Would marriage really not solve this man's problem?

Question

Another question on pikuach nefesh. The Talmud [Sanhedrin 75a] recounts this story:

There was an incident involving a certain man who set his eyes upon a certain woman and passion rose in his heart [and he became deathly ill]. And they came and asked doctors [what to do]. And the doctors said: He will be cured only if she has sex with him.

-The Sages said: Let him die. She may not have sex with him.

-The doctors said: She should at least stand naked before him.

-The Sages said: Let him die. She may not stand naked before him.

-The doctors suggested: The woman should at least talk with him behind a fence in a secluded area.

-The Sages insisted: Let him die. She may not converse with him behind a fence.

[An objection: If the woman is married, the matter is understood. But if she is single] let the man marry her [if she agrees]. Rabbi Yitzḥak said: His mind will not be eased by marriage, as it is stated: Stolen waters are sweet, and bread eaten in secret is pleasant. [Prov. 9:17]

In other words, Rabbi Yitzhak decided that only illicit sex could have cured the man. On what basis did he make that assertion? In most cases, a man in that situation would be happy if the woman agreed to marry him. The problem arises only if she does not want to marry him.

Answer 1

This question is based on a misquote of the Talmud. Here is the actual text:

ולינסבה מינסב לא מייתבה דעתיה כדר' יצחק דא"ר יצחק מיום שחרב בית המקדש ניטלה טעם ביאה וניתנה לעוברי עבירה שנאמר (משלי ט, יז) מים גנובים ימתקו ולחם סתרים ינע

If the woman was unmarried, let the man marry her? His mind would not have been eased by marriage. As Rabbi Yitzchak says: Since the day the Temple was destroyed, sexual pleasure was taken away from those who engage in permitted intercourse and given to transgressors, as it is stated: “Stolen waters are sweet, and bread eaten in secret is pleasant” (Proverbs 9:17). Therefore, the man could have been cured only by engaging in illicit sexual interaction.

Rabbi Yitzchak is not even commenting on the incident under discussion. He is not talking about a case of illness. The Talmud is just using a statement he once made about human nature to partially support the diagnosis made at the time of this incident. The identity of the person who made this diagnosis is not revealed; it may have been the doctor.

Answer 2

Rav Yitzchak was not part of the decision there. Obviously the Rabbis involved in the decision would have had to consider the possibility of marriage if it was relevant, and assuming it was relevant they decided it would not have helped.

The gemera reports the story, and asks why marriage would not have been a solution. Rav Yitzchak explains that the need for specifically illicit relations could have created this situation where marriage would not have helped him.