Taking Pills to Ease the Fast

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In recent years, it has become popular for products to be marketed that will make the fast on Yom Kippur easier. On a certain level, this makes sense. Fasting for twenty-five hours while also spending most of the day standing on one’s feet as one prays in synagogue can make the day uncomfortable at best and unbearable at worst. It makes sense that we might take steps to make the day a little easier, if only so that we can be more present and less distracted during the davening.

Already in the early twentieth century, pills to aid in fasting were being sold, and Rabbi Mordechai Yaakov Breisch asked whether it was permitted to use them. Rabbi Breisch, author of the Chelkat Yaakov, was a noted posek who lived in Poland and Germany and later escaped to Switzerland before the Holocaust. In a teshuvah (Chelkat Yaakov, Orech Chaim 216), he explores whether taking the pills on the day before Yom Kippur is permitted. One might think, he explains, that there is a problem because the Torah emphasizes that Yom Kippur is meant to be a day of affliction. If so, making the fast easier, might, at the very least, violate the spirit of the Torah if not the letter of the law. However, Rabbi Breisch points to the fact that the Torah also commands us to eat on the day before Yom Kippur and that this too is a mitzvah. We make sure to eat before Yom Kippur to ensure that we will be able to fast properly on the day that is to follow.

Rabbi Breisch argues that taking such a pill before Yom Kippur should be seen as no different than one who eats extra food before sundown so that they will feel fully satiated as they enter the holiday. The Talmud itself already notes that one feels full as long as the food one has eaten is still being digested, and that as a result of this, God has compassion on dogs who might have difficulty finding food by allowing the food they eat to stay in their belly for three days. Taking a pill on the day before Yom Kippur to ease the fast functions similarly. Though one swallows it on the day before Yom Kippur, it slowly releases its medication in one’s belly over the course of the day so it can enter into the bloodstream and reduce hunger. One should look at it as no different than a piece of food that takes a long time to digest and staves off hunger.

It is important to note that in Chazon Ovadiah (Yamim Noraim, p. 256), Rabbi Ovadiah Yosef supports the position of the Chelkat Yaakov but also cites Rabbi Shlomo Zalman Auerbach who states that one should not use suppositories on Yom Kippur itself to ease the fast. While they may not be considered a prohibited form of eating, using them on Yom Kippur would violate the spirit of the day and, in the famous words of the Ramban, cause one to be a scoundrel with the permission of the Torah.

שו”ת חלקת יעקב אורח חיים סימן רטז

 ותבנא לשאלתנו הנ”ל, לבלוע כדור כזה בעיו”כ בכדי להשקיט רעבונו ביום כיפור, מפאת שבכל פעם נימוק גרעין אחד שבתוך הכדור וזה מועיל נגד הרעב .

אינו רעב, עי’ ברכות נ”ג כמה שיעור עיכול כל זמן שאינו רעב… כאן באכילה מרובה כאן באכילה מועטת, ואף דחילוק זה רק לר”ל אבל מסתמא גם ר”י לא יחלוק ע”ז דאכילה מרובה זמן העיכול יותר, ועי’ שבת קנ”ה ב’ יודע הקב”ה בכלב שמזונותיו מועטין לפיכך שוהה אכילתו במעיו שלשה ימים, חזינן דהרעב בא יחד עם עיכול מאכל שבמעיו – הכי יעלה על הדעת שאסור לעשות כן. וני”ד נמי כן הוא, לפי שהסביר לי רופא דתי השערתו, באלו הכדורים שבולעים בכדי להשקיט הרעבון מסתמא כן הוא, דהכדור כרוך במעטפה או קליפה של איזה חומר, ובתוכו הגרעינין, ובביאת הכדור להקבה תימס הקליפה מכח העיכול שבקבה, והסיבה שהגרעינין שבכדור אינם נמסים יחד, או שכל גרעין מעוטף בקליפה מיוחדת באופן שגרעין אחד ימס בזמן מאוחר זה אחר זה, יען כי הקליפות שונות בחוזקן נגד כח העיכול, או אפשר שהחומר בעצמו שבכל גרעין שונה בחזקו נגד כח העיכול, וכשיתחיל להתעכל בא יבא כח הזנה שבו להדם ומשקיט הרעב, כמו בשארי אוכלין שההזנה בא יבא יחד עם העיכול ולאחר שיתעכל נפסק ההזנה ובא הרעב – וכן במאכלים יש שהם קלין להתעכל ויבא הרעב לאחר זמן מועט, ויש שהן קשין להתעכל ושוהה הרעב לבא עד זמן מרובה הכי אסור לאכול בערב יו”כ מאכלים הקשין להתעכל, רק משום חשש קרי מבואר בשו”ע לאכול בעיו”כ מאכלין קלין להתעכל ולא משום ששוהין להתעכל ושוהה הרעב לבא. ואי משום שעושה בכוונה בני”ד בכדי שלא יסבול הרעב וביו”כ עינוי כתיב כמו שהעיר כת”ה – מה בכך אדרבה לשון רש”י ביומא פ”א ב’ וז”ל כלומר התקן עצמך בתשעה כדי שתוכל להתענות בעשרה, ובר”ה ט’ א’ ז”ל כל דמפיש באכילה ושתי’ טפי עדיף – וכאמור דכל הענין רק בהנאת מעיו, ברור דמותר כיון דנעשה הכל מעיו”כ. 

 אכן לדעתי אין להתיר זה לאדם בריא מטעם אחר, מי יערב לו שהכדורים נעשים בתכלית הכשרות בלי איזה חשש תערובות איסור – כשהדבר נוגע לחולה, אין מדקדקין כל כך משום חשש סכנה או רק הסתעפות סכנה, עי’ תשובת רע”א סימן ס’ – אבל באדם בריא רק שלא יסבול הרעב, צריך לידע בברור שאין שום חשש תערובות איסור, כן נלפענ”ד. 

We come to our question about whether one can swallow a pill like this on the day before Yom Kippur in order to quiet one’s hunger on Yom Kippur, by releasing small parts of the pill that work against the hunger.

In my opinion, it is obvious that it is permitted even if we need to analyze the enjoyment the stomach derives from this on Yom Kippur. First and foremost, the act of eating [taking the pill] is done on the day before Yom Kippur and not on Yom Kippur itself. If so, then in my humble opinion this is exactly the same as one who eats and is satiated on the day before Yom Kippur and when it gets close to sunset, wants to eat additional food with the intention that they should eat plenty, and that the time of digestion will last longer, for as long as the food is not fully digested, one is not hungry. See Berachot 53, where it says that the length of digestion is the time that one is not hungry… this applies whether one eats a lot or a little. Even if this distinction is according to Resh Lakish, it can be assumed that Rabbi Yochanan does not disagree that eating plenty will cause the time of digestion to last longer. See Shabbat 155b in which it states that God knows that a dog’s food is scarce, therefore its food stays in its belly for three days. One sees that the hunger comes together with the digestion of food in one’s belly. How could it occur to one that that it would be prohibited to do this? The same is true in our case [of swallowing a pill to ease the fast] as was explained to me by a religious doctor. In his evaluation, these pills that one swallows to quiet hunger are in general wrapped in a covering or capsule of some material and inside of it are small little balls. When the pill arrives to the stomach, the outer covering dissolves from the digestive fluids in the stomach. The reason that the small little balls of medicine do not dissolve with it is because each little ball is covered in its own special material such that each dissolves one after the other or because the different coverings have different resistances to the digestive fluids, or because the little balls of medicine themselves have different resistances to the digestive fluid. When they begin to digest, their satiating power enters the blood and quiets the hunger similar to other foods in which their satiating power coincides with [the time of] digestion. When digestion stops, the hunger comes. So too with foods that are easy to digest, hunger comes quickly after. Foods that are harder to digest and stay [in the stomach] cause hunger to be delayed for a long time. Such foods are prohibited on the day before Yom Kippur only because they may cause a seminal emission as it explains in Shulchan Aruch that one should eat foods that are easy to digest and not because such foods [which are hard to digest] cause the hunger to be delayed. If one wanted to argue [it was prohibited to take the pills] because one does so intentionally not to suffer from hunger and regarding Yom Kippur, it is written “affliction,” as the questioner raises, what of this? On the contrary, the language of Rashi in Yoma (81b) is that you should “prepare yourself on the ninth [of Tishrei], so that one will be able to fast on the tenth.” In Rosh Hashanah (9a), Rashi says, “all those who increase their eating and drinking [on the ninth of Tishrei], it is considered better.” Regarding the matter [that taking pills might be prohibited because they are like] deriving enjoyment from eating, it is clear that it is permitted because everything was done on the day before Yom Kippur.