruch (Yorah Dei'ah 81:2) says that milk from a non-kosher animal is not kosher, the kashrus of the urine from a non-kosher animal is a machlokes, but everyone agrees that human urine is kosher.  Eeyeww (your mother/wife/sister/daughter) opine... GROSS!  They are correct, and all urine is really forbidden because of בל תשקצו/don't be disgusting; so why in the world is the kashrus of any urine even relevant?!  We'll get to that, but first let's just get p'shat in this siman.  Why do I need to be told that milk from a non-kosher animal is not kosher (isn't that like saying putting a milchig spoon into a milchig pot remains milchig?), what is the source of the machlokes regarding animal urine, and why is there is there a difference between human and animal urine.

The answer the question of why I need to be told that milk from non-kosher animal is not kosher, I merely need to ask: Why is milk from a kosher animal kosher?  (Leave it to a Jew to answer a question with a question...)  After all, blood is not kosher and milk is also a life giving fluid that comes from a living animal that was not kosher slaughtered.  (I know that is an abuse of grammar; deal.)  Essentially the gemara has no verses to directly prove the kashrus of milk from a kosher animal, but we have verses that are essentially based on the existence of kosher milk.  We are promised a "land flowing with milk and honey"; it would be a dirty trick if we couldn't actually drink the milk.  Mixtures of milk and meat cooked together are forbidden; the ingredients themselves mush be kosher, otherwise it is not the cooking together that made it forbidden.  Once we see that that Torah had to מחדש to use that milk from any source was kosher, I then need a limitation to restrict that חידוש to only kosher animals.  In fact, the gemara does present such a חידוש.

Why is there a disagreement about whether animal urine is kosher or not?  The side that forbids says that urine, just like milk, would need a חידוש to permit it; there is no such חידוש, so animal urine is forbidden.  The side to permit says, "water went in an water went out".  Granted it has some icky chemicals in it, but there is nothing "animalish" about it; after all, the rejected by the animal.

What about human urine?  Everyone agrees that regarding human urine we say, "water went in an water went out".  However, human flesh is forbidden, so you might have thought that urine was also forbidden.  (I didn't make this stuff up; scout's honor.)

Fine, fine, fine... but urine is still icky and forbidden by בל תשקצו, so what practical difference does it make if technically it might be kosher?  Pshaw... that's easy: it is used for medicinal purposes.  It turns out there is a main stream drug used in the treatment of menopausal and post-menopausal symptoms called Premarin.  (I had never heard of it before, but a post-menopausal woman I asked certainly had heard of it.)  The name Premarin is a brand name that comes from its source: pregnant mare urine.  (Said post-menopausal woman was not thrilled to hear that.)  The treatment can be prescribed as a cream (not relevant to our discussion), intravenously (ditto),  and a pill -- bingo!

Now... finally... why are we allowed to ingest non-kosher medicines?  This is a case where the patient is not deathly (albeit uncomfortable), so we are not relying on saving a life.  The Torah says that anything that is inedible cannot be non-kosher.  The Chazal, however, said that if someone is willing to eat something that others find inedible, then for him the item is (mi'd'rabanan) edible and therefore (mi'd'rabanan) potentially not kosher.  This is known in halacha as אחשביה; basically, your actions showed that you consider it edible.  So why are we so freely permitted to take medicine without checking too closely?

There are two basic opinions: R' Moshe says that a sick person will do all sorts of weird stuff to get better, so the fact that he eats something doesn't prove he considers it edible, just that you hope it will make you better.  Therefore, the medicine is still considered inedible -- even mi'd'rabana -- and so the there is no problem with taking the pill.  The Chazon Ish, however, says that sick person has an interest only in the medicine and couldn't care less about whatever else is in the pill that is use to transport the medicine into his system.  According to R' Moshe, then, there is no problem taking the Premarin because the active ingredient (urine) is still considered inedible.  According to the Chazon Ish, though, since the medicine itself is the non-kosher ingredient, and the act of taking the medicine renders that active ingredient edible (mi'd'rabanan), it is still problematic to take that pill.

One thing upon which I have deep confidence: there is no machlokes that it is dangerous to argue with a menopausal woman.


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