Ki Tissa 5769: The Spice of Death, Used for Life

I have an obsession. It started with sex, but ended up as my breakfast. Every morning, I usually get up, get dressed and drive to a Starbuck's close to where I will be working for the day. Every day, I order the same thing for breakfast: A venti coffee and oatmeal. While I drink the coffee black, I do add something to the oatmeal. Since the first time I have done so, I have I’ve noticed something. What I added to my oatmeal is mentioned in this week’s portion, though it is far from edible.

23. Take you also to you the best spices, of pure myrrh five hundred shekels, and of sweet cinnamon half so much, two hundred and fifty shekels, and of sweet calamus two hundred and fifty shekels, 24. And of cassia five hundred shekels, according to the shekel of the sanctuary, and of oil olive a hin; 25. And you shall make it an oil of holy ointment, an ointment compound according to the art of the apothecary; it shall be a holy anointing oil.[Exodus 30]

This is to be the oil which all of the vessels of the temple are to be anointed with. There are debates as to the mass of the shekel, making conversion into modern units difficult. 9, 11, 14, and 17 grams are commonly possibilites. Adin Steinstalz in his Talmud: A Reference Guide defines a shekel as 9 grams, and in the lack of any better conversion factor we can come up with a formula of dry ingredients:

Myrrh 500 Shekels (4500gr)

Cinnamon 250 Shekels (2250gr)

Sweet calamus 250 Shekels (2250gr)

Cassia 500 Shekels (4500gr)

This spice power was then suspended in a hin of olive oil. A hin of olive oil is also debated, but this might be 7.1 liters. That would mean if the dry ingredients were added directly to the oil there was 1.9 grams/ml of spice, an amount which would be closer to a paste than flowing oil.
The Talmud however, notes the dry ingredients was extracted by heating this mixture, and the resultant extract was what was added to the oil [K’ritot 5b]. The Talmud also makes adjustments by adding 250 shekels more of sweet cinnamon [K’ritot 5a-b].
Looking at these concentrations, I have for long time suspected something about the anointing oil for the vessels. Part of my suspicion comes from the punishment for using the stuff.

32. Upon man’s flesh shall it not be poured, nor shall you make any other like it, after its composition; it is holy, and it shall be holy to you. 33. Whoever compounds any like it, or whoever puts any of it upon a stranger, shall be cut off from his people.[Exodus 30]

While it is a sacred material, I’ve wondered about such warnings which sound very much like the warnings of a chemical manufacturer when warning a consumer. When I first wondered about this about ten years ago, I was researching the large number of botanical references found in the Song of Songs. Cinnamon, myrrh, and calamus all occur in one verse:

14. Spikenard and saffron; calamus and cinnamon, with all trees of frankincense; myrrh and aloes, with all the chief spices; [Song of Songs 4]

Translating the Song I wondered if this was not just a metaphor for some very expensive imported plants, but something more, an herbal pharmacopeia. In the Song of Songs I was looking for aphrodisiacs, but what I found was far more interesting. As I did my research I found out several things about each of these spices:
Cinnamon and Cassia: As far as modern trade names are concerned these are both cinnamon. However, Cinnamon or sweet cinnamon (Cinnamomum zeylanicum) is the imported Indian and Sri Lankan species, and cassia (Cinnamomum cassia) is from China, sometimes called Chinese cinnamon. While both have in common the chemical cinnamaldehyde making up 65-80% of its volatile oil, Cassia has less of other active chemicals than Cinnamon, including the antimicrobial o-methoxycinnamaldehyde.
Cinnamon in Hebrew is Kinmon and cassia in Hebrew Kidah. However the Aramaic translation of Exodus 30 has k’tziata, which sounds a lot more like cassia. Kidah and Kinmon has only three occurrences each in the biblical text. The use of the two types of cinnamon do have a sensual side to them, as noted in the Song of Songs (4:14) passage and in the Seductress of Proverbs (7:17) both times associated with anther of the ingredients of the anointing oil, Myrrh. Cassia and Calamus also occur together in Ezekiel 27:19 in terms of being an item traded from afar.
In laboratory experiments, cassia and cinnamon both have been found to retard microbial growth including a wide variety of disease-causing bacteria and fungi. Other research has pointed to other uses. Its folk use as a remedy for abdominal pain seems to have some evidence. Lab tests on animals describe the relaxation of intestinal linings when exposed to cinnamon. The German Commission E, the German government commission given responsibility over herbal supplements in Germany, found evidence it was as effective as cimetidene in controlling gastric problems. However research has also shown it has little to no effect on Helicobacter pylori, the cause of many ulcer related problems. Cinnamon has shown a its greatest promise as a food preservative to retard E. coli and Salmonella among other food pathogens.
Myrrh: While the other three ingredients have only three occurrences, Myrrh had fifteen. Eight are in the Songs of Songs and may have meaning more in its extraction as much as its use. Myrrh is the sap of a tree of genus Commiphora found primarily in the Middle East. Which species is anyone’s guess, because all have similar properties. To harvest Myrrh, one has to massage out the whitish or reddish sap from a slit made in the tree’s twigs, suggesting one of its sexual connotations particualy in the scene in Chapter 5 of the Song of Songs. Myrrh’s other sexual connotation may be hinted themost in its one mention in the book of Esther. One of the precautions given about myrrh in virtually every folk tale and pharmacopeia about it and in several academic journals is its uncanny ability to initiate menstruation. Thus all sources forbid the use of myrrh with pregnant women due to the possibility of miscarriage. Therefore in the case of Esther 3:12 the six months, or two trimesters of Myrrh treatments may be a case of an induced abortion and contraception to assure any child born of the woman chosen queen was a legitimate heir to Ahasuerus’ throne. I could even speculate in one other case about such an abortion: the bitter waters rite for a woman suspected of adultery. Such a rite required the dust from the Mishkan, the same dust the Myrrh infused anointing oil dripped. When ingested, the high concentration of myrrh in the dust on the Mishkan floor might have caused an abortion from an illicit affair, what the text refers to as her thighs falling [Numbers 5:27].
But once again, Myrrh or Mor in Hebrew most documented use in medical literature is as an antimicrobial and fungicide. It was one of the items used in embalming fluid of the Egyptian mummification process, and does wonders in killing all kinds of molds. Apparently it also stimulates the human immune system as well. Due to its difficult harvesting methods and the scarcity of the plant, it is very expensive to use. Thus there is not a significant amount of modern research into its properties.
Sweet calamus: Called Kaneh in both Hebrew and Aramaic, there have been many debates as to what it really is. Most authorities including Israeli biblical botanist Zohary agree it probably is one of the grass species Cymbopogon, with Zohary championing Cymbopogon marinii, commonly known as ginger grass, even though there is another species indigenous to Israel. There is evidence of its use from Egyptian tombs by the smell reported of ginger grass still evident when sealed tombs are opened. People today probably know the East Asian species best, Cymbopogon citratus or lemongrass. As Ezekiel 27:19 and Jeremiah 6:20 seem to indicate Kaneh was an import to Israel, probably from India. One extract from Cymbopogon nardus is citronella, known for its insect repellent properties. All species of Cymbopogon are bactericidal, and there is some laboratory evidence that some may also be antiviral.
There is a consistent pattern among all of the spices of the anointing oil. All, in one way or another are demonstrated antimicrobials. When the raw spice was concentrated into essential oils then placed in an olive oil suspension this became one of the first recorded sanitizers. It purpose was not one of directly of life, but of death to microorganisms. Given the amount of blood and animal carcasses that were part of the priestly sacrifices, killing microorganisms on surfaces makes sense as a way to limit illness from contamination. It is not coincidental that right before the anointing oil God tell Moses to build a handsink, and that Aaron and his sons are to “wash with water, that they do not die” [Exodus 30:20] The health and safety of the priests depended on good decontamination procedures from their daily tasks. The anointing oil was probably the worlds first recorded antiseptic.
But like the bleach we use today, it was not made for human consumption. While all of these ingredients were edible in small quantities, at the concentrations in the anointing oil they might very well be toxic. While some of the others have potential for contact dermatitis, cinnamon and cassia essential oils can cause burns to human skin if left on for prolonged periods. In an oil base this is very likely, demonstrated by cases where it is suspended in petrolatum, and thus another reason for the prohibition of placing on a human being. When we read the phrase “cut off from his people” the rabbis understand this not as a literal ex-communication, but a death penalty meted out by God. Put another way, when that phrase occurs, there is the potential for lethal consequences. In the anoiting oil, toxic levels of cinnamaldehyde alone could cause painful burns.
We tend to think of many of our advances in science as happening in only the last 500 years, and tend to forget that there were people observing the natural world far before that. Some of what those people found was wrong, but more and more, we are finding evidence that was thought superstition was effective cures. I’ve not had problems with gastritis or heartburn since I started eating my cinnamon oatmeal every day. Instead of swallowing Tagamet, I think I’ll keep enjoying a little cinnamon in my oatmeal.

Parshat Nitzavim 5768: That you may live

I wanted to write something else this week, but I've been thinking environmentally lately, for a lot of reasons.

One was a major reason I never got to write a Shlomo's Drash last week. Due to the sloppy seconds of a hurricane, the nearby rivers flooded. Apparently while leaving its banks, the Des Plaines River decided to visit a switching box for telephone and internet to my office, silencing all landlines for days. Throughout the Mississippi river valley and of course the coast of Texas, there were incidents of flooding and damage far worse than ours. Yet in many of these places the damage from mold has only just begun, both to buildings and to the people living in them. I have a friend and colleague who was a relief worker from Katrina, who still suffers from a severe mold infection she picked up getting food facilities operational in the aftermath of Katrina.

Another reason is a phrase from last week's portion Ki Tavo in Deuteronomy 28:27.

27. The Lord will strike you with the pox of Egypt, and with the swellings, and with the scab, and with the itch, from which you can not be healed.

It mentions many diseases and during our usual Saturday morning Torah discussion after the Torah service, a physician in my congregation noted how powerless it seems physicians were in this scenario. I countered with an interesting thought: this is about not curative medicine but preventative. This is a matter of environmental health. Many of those diseases start with waterborne parasites and bacteria and lack of care for the water supplies.

This week we read

19. I call heaven and earth to record this day against you, that I have set before you life and death, blessing and cursing; therefore choose life, that both you and your seed may live; [Deuteronomy 30:19]

I've thought a lot about that in terms of our environment. Much of what I do for a living is making sure what is in the natural world around us does not hurt us. As terrifying as a tiger lion or rattle snake looks, such animals are no where as dangerous or kill as many people as Tuberculosis or HIV, which are completely invisible. Such is true with bacteria like species of Salmonella and Shigella or the parasite Entamoeba histolytica. These are found in contaminated waters and foods which look perfectly edible or drinkable, yet they kill millions yearly.

I thought of Snow this week in all the flooding. Not the white stuff but the man, John Snow. Another friend and college will be on sabbatical in England this year. My first question to her was “are you going to The Pump?” In my profession as a health inspector, we may inspect thousands of water pumps, but there is only one Pump. Near 39 Broadwick Street in London is the pump that in 1854 Dr. John Snow and Reverend Henry Whitehead deduced was the source of a cholera outbreak, one of the first to connect water supplies with the disease. By removing the handle and preventing people drinking the water, they ended the outbreak which claimed the lives of 616 people.

A white powder that wasn’t snow was also on my mind – powdered melamine. It’s all over the news feeds I read. In china, Close to 13,000 children have been hospitalized and close to 40,000 more have been affected due to the practice of not adding enough milk to infant formula and covering up the lack of protein by adding melamine. The material has been collecting in infant’s kidneys causing painful kidney stones.

19. I call heaven and earth to record this day against you, that I have set before you life and death, blessing and cursing; therefore choose life, that both you and your seed may live; [Deuteronomy 30:19

From the heavens come rain which falls and finds their way into rivers. From some of those rivers water seeped into the earth, making water tables and aquifers. From wells dug into the ground, like the inhabitants of Broadwick Street in the 1800’s, some get their water. As I write this, I’m looking at the blue water of Lake Michigan, the source of my drinking water, which too has had it problems with Cholera and Salmonella, till the lock I’m looking out upon helped to reverse the flow of the Chicago River.

Moses challenges us in Deuteronomy

15. See, I have set before you this day life and good, and death and evil; 16. In that I command you this day to love the Lord your God, to walk in his ways, and to keep his commandments and his statutes and his judgments, that you may live and multiply; and the Lord your God shall bless you in the land which you are entering to possess. 17. But if your heart turns away, so that you will not hear, but shall be drawn away, and worship other gods, and serve them; 18. I announce to you this day, that you shall surely perish, and that you shall not prolong your days upon the land, to which you are going over the Jordan, to enter and possess.[Deut. 30:15-18]

We are given the responsibility for the commandments. We can do them or we don’t. Many of them affect the environment around us and the people around us. We can be unethical in our business dealings, putting poison in food to make a bigger profit. We can ignore not just the widow and the orphan but the sources of water that they drink. We can exploit the soil until there are no nutrients left in it. Because it is too expensive or too much of a bother, in many ways in our world, we can not bother to put that parapet on the roof. To do any of these leads to the curses, the chemical, microscopic and some not so microscopic demons that will attack and defeat us.

To do the commandments we must obey them on many levels if we are to live healthy. It is not God’s punishment, but our own foolishness that brings cholera outbreaks. We must remain diligent against the attackers. Moses says there is no real cure for this stuff. As we have learned with antibiotic resistance, there is only prevention; there is only the fence around the Torah.

Writing the Drash for Nitzavim means the end of year 5768 and the beginning of 5769. While I fell into this life through a series of odd coincidences and what I thought of as curses, the prevention of disease, Environmental Health, is my life calling and the biggest blessing in my life. 5769 will be a year where that will be true more than ever as I step up to several new tasks on the national level. How we treat the environment and how it treats us determine a lot of our own health.

As 5769 begins, remember to choose life.

Ki Tetze 5768: What is Environmental Health?

At the end of a nonstop string of commandments this week we read two rather interesting and contradictory commandments. We are to remember Amalek did to us [Deut 25:17], and we are to erase the memory of Amalek [Deut 25:19]. How can we do both? I believe the answer is woven throughout this week’s Torah reading, but its key is rather simple:

8. When you build a new house, then you shall make a parapet for your roof, that you should not bring any blood upon your house, if any man falls from there. [22:8]

What does a biblical enemy have to do with a railing? First let’s look a little closer at Amalek, who first show up in the Book of Exodus not long after the Israelites cross the read Sea out of Egypt[17:8-16]. They begin their pattern of picking on the rear, on those who cannot defend themselves. We later read in I Samuel 30 of an Amalekite Attack in the settlement of Ziklag, where David had settled to keep out of Saul’s way. David and all his troops go to war, and while gone, Amalek raids Ziklag and takes all the women and children. Yet when David attacks the Amalekites, he makes easy work of them. The Amalek of the Bible attacks the weak and defenseless.

I interpret the modern Amalek as disease. Salmonella enteritis, Aspergillus flavius, Bacillus anthracis, E. coli STEC, Shigella sonnei, Mycobacterium tuberculosis, and Vibiro cholera are just some of the soldiers of Amalek, be they bacteria, viruses, parasites or fungi. Most often these soldiers attack the weak or when we leave ourselves defenseless. Like David, who forgot to leave a garrison, when we are not diligent they strike, often taking lives as easily as someone falling off a roof.

Like that rooftop terrace, the easiest, best way to keep people alive is to prevent them from falling off. According to Torah, it is preventative actions that are key to survival. We as Jews believe that preventative actions are so important, not only do we do things like put railing on roofs, but put fences around the Torah itself, preventative actions to prevent transgression. Prevention works. Had David left a few good men behind, Amalek would not have attacked. Even if they did they would have been easily defeated. We have such soldiers in the modern war against Amalek. They are called Environmental Health professionals. When I’m not writing Shlomo’s Drash, I happen to be one.

Many people get Environmental Health mixed up with environmental protection. Environmental protection I usually define as protecting the environment against us, while environmental health is protecting us from the environment. Environmental health professionals instruct people how to make what is contaminated into what is pure. We as EH professionals try to prevent contamination, so that the people will live and not die. We include indoor air quality experts, epidemiologists, and wastewater treatment specialists. Many of us, including myself are involved with food protection. If those soldiers of Amalek do get loose and start to cause trouble we find them and do our best to contain them. Much of this is reminiscent of a good chunk of the book of Leviticus in chapters 11-16 which talks about such contamination issues from bloodborne pathogens, mold infestations of homes, sexually transmitted diseases, and even what most biblical translations call leprosy, which more likely was fungal infections. Leprosy is once again mentioned in this week’s portion:

8. Take heed in the plague of leprosy, that you observe diligently, and do according to all that the priests the Levites shall teach you; as I commanded them, so you shall take care to do.

In a sense Environmental Health is the role of Levitical priests with a strong science background. Ancient peoples did learn important lessons in public health. There is one passage in this week’s portion which particularly interests me. When in military maneuvers against an enemy, there is a commandment to have latrines:

13. You shall have a place also outside the camp, where you shall go out to it; 14. And you shall have a spade among your weapons; and it shall be, when you will ease yourself outside, you shall dig with it, and shall turn back and cover your excrement; 15. For the Lord your God walks in the midst of your camp, to save you, and to give your enemies before you; therefore shall your camp be holy; that he should see no unclean thing in you, and turn away from you. [23:10-15]

The Talmudic Rabbis take this further:

R. Johanan also said: If one desires to accept upon himself the yoke of the kingdom of heaven in the most complete manner , he should consult nature then wash his hands and put on tefillin and recite the Shema’ and say the tefillah: this is the complete acknowledgment of the kingdom of heaven.[Berachot 15a]

Fecal contamination is a major cause of foodborne and waterborne illness. In these two passages from the Torah and Talmud, it is clear that cleanliness and good hygienic practices are holy acts. The rabbis elevate washing ones hands after defecation to the same level as the morning prayers. Interestingly, the spade is not a mere vessel or implement but specifically called a weapon. It is the weapon used against the modern and probably the ancient Amalek. Preventing disease by keeping away what causes disease is a mitzvah. Environmental health’s duty is to do exactly that.

What I do for a living may not be considered some holy job like a rabbi. But in teaching people to wash their hands, cook their food well, store their food below 41°F and wash everything in sight, I am doing something holy, and something sacred. By telling people not to store something on the floor, to close up holes that mice or rats can crawl through, I am installing that railing on the roof.

As I learned when I taught a session on kashrut at my national professional meetings, Jews are a tiny minority in Environmental Health. Yet I also learned that day the Torah has much to teach us about EH. For me, my life in Environmental Heath is not just a profession but a mitzvah handed down by God to Moses at Sinai.

To remove the memory of Amalek and to remember Amalek is not contradictory. It is the role of those of us who keep disease from ever striking. We can get to place where we forget the horrors that disease causes on us, because disease is no longer there. We must get there with constant diligence against disease, and the ever changing, mutating, evolving pathogens that make up the army of Amalek.

What is Environmental Health? It is a mission from God.

Parshat Balak 5767: The Peor Outbreak

Numbers 22:2-25:9

In this portion, King Balak of Moab watches all of his neighbors go down to defeat militarily at the hands of the Israelites. He sends envoys to the greatest magician in the area, Balaam, to curse the advancing Israelites. After a series of adventures, Balaam meets up with Balak, and sets up the curse. Three times in a row, the curse ends up as a blessing, the most famous now known as the prayer “ma tovu” and Balak is furious. But Balaam comes up with a plan for biological warfare. At the very end of this section, we read:

Israel stayed in Shittim, and the people began to commit harlotry with the daughters of Moab. They called the people to the sacrifices of their gods; so the people ate, and bowed down to their gods. Then Israel attached himself to Baal-Peor; and the anger of the Lord was kindled against Israel. [Numbers 25:1-3]

A plague ensues, killing 24,000 people, more than any other plague. The plague ends in a bizarre manner:

And, behold, one of the people of Israel came and brought to his brothers a Midianite woman in the sight of Moses, and in the sight of all the congregation of the people of Israel, who were weeping before the door of the Tent of Meeting. When Pinhas, the son of Eleazar, the son of Aaron the priest, saw it, he rose up from among the congregation, and took a javelin in his hand;

He went after the man of Israel into the tent, and thrust both of them through, the man of Israel, and the woman through her belly. So the plague ceased from the people of Israel. [Numbers 25-6:8]

I’m obsessed about this plague. Actually I’m intrigued by what the rabbis did with it. There are two clues in the text that explain how they come to their conclusions. The first is the name of the pagan god, Baal Peor. Baal in Hebrew means master or lord, and the common beginning of a number of such pagan god-names. So in Hebrew for example Zebuv means flies. Thus the Baal Zebuv (Beelzebub in Greek) of II Kings 1 can be translated the lord of the flies. Breaking the word Peor into syllables we have Peh meaning opening and Ohr meaning skin. Thus Baal Peor is lord of the skin orifices.

The second is a phrase in the text the people ate, and bowed down to their gods [Numbers 25:3] The Rabbis believed that there was significance to this sequence, best explained in the following story:

Rab Judah said in Rab's name: A gentile woman once fell sick. She vowed, “If I recover, I will go and serve every idol in the world.” She recovered, and proceeded to serve all idols. On reaching Peor, she asked its priests, “How is this worshipped?” They replied, “People eat beets, drink strong drink, and then uncover themselves before it. She replied, I would rather fall sick again than serve an idol in such a manner.” [Sanh. 64a]

As an Environmental Health professional I see this as an outbreak from fecal sources. When one eats and sacrifices in a room full of sewage bad things are going to happen.

Last week I began a speech at my professional association’s conference with the Peor incident. In Hebrew there is no word for enforcement, the modern word actually is a word for oppression. The point of my speech was good EH people modify the behavior of others instead of enforcing behavior. Health inspectors need to be more story tellers and less cops.

While attending sessions at the National Environmental Health Association (NEHA) Education Conference and talking to many people between sessions, I kept getting a sinking feeling. Environmental Health Professionals, what some people call health inspectors or sanitarians get a bum rap. We either get ignored or blamed for not doing the right thing. Yet we are rarely given the resources to do our job properly in the first place. From government regulators to industry auditors, the story was the same. Environmental heath is the under funded orphan of public health.

We are often confused with environmental protection. Environmental protection might be described as protecting the planet from environmental contaminants. On the other hand environmental heath is protecting people from biological and chemical contaminants in the environment.

Environmental Health is a prevention, investigation and education activity, and thus its benefit is difficult to see. If done well, nothing happens. It thus becomes the last thing to be funded either in industry or in government.

Yet this is not the frame of mind in Biblical thinking. Prevention, from the fence on the roof to the fence around Torah is deeply rooted in biblical tradition. One example given not long after the Baal Peor incident is this one:

You shall have a place also outside the camp, where you shall go out to it; You shall have a spade among your weapons; and it shall be when you will ease yourself outside, you shall dig with it, and shall turn back and cover your excrement;[Deut 23:13-14]

It is a matter of environmental heath to keep fecal matter away from public areas and to dispose of it properly. It’s a commandment to dispose of sewage properly.

The lead character in the biblical environmental health story is the Priest, which throughout both Leviticus and Numbers we hear of the number of health related issues the priest was responsible for. Yet the priest who was responsible was not the High Priest, but the vice priest. The High Priest, in order to do his sacrificial duties, could not be involved with public health. Too many situations required quarantine and decontamination procedures which would make him unfit for performing sacrifice. Instead it was the second in command who did these things.

The man who stops the plague of Baal Peor is none other than the vice priest, Pinhas. He stops it by killing just one Israelite having sex with a Midianite in the Mishkan. In doing so he changes the minds of everyone who was seduced into Baal Peor worship. The seduction had reached the point of addiction according to the rabbis. By changing people attitudes he saves everyone. In my mind Pinhas is the first Environmental Health official, the first good Sanitarian.

While I don’t condone throwing javelins through health regulation offenders, Pinhas begins a model which we find throughout the tradition. Balaam in this section is involved with magic and in many places in the Torah we find prohibitions against magic. Yet, there is one kind that the Talmud condones: Magic that keeps people healthy. Such practices can be curative, but even more important is preventative magic. Pinchas in killing one person broke Balaam’s spell of seduction. Exposure to the pathogens hovering around Baal Peor’s temple stopped, and contamination waned. It was miraculous, but it also was good science through prevention and behavioral science. Following the ideal of building a fence around Torah, the Rabbis did the same thing for human beings, noting preventative practices. Describing many of the microorganisms of today as demons they instituted many policies that still stand the test of time. For example, they advised against spending time in swamps or sewers, advocated washing hands before eating, and prohibited eating food which has sat out too long or under a bed.

When I wonder about environmental health I go back to the ancient sources, and see that it has always been there. It may have been demons instead of microorganisms back then, but the world still had EH in some form or another. We in EH have been protecting the population since the Exodus from Egypt, and I truly hope we will do so till the end of time.