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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2The 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– samCommented Jul 27, 2012 at 20:04
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2@sam, why don't you write this up into an answer?– HodofHodCommented Jul 27, 2012 at 20:49
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The S'dei Chemed has a couple chapters on this issue. It was also published as a separate pamphlet called, "A Collection of Laws - S'dei Chemed, Pamphlet Metzitza and Miluim", subtitled "Which talks about the laws of Metzitza, which must be done for the Mitzvah to be performed properly, and specifically with the mouth." I haven't read it, but it looks like it addresses the question.– MenachemCommented Aug 22, 2012 at 21:31
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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 See here: PROPER PERFORMANCE OF MITZVAS BRIS MILAH– YehoshuaCommented Dec 19, 2012 at 22:33
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en.tvunah.org/2014/02/18/metzitza-bpeh– Double AA ♦Commented Apr 28, 2016 at 6:42
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3 Answers
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 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 ♦Commented Jul 31, 2012 at 21:51
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also by mentioning that they should do it in a safer manner.– Ariel KCommented Jul 31, 2012 at 23:24
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1and that the gemara implies its not so important for the bris itself, its just a safety measure.– Ariel KCommented Jul 31, 2012 at 23:26
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1Frankly I don't see any other way of reading that Gemara.– Double AA ♦Commented Apr 11, 2013 at 18:26
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According to the Chatam Sofer, shouldn't it be prohibited to do on Shabbat? We don't allow heating water on the third day after the Milah anymore (OC 331:9), even though in the days of the Gemara they thought that was Pikuach Nefesh. This is the same thing; it just took people longer to realize the science was bogus.– Double AA ♦Commented Aug 17, 2017 at 20:34
Metzitzah B'peh is rooted in the Talmud, and has been safely practiced for thousands of years.
The suggestion that Metzitzah B'peh was involved in the transmission of the herpes simplex virus cases in New York City, has never been conclusively proven. In fact, the link is not as "scientifically" obvious as one may think. The vast majority of neonatal herpes cases in NY City are males who did NOT have MBP, and FEMALES.
The only conclusive way of identifying the source of a herpes infection is DNA tests. We would need to test the DNA of the practitioner, and compare it with the DNA of the virus in the baby. Otherwise, the baby could have gotten it from someone else.
In the cases cited, New York City ignored science, and declines to employ DNA testing, the universally recognized gold standard in determining the source of an infection. Thus, the city actually put the infants’ lives at risk by allowing these other transmitters to continue unhindered.
https://hamodia.com/2015/01/12/results-rockland-tests-mohalim-puts-pressure-nyc/
https://yated.com/landmark-program-uncovers-false-positive-in-neonatal-herpes-case/
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"The only conclusive way of identifying the source of a herpes infection is DNA tests." This is theoretically true but practically it's an obviously absurd standard. By the same standard you can't fairly claim it's been safely practiced for thousands of years since no one has tested that with DNA. More likely is rather that many kids got sick from it and no one knew why (and assumed it had to do with cumin or hot water or something). Scientists don't run double-blind studies on all sorts of obvious things that there is no reason to doubt.– Double AA ♦Commented Jul 25 at 22:34
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(To be clear, I know nothing about any specific evidentiary issues in NYC, just as Isaac noted above, medically speaking it's obviously a stupid idea. Maybe halacha mandates it anyway maybe not, but there's no need for a double blind study to know medically it's pointless and has at least some risk.)– Double AA ♦Commented Jul 25 at 22:48
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2"Metzitzah B'peh is rooted in the Talmud" To my knowledge the Talmud never specifies בפה. Can you back up this assertion? Commented Jul 25 at 22:54
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1The term is not exclusively used to refer to a function performed orally. See here for the many instances in which the term is used (including to describe one of the functions of a sponge): benyehuda.org/dict/24412/48472 Hazal did not specify that the function must be performed orally. Commented Jul 25 at 23:19
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1The term refers to a function not a method. A common context of that function is oral sucking but there are clearly other contexts in which the function occurs (as demonstrated). Accordingly, Hazal prescribe that a certain function be performed and did not specify a method. That may or may have not been the commonly employed method (I wasn't there and they do not say) - but such was never legislated. It is not until about 700 years after the closing of the Talmud that we find the oral method specified in any source. Commented Jul 25 at 23:54
Yes of course it's necessary. So called health dangers are so infinitesimal that to change the correct procedure for bris milah is not only a violation of mesorah it's a violation a man's ability to think.
See rambam hilchos bris milah ch 2 halacha beis anyone who does not perform the metzitzah should be removed from their position.
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1Indeed, and the traditional sources also says we must sprinkle ground cumin on the wound, the risk from which is even lower. Only someone who can't think would leave their spice rack at home on the eighth day and risk changing the mesorah and harming the baby– Double AA ♦Commented Jul 24 at 13:15
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1But must it be done by mouth, directly, or does an instrument suffice? The latter is still b'feh, no?– 5784Commented Jul 24 at 13:43
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2This does not answer the question. The question is "Is Metzitzah B'peh a must?" The only source you cite does not specify that מציצה must be done בפה. The Rambam states: ואחר כך מוצץ את המילה עד שיצא הדם ממקומות רחוקים כדי שלא יבוא לידי סכנה. וכל מי שאינו מוצץ מעבירין אותו. "And afterwards one should draw upon the milah until the blood in the distant places emerges in order so that he [the infant] does not come to be endangered. And anyone who does not draw [blood from the milah] we remove him." He does not specify how the blood should be drawn. Commented Jul 24 at 14:18
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3The Talmud does not specify that it must be accomplished via oral suction, therefore the Rambam does not mention it/require it either. So again, you cite no source mandating that it be accomplished orally (בפה). Accordingly, you have not answered the question as asked. Commented Jul 24 at 16:14