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Rambam Hilchot Avodat Kochavim 11:12 writes:

הלוחש על המכה וקורא פסוק מן התורה, וכן הקורא על התינוק שלא יבעת, והמניח ספר תורה או תפילין על הקטן בשביל שיישן - לא די להם שהם בכלל מנחשים וחוברים, אלא שהן בכלל הכופרים בתורה, שהן עושין דברי תורה רפואת גוף ואינן אלא רפואת נפשות, שנאמר (משלי ג כב): "ויהיו חיים לנפשך".אבל הבריא, שקרא פסוקין ומזמור מתהילים כדי שתגן עליו זכות קריאתן וינצל מצרות ומנזקים, הרי זה מותר.

A person who whispers an incantation over a wound and then recites a verse from the Torah, who recites a verse over a child so that he will not become scared, or who places a Torah scroll or tefillin over a baby so that it will sleep, is considered to be a soothsayer or one who cast spells. Furthermore, such people are included among those who deny the Torah, because they relate to the words of Torah as if they are cures for the body, when, in fact, they are cures for the soul, as [Proverbs 3:22] states: "And they shall be life for your soul."

It is, however, permitted for a healthy person to read verses [from the Bible] or chapters from Psalms so that the merit of reading them will protect him and save him from difficulties and injury.

On the basis of this Rambam it seems like any nonsensical segula like putting a key in a challah or eating an etrog to facilitate childbirth is essentially advocating a prohibition of divination or however you want to translate Nichush.

I myself am not a kabbalist, so can someone shed some light on how segulot similar to those found here are halachically permissible?

To clarify, my question is not where we see examples of segulot being used in classical literature, but why they do not fall under the Rambam's prohibition of Nichush as seen in the example above. I am asking about practical segulot rather than strange procedures advocated by the Gemara in various places, because those passages can be understood as non-literal in nature.

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Faith and folly a must read written by one of the biggest mekubalim Rav Yaakov Hillel. –  sam May 20 at 0:23
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Downvoter - I'd be grateful to know what is wrong with this question. –  Yehuda May 20 at 2:16
    
Very possibly assur....see lecture by Rav Herschel Shechter here –  Shokhet May 20 at 4:50
    
Basically what he says is that each segula must be checked out to see whether or not it makes sense to work based on what we know in halacha and/or science [he says that ayin hara does really exist, because it's basically a prayer for a heavenly audit] and those that can't be made sense of are assur –  Shokhet May 20 at 4:53
    
the vilna gaon says the rambam strayed from the torah in these matters due to reading too much philosophy. he cites an example of the rambam denying things like that kishuf works which the gemora states explicitly that it does work. source - lev tov preface to the shaar yichud citing the biur hagra on yoreh deah. –  ray May 20 at 6:02

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See Chochmas Adam (89:3) who writes that if the action is medically sound or is sugulah based it is not subject to the prohibition of nichush or darchei Emori. Using words of Torah and objects of Kedusah like tefillin for healing is neither medically sound nor a traditional or effective remedy and is therefore prohibited. All segulos must be examined individually if they are traditional or effective.

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With many segulos there is some doubt as to whether there is a clear Jewish tradition which will thus permit its use, or not. For example, the "red string" to ward off ayin hara is the subject of some debate (see Darchei Teshivah YD 179:21 who forbids it and Be'er Moshe (Debrizin) 8:36 who permits it based on old traditions). I have heard that recent Poskim has similar divergent views on this matter (Rav Schachter forbidding and others permitting)

For more references, see here in Hebrew and here in English and a shiur by Rav Schachter (courtesy Shokhet)

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+1...it should be noted though, that while Rav Shachter prohibits the red string ("roiteh bendel" in the shiur) because he couldn't find a reason for it, others have suggested that the red color is supposed to remind us of the embarrassment (accompanied by blushing) that Rachel suffered when she gave up the signs to her sister ... this reminds us to sacrifice for the dignity of others, and it would be from there that all the benefits of the red string come –  Shokhet May 20 at 13:24
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Yeah, I know it's a little weak, but it's there as a limud zchus –  Shokhet May 20 at 13:25

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