Yom Kippur 5785 – Intriguing Questions & Answers
Yom Kippur 5785
Rinsing One’s Mouth After Vomiting on Yom Kippur
Q: May one who vomited on Yom Kippur, leaving an unpleasant taste in his mouth, rinse his mouth?
A: The Rema (Orach Chaim 613:4) rules that it is prohibited to rinse one’s mouth on Yom Kippur, as we find elsewhere (567:3). The Mishnah Berurah (11) adds that b’makom tzaar, it is permitted to rinse the mouth with water during a fast, provided one is extremely cautious to bend their head and mouth downwards so that the water does not enter the throat. Even on Tisha B’Av, it is permitted when one is in distress. This applies even to Tisha B’Av. On Yom Kippur, however, one should be stringent.
However, the Chayei Adam (Hilchos Taanis, 132:20) writes that “in situations of great distress, it is permissible to rinse the mouth with water even on Tisha B’Av, as long as one is very careful to bend their head and mouth downwards to prevent water from entering the throat. For Yom Kippur, one should be stringent, as much as possible.” It is worth noting, however, that the Mishnah Berurah does not quote the words “as much as possible” in his citation of Chayei Adam. Nevertheless, in a situation of great need, such as a pregnant woman or similar cases where vomiting occurs and the taste in the mouth is particularly unpleasant, one may be lenient to rinse the mouth with the head bent downwards to avoid swallowing. If one has access to bitter water for rinsing, it is preferable to use that.
Several contemporary Poskim permit rinsing in such cases, explaining that this is done merely “l’hasir lichluch,” to remove filth. On Yom Kippur, only sichah (applying oils) is prohibited even for the sole purpose of removing sweat, as we are generally more stringent regarding sichah. Thus, for the prohibition of rechitzah (washing), there is room to be lenient in such cases. However, rinsing the mouth carries an additional concern that one may swallow, as is the concern in all fasts, and therefore one must take caution by keeping the head downwards, and preferably, using bitter water. See Shu”t Shevet Halevi (4:54).
I later found in Shevet HaKehati (Vol. 4, 166:2) who was asked about this matter and ruled that there is room to permit it. Although the established ruling is that rinsing the mouth on Yom Kippur and Tisha B’Av is forbidden—even for someone in great distress, this is only permitted on Tisha B’Av, but for Yom Kippur, one should be as stringent as possible, as stated by the Chayei Adam—nevertheless, in our scenario, there is reason to permit.
Although the Rema (613:4) notes that the custom is to be stringent and that even an istinus (particularly finnicky person) should not rinse their mouth with water, nevertheless, the Shulchan Aruch HaRav quotes Acharonim who rule that if one has dirt on their face or eye discharge, it is permissible to wash it off, as the prohibition of washing and other afflictions (aside from eating, drinking, and working) are all d’rabanan. That which the Maharil forbids rinsing the mouth is (only) due to concern that one may swallow something. Therefore, even though rinsing the mouth is prohibited to remove bad breath, if there is vomit and one is distressed, it is permissible to rinse while keeping the head downwards to avoid swallowing. One may also consider that even if some water is swallowed, it would be rendered unfit for drinking by the vomit. For all these reasons, there is a basis to permit rinsing in this case provided he bends his head downwards, provided that other great Poskim agree. From what we see above, several prominent Poskim indeed permit doing so in such cases when one experiences great distress.
Should an Alzheimer’s Patient Fast on Yom Kippur?
Q: Is an Alzheimer’s patient required to fast on Yom Kippur?
A: When it comes to Alzheimer’s patients, it is known that the brain’s blood vessels require hydration, and possibly even food, for proper functioning. Therefore, it is difficult to establish a general rule, as there are various stages of the disease. Particularly in cases where the patient no longer recognizes that it is Yom Kippur and is in a state of complete dementia, the opinion of Harav Shlomo Zalman Auerbach zt”l (as related by Harav Neventzhal) permitted giving them to eat as usual, when they no longer recognize that it is Yom Kippur. However, I must emphasize a point that I heard from my father, zt”l, who was a specialist in geriatric care. As I have mentioned in his name in my sefer Ohel Yaakov on the laws of Yichud, an Alzheimer’s patient generally has strength and desires similar to a healthy person but lacks the cognitive ability to fully comprehend and differentiate between things.
However, the illness itself does not necessarily provide a reason to exempt the patient from fasting. Whenever I consulted with him about Alzheimer’s patients before Yom Kippur, he never gave a one-size-fits-all ruling, but rather would evaluate each patient individually. See Shu”t Shraga HaMeir (5:22).
Additionally, I found in the Madrich L’hora’ah (Vol. 3, p. 34) that the Raavad of Skver, R’ Yosef Yisroel Eisenberger, shlit”a, author of Shivtei Yisrael, discusses the opinion of a doctor regarding Alzheimer’s patients. The doctor stated that there is no inherent reason to exempt an Alzheimer’s patient from fasting. However, R’ Eisenberger suggests that when the patient has the status of a shoteh, (but still knows that it is Yom Kippur) they are exempt from fasting. Nevertheless, it is forbidden to actively feed them on Yom Kippur. Therefore, if possible, it is best to place the food before them on the table and let them take it themselves.
Is it Permitted to Swallow Pills on Yom Kippur?
Q: Many people ask whether they are allowed to continue taking medication that they started before Yom Kippur, or take daily during the year, and whether they may swallow these pills on Yom Kippur as well.
A: A person who is not dangerously ill may swallow medicine on Yom Kippur without water if necessary. This is based on the Mishnah Berurah (613:10; 614:2), who explains that any medicine that is permissible to take on Shabbos is also permissible on Yom Kippur. Therefore, if someone is experiencing severe pain on Yom Kippur, they may swallow a pain relief pill like Tylenol or the like without water. Similarly, if someone is taking antibiotics for a week-long course of treatment, they may continue taking them on Yom Kippur. However, it is advisable to consult with a doctor to see if the pill can be taken before or after Yom Kippur, to avoid taking it during the fast. See also Chut Shani, (Hilchos Yom Kippur, p. 165).
If the medicine does not have a bitter taste, Shmiras Shabbos Kehilchasa (39:8) quotes Rav Shlomo Zalman Auerbach zt”l, who advises that one should wrap the pill in a thin piece of tissue and swallow it covered. This is certainly considered an “achilah shelo k’darkah, eating in an unusual manner,” which is permitted. Shmiras Shabbos Kehilchasa further writes that according to the Shaagas Aryeh and the Achiezer, this method should also be used for bitter medicine, since swallowing the pill as is would be considered achshivei l’achilah, rendering it into a food, as the person desires the medication itself. However, we would not say achshivei on the tissue. In practice, however, we follow other Poskim who argue with the Shaagas Aryeh on this matter.
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