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There is a lot of talk in the news, etc., about Metzitzah B'peh that employs direct oral contact being dangerous.

First: If it is dangerous, shouldn't pikuach nefesh push it off?

Second: How important is it to a Bris in the first place?

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Hello Mendy, welcome to Mi Yodeya, and thank you for this question! Please consider registering your account, which will give you access to more of the site's features. I hope to see you around! – HodofHod Jul 27 '12 at 1:03
See this article in Yated, which claims that there is a vendetta against Metzitzah B'peh and that (at least some of) the cases of herpes related fatalities have nothing to do with Metzitzah B'peh: yated.com/content.asp?categoryid=0&contentid=686 – Menachem Jul 27 '12 at 2:04
@Menachem, given what everyone knows about germs nowadays, how could anyone possibly, in the name of health, introduce saliva into a cut on the infant's genitals? It doesn't take a vendetta to know that's a bad idea. – Isaac Moses Jul 27 '12 at 2:56
The Avnei Neizer 1:338 discusses this issue at length and it seems like it should be done b'peh(the Maram Schick held like this as well,hebrewbooks.org/pdfpager.aspx?req=1345&st=&pgnum=369 . Rav Tzvi Frank (Har Tzvi 214) held one can use a glass tube and mentions the Chasam Sofer who held a sponge is good ,but said one needs to learn how to do it properly ,hebrewbooks.org/pdfpager.aspx?req=22460&st=&pgnum=217 – sam Jul 27 '12 at 20:04
@sam, why don't you write this up into an answer? – HodofHod Jul 27 '12 at 20:49

The gemara strongly implies that metzitzah is done for health reasons. Nowadays, we can follow that tradition safely by doing it with a tube. It seems ironic to to follow the gemara's health-suggestions in a way (b'peh) that we know to cause health-risks. However, some groups feel that there are other reasons for doing Metzitzah and that it should still be done since the health risks are small. If so, they should make strong safeguards to lessen the risk of transmitting disease.

Hakirah has an article from 2006 available online about metzitzah b’peh (pdf), which I summarize below (from my previous summary).

In the article he explains the historical medical background to metzitzah. In ancient times, people didn't know that blood circulated or that pathoegns cause disease. The hellenic system of medicine thought blood was attracted to cuts and could decay and form pus, so it was necessary to get the blood to flow from a cut to prevent disease. (The author cites R’ Nachum Rabinovitch who compares the Rambam’s requirement for metzitzah to the Rambam’s suggestion to suck the blood out after a snake bite). He discusses some modern-day rationals for doing MBP, but then refutes them.

The next part shows that metzitzah b’peh is a danger and many cases are cited where it has unfortunately caused harm to infants. He also tells the the history of MBP, and quotes some of the discussions about it from the 19th century. He then discusses the p’sak of the chasam sofer who didn’t even consider metzitzah b’peh to be a minhag. He concludes that if most of the litvishe gedolim accepted that MBP was a danger, surely now, when we know much more about transmission of diseases, we should not risk it.

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You seem to be addressing only question 1 of the two questions above, and doing so by quoting Hakirah as saying "It should". Right? – msh210 Jul 31 '12 at 21:51
also by mentioning that they should do it in a safer manner. – Ariel K Jul 31 '12 at 23:24
and that the gemara implies its not so important for the bris itself, its just a safety measure. – Ariel K Jul 31 '12 at 23:26
Frankly I don't see any other way of reading that Gemara. – Double AA Apr 11 '13 at 18:26

The Tshuvos Venanhagos says that while R' Chaim Brisker allowed Mohelim to do a Metzitza with a short pipette when there was a tuberculosis epidemic, the Tshuvos Vehanhagos says that one should avoid relying on this heter.

Moreover, he quotes the Levush Mordechai writes that Metzitza is not just for health reasons but is actually part of the Mitzvah.

The Tshuvos VeHanhagos continues and answers the original question: Can a Mohel refuse to do Metzitza BePeh if he is scared that the child is sick (R"L) with AIDS? He answered that as there have not been many cases of Mohelim getting sick from babies, one must rely on Shomer Mitzva lo Yodeya Davar Ra. Moreover, as he says that if one must be choshesh for (suspect) such risks as pikuach Nefesh, then one would not be allowed to do a bris, ever. However, he says that if a mohel refuses to do metzitza bepeh due to fear of AIDS, he is not called a sinner, but one should try to find a different mohel who will.

Moreover, he says (amazingly IMHO) that doctors said that doing Metzitza Bepeh on a baby with AIDS is not dangerous if one washes his mouth out.

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Is he talking about where there is reason to suspect HIV (eg, a parent has it), or about stam being careful? – Double AA Aug 28 '12 at 3:58
@DoubleAA I think it refers to cases where there is just a worry. However, he says that it's not dangerous to do Metzitza bepeh even if the child has definite HIV if the mohel washes his mouth out well. – Shmuel Brin Aug 28 '12 at 4:36
No, he says some doctors told him that. It's not a psak, it's a quote. Anyone faced with a real shayla should ask a medical professional for the best current advice, just like R Shternbuch did. – Double AA Aug 28 '12 at 4:45
How is it part of the actual mitzvah!?! – Yehoshua Mar 31 at 1:18

Back in September (2012) there was well written article by Rabbi Moshe Zuriel (from Bnei Brak) posted on the Parsha Blog about this topic. Much of the mareh makomos that are brought in the article have already been mentioned here. However I'd like to contribute the article as it answers the question and I find it to be well-written and posing very good points


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I strongly disagree. The article is extremely one-sided and does not really cover both sides of the debate. – Shraga Dec 19 '12 at 23:16
@Phil I said it's well-written and posing very good points. I didn't say anything about being fair. A One- sided article might not be fair but can still be well-written and pose good points (for his side at least.) He points out that there is no makor in Shas, Rambam, or Shulchan Aruch. Now I would certainly say there is a strong reason to do it with the mouth since seemingly that's how it was always done (I certainly don't plan on taking a mohel who doesn't do it this way.) Where is the makor then that it has to be done with the mouth davka? – Yehoshua Feb 3 '13 at 11:11
Why the down vote? – Yehoshua Apr 11 '13 at 18:14
@Shraga Don't know what you mean. It covers all sides. – Double AA Apr 29 '15 at 15:42
@Shraga reading it again it's a brilliant, well-written article. – Yehoshua Mar 31 at 1:16

protected by Double AA Dec 19 '12 at 15:28

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