A Scientific, Halachik, and Medical Analysis of Metzizah BePeh

Abstract

Metziztah BePeh, oral suction, is part of the Jewish ritual circumcision and is performed by many segments of the Orthodox Jewish community, including Sephardim, Chassidim, and “Yeshivish” Jews. In the past decade, the media has linked the practice of MbP to Herpes simplex infection in infants. In 2011, a baby in New York City died of Herpes simplex-1 and health officials of DOHMH and Centers for Disease Control (hereinafter, CDC) linked the infection to MbP based on eleven cases of neonatal herpes reported from 2000 to 2011. The aim of this paper is to first provide a background in Herpes simplex infection, specifically type 1, which has been associated with infants who have developed neonatal herpes following a bris with MbP. Next, a discussion of both the components of a Jewish circumcision and the halachik relevance of MbP will be presented. If one believes that MbP is an integral part of the bris procedure, and without it the bris would not be complete, then there is little room to change the practice. However, if one believes that MbP is not an integral part of the bris procedure, but rather was introduced into Jewish law as a therapeutic measure for the infant, then if modern medicine seems to prove contrary effects, it is easy to argue that the practice of MbP should be altered or discontinued. Finally, different medical points of view regarding the safety of MbP will be presented. Some doctors believe that there is absolute evidence that MbP does indeed causes the transmission of Herpes simplex virus and therefore they would the recommend the discontinuation of MbP. Other doctors, however, believe that there is no concrete evidence of transmission of virus and thus the custom of MbP must be protected.