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 Shabbat Parashat Korach| 5764Ask the RabbiQuestion: In order to digest milk properly, I need to take lactose pills. Is it permitted to take such pills on Shabbat, in light of the prohibition on refuah (medical treatment)?
Answer: Before we try to solve your problem, let us “digest” the topic a little more broadly.
There is a rabbinic prohibition to resort to medical treatment on Shabbat (Shulchan Aruch, Orach Chayim 328:1, from mishna Shabbat 111a). This is out of fear that one may violate Shabbat in the course of the treatment, or, in the classical situation, in preparing medicines (by grinding). However, this prohibition is chipped away at from both sides. When one is truly sick, then he is permitted to take medicine to improve his situation. And, as relates to our issue, there are some health-related actions that are not considered medicinal.
Food, in addition to being tasty and providing energy for the day’s activities, may also have medicinal value in a variety of ways. Yet even the healthiest foods are not included in the prohibition on refuah (Shabbat 109b). Things (including some herbs and tablets) that are arguably food-like but are eaten only by unhealthy people are prohibited (ibid.). But is that prohibition only for unhealthy people or even for healthy ones? The Shulchan Aruch (ibid.:37) says it is permitted for healthy people, as they do not need refuah. (Some explain that while one who feels ill may be distressed enough to inadvertently violate Shabbat when seeking a remedy, this fear does not apply to a healthy person- see Tzitz Eliezer XI, 37). On the other hand, the Magen Avraham, one of the Shulchan Aruch’s primary commentators, tries to prove otherwise, that medications are prohibited even for those who are not suffering at all (ad loc.:43). Tzitz Eliezer (ibid.) accepts the Shulchan Aruch’s opinion, but Rav Moshe Feinstein (Igrot Moshe, OC III,54) said that it is difficult to dismiss the Magen Avraham, under normal circumstances. (This is the implication of the Mishna Berura 328:121, as well).
An apparent common application of this machloket iswhether a healthy person can take vitamins, which are not really food (we don’t make a beracha on them). However, R. Feinstein rules that it is permitted to take vitamins on Shabbat, because even the Magen Avraham would agree. He reasons that to be a medicine, something must have some type of direct positive effect on the body. If it is just preventative of disease, by providing the body with substances that keep it working smoothly, that could not be considered medicine.
What about lactose pills? There are different ways to look at the matter. On one hand, the person feels fine when he takes it. On the other hand, he has an existing deficiency which will, given that he has just ingested or is about to ingest milk, cause him pain in the relative short term without the pills. (Shemirat Shabbat K’hilchata 34:18 is stringent in such cases).
Fortunately, by lactose pills, there are additional grounds for leniency, based on how they work. Most medicines strengthen the body and its workings or fix problems that have arisen in it. But lactase replacement pills act on a more technical plane. They simply break down milk’s lactose into sugars that the body can absorb. In fact, one can even put the pill into the milk and have it do its job outside the body. Thus, the pill just causes that the problematic condition never arises. The body’s deficiency is not addressed, as it is not healed into producing its own lactase enzyme. Therefore, the situation is more lenient even than that of vitamins, which help give the body strength and resources to deal with future problems.
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