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DAAT · LEVEL 4 — DAAT HARAV (CHABAD) & HALACHA LEMA'ASSE

שולחן ערוך · יורה דעה

Siman 187 — A Woman Who Bleeds From Relations: Makor or Wound, Diagnosing the Source, and the Rama's Leniency
סימן קפ״ז · דעת הרב והלכה למעשה
דיני אשה הרואה דם מחמת תשמיש
שיטת הצמח צדק וחב״ד · פסק הבית יוסף והרמ״א · נושאי הכלים והפוסקים בזמננו · ממד רפואי
🕯️ דעת הרב · פסק הלכה ולמעשה 🕯️
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Daat HaRav (Chabad) & Halacha lema'asse

The shitah of the Tzemach Tzedek and Chabad on ro'ah machmat tashmish,
then the halacha lema'asse of the nossei kelim and the contemporary poskim — Rav AND physician

Subject:
שולחן ערוך יורה דעה סימן קפ״ז (י״ד סעיפים)
אשה הרואה דם מחמת תשמיש: מקור או מכה, בדיקת שפופרת, תולין, נאמנות, רפואה, ובתולה

Register (sensitive and medical subject):
The subject is intimate, grave, and touches on medicine.
We expose the sugya and the shitot with sobriety ; we never rule on a personal case,
and we propose no self-diagnosis. Every practical conclusion refers to
your Rav (or a Chabad Rav / Dayan / Yoetzet) AND a competent physician (gynecologist).

Writing and iyun:
הרב יוסף חיים סממה · DAAT

How to read this level. Siman 187 treats the grave and delicate case of the woman who bleeds because of relations (ro'ah machmat tashmish): this blood renders her נדה, and if it recurs, the concern that it comes from the מקור (the uterus) would forbid her to that husband. The whole siman seeks to distinguish the source (uterine makor vs makah / tzedadin — a wound or the walls) and to be lenient where possible. It has fourteen seifim: ro'ah machmat tashmish three times in a row and the sequence of husbands ; the bedikat shefoferet (the diagnostic tube) ; what may be attributed elsewhere — tolin (veset, makah, sfek sfeika) ; the ne'emanut "makah yesh li" ; refuah ba-zman ha-zeh ; and the betulah. This level has two parts. (1) Daat HaRav — the Chabad shitah: unlike kashrut, here there is a genuine Chabad halakhic tradition, whose authority of reference on Niddah is the Tzemach Tzedek. (2) Halacha lema'asse: the general pesak (Beit Yossef, Rama, Shach, Sidrei Tahara, Chochmat Adam, Aruch haShulchan, Noda BiYehuda) and the contemporary pesak (Taharat haBayit, Shevet haLevi, Badei haShulchan, and the Nishmat Avraham for the medical angle). We cite only real and attested positions ; where a specific Chabad ruling is not established with certainty, we present it at the level of principle — never inventing a responsum, a number, or a minhag. This siman is both halakhic and medical: every practical conclusion (lema'asse) concludes with the referral to your Rav (or a Chabad Rav / Dayan / Yoetzet) AND a physician (gynecologist) — never self-diagnosis, never alone.

📑 תוכן העניינים

  1. שורש הסימן — מקור או מכה, ובירור מקור הדם (י״ד סעיפים)
  2. פסק המחבר והרמ״א — מסגרת הסימן בי״ד סעיפים
  3. שיטת הצמח צדק וחב״ד — דעת הרב על הרואה מחמת תשמיש
  4. ג' פעמים והקלקול — סדר הבעלים, וקולת הרמ״א « אין אנו נוהגין להוציאה »
  5. בדיקת שפופרת והאבחנה הרפואית — מקור או צדדין, אז והיום
  6. תולין — וסת, מכה, וספק ספיקא של הרמ״א (סעיף ד-ה)
  7. נאמנות « מכה יש לי » — וברי לי שאינו מן המקור (סעיף ו-ז)
  8. רפואה ובזמן הזה ובתולה — והממד הרפואי המודרני (סעיף ח-ט, יג)
  9. פסיקת הספרדים בזמננו — טהרת הבית, ילקוט יוסף
  10. פסיקת האשכנזים והממד הרפואי — סדרי טהרה, שבט הלוי, נשמת אברהם
  11. סיכום מעשי וטבלאות — ולמעשה, שאל את רבך ורופא

📜 The Text of the Shulchan Aruch — The Opening (י״ד סעיפים)

אִשָּׁה שֶׁרָאֲתָה דָּם מֵחֲמַת תַּשְׁמִישׁ מִיָּד... מְשַׁמֶּשֶׁת שָׁלֹשׁ פְּעָמִים ; אִם בְּכָל ג' פְּעָמִים רְצוּפִים רָאֲתָה דָּם — אֲסוּרָה לְשַׁמֵּשׁ עִם בַּעַל זֶה, אֶלָּא תִּתְגָּרֵשׁ וְתִנָּשֵׂא לְאַחֵר.

הַגָּה : וְיֵשׁ אוֹמְרִים שֶׁאֵין אָנוּ נוֹהֲגִין לְהוֹצִיאָהּ.

The framework (ro'ah machmat tashmish). A woman who sees blood because of relations (machmat tashmish), immediately, examines herself three times ; if, in those 3 consecutive times, she saw blood → she is forbidden to that husband: she separates and marries another.

Rama (הגה): but some hold "we do not have the custom to make her leave" — the divorce is no longer forced.

— Shulchan Aruch, Yoreh De'ah 187:1 (of י״ד seifim) · Talmudic basis: נדה (ro'ah machmat tashmish, bedikat shefoferet, makor / tzedadin) · Sefaria YD 187:1

1. שורש הסימן — Makor or Wound, and Diagnosing the Source

The foundation. Siman 187 poses a double problem when a woman sees blood because of relations: (a) she becomes נדה ; and (b) if it recurs, the concern that this blood comes from the מקור (the uterus, the source of the tum'ah) threatens to forbid her to that husband. The entire effort of the siman is to identify the source: if the blood is from the מקור → grave ; if from the צדדין (the walls) or from a מכה (a wound) → it is "external" blood, and one may be lenient. This distinction — makor vs makah / tzedadin — structures the fourteen seifim.
"Miyad" — the shiur (Taz s.k. 1, Shach s.k. 1). The seif stipulates that the blood must appear immediately (מיד), "in the time it takes her to reach out her hand… and wipe herself." The Taz (s.k. 1) stresses this "miyad" ; the Shach (s.k. 1) fixes its shiur: what appears within that brief interval is in the category of asham talui (the doubt attributed to relations) ; beyond it, it is other blood, and she is טהורה on that account. The window is narrow, and it is what makes the blood ro'ah machmat tashmish.

The link with siman 186

Seif 5 of siman 186 already stated the principle — seeing machmat tashmish 3 times in a row forbids her to that husband — and referred "to the following siman." Siman 187 is that development: the mechanics of the 3 times (the חזקה of the kilkul), the sequence of husbands, and above all the means of leniency (the bedika, the tolin, the ne'emanut, the refuah). One does not read 187 without 186, nor without the framework of today's medical diagnosis.

2. פסק המחבר והרמ״א — The Map of the Siman

Siman 187 has fourteen seifim. The Mehaber sets the framework (ro'ah machmat tashmish 3 times and the sequence of husbands ; the bedikat shefoferet ; tolin by the veset or the makah ; the ne'emanut ; the refuah ; the betulah) ; the Rama (הגה) is lenient ("ein anu nohagin lehotzi'ah") and refines the conditions of the tolin and the sfek sfeika. Here is the map.

SeifSubjectRuling (anchored in the text)
1Ro'ah machmat tashmish 3 times ; the sequence of husbandsSees machmat tashmish 3 times in a row → forbidden to this husband ; separates, marries a 2nd ; same 3× → a 3rd ; same → forbidden to all until a bedika. Rama: "ein anu nohagin lehotzi'ah" (divorce no longer forced).
2Bedikat shefoferetA tube (שפופרת) with a מכחול wrapped in מוך, inserted to where "ha-shamash dash" ; blood at the tip → from the makor → asurah ; otherwise → from the tzedadin → muteret. "Af ba-zman ha-zeh one may rely on this bedika."
3Bedika under the 1st husband ; tza'ar/ke'evShe may examine herself under the 1st after 3× (heter for him) ; some forbid to the 1st from the 3rd tashmish on, even by bedika. One relies on the 1st opinion to be lenient. If tza'ar/ke'ev during relations → all agree one relies on the bedika with the 1st (Ritzva).
4Samuch le-vesetRelations samuch le-veset → one attributes to the veset, and it is not "machmat tashmish."
5Makah ; veset kavua ; sfek sfeikaA makah there → one attributes to the wound's blood ; if that blood differs → one does not. Rama: all this with a veset kavua (then one attributes outside the veset even without certainty the wound bled) ; without a veset kavua, if doubt makor/tzedadin → sfek sfeika ; but if certainly from the makor → one does not attribute (without veset kavua) unless certain the wound bleeds.
6Ne'emanut "makah yesh li"Believed to say "I have a wound there," or "I am sure this blood does not come from the makor" → tehorah.
7Chorim u-sedakim ; a single spotExamining all the chorim u-sedakim, if she finds blood only at a single spot on the side → attribute to a wound on that side ; all the more so if she feels pain there on touch and nowhere else.
8Refuah (treatment)Possible before the matter is chazak (established) ; afterward, some doubt ; some permit if a Jewish physician says she is cured ; if her sightings ceased through the treatments and they evidently worked → one relies even on a non-Jewish physician.
9Charerat dam ; ba-zman ha-zehSuddenly frightened, a charerat dam fell out and she was cured → permitted ; sees machmat tashmish again even once → not cured ; ba-zman ha-zeh one no longer permits by this means (Ramban/Raavad) ; but one does not separate her from the husband after this "treatment" until she bleeds again.
10Seen bishe'at tashmish ; leil tevilahSeen at the moment of tashmish: permitted a 2nd time after taharah ; the logic of the chashash once (leil tevilah), dilug, etc. Rama: 3× at the 1st bi'ah after each tevilah → forbidden (impossible to immerse and serve).
11After half a year ; a veset of machmat tashmishSeen machmat tashmish then, after six months, again → permitted (no veset set in 3 vestot) ; choshehet the last time ; if she fixed a veset of machmat tashmish 3× → permitted between the vestot, withdraws on the veset days until uprooted 3×.
12Asur le-hashhotahRo'ah machmat tashmish 3×: forbidden to keep her (to delay the divorce, formerly), except by a third party (shalish), who goes to her only with witnesses.
13BetulahOne who bleeds at the first relations → presumed dam betulim until one relations without bleeding ; then 3× → chazakah of machmat tashmish. Rama: even without it ceasing, if there is no pain at all, like all women (not dam betulim — Maharam Padua) ; a man who bleeds (pi ha-amah) → one attributes to him (Rashba ; cf. ק״צ ס״כ).
14Wounds/sores ; tevilah impossibleA woman with wounds/sores who cannot immerse → she leaves the husband, so as not to prevent him from peru u-revu.
כלל הפסק של הסימן :
הַכֹּל סָב סְבִיב בֵּרוּר מְקוֹר הַדָּם : אִם מִן המקור — חֲמוּרָה ; אִם מִן הצדדין אוֹ מִן המכה — יֵשׁ לְהָקֵל. וְהָרוֹאָה מחמת תשמיש ג' פְּעָמִים — אֲסוּרָה לְבַעַל זֶה, וְקִיֵּל הָרְמַ״א אין אנו נוהגין להוציאה. וְכָל קֻלּוֹת הַסִּימָן — בדיקת שפופרת, תולין (וסת / מכה / ספק ספיקא), וְנאמנות — תְּלוּיוֹת בִּקְבִיעַת הַמָּקוֹר, וּבִזְמַן הַזֶּה גַּם בָּרוֹפֵא.

3. שיטת הצמח צדק וחב״ד — Daat HaRav

Note on method (important). This part presents the Chabad halakhic approach to ro'ah machmat tashmish and Niddah. Unlike kashrut, here there is a genuine tradition of Chabad pesak. We present it at the level of principle and of the authorities ; we attribute to the Tzemach Tzedek and to no Rebbe any specific ruling, responsum number, or minhag that we could not verify. For the detail of a case — all the more so for so grave a case — the Chabad practice is to turn to a Chabad Rav or a Dayan, and, on the medical side, to a physician.

The Tzemach Tzedek — Chabad's authority of reference on Niddah

The Tzemach TzedekRabbi Menachem Mendel Schneersohn (1789-1866), the third Rebbe of Lubavitch and grandson of the Admur HaZaken — is the foremost posek of Chabad, in particular in Taharat haMishpacha. His collection of responsa and pisqei dinim (the Shut Tzemach Tzedek) covers Yoreh De'ah and the laws of Niddah extensively, and it is to him that the Chabad tradition turns first for these questions, including grave cases such as ro'ah machmat tashmish. At the level of principle, the Chabad school is characterized by great stringency in Taharat haMishpacha joined to the care of seeking the real heter where halakha permits — precisely what this siman aims at through diagnosing the source.

Daat HaRav and the heart of the siman. On the very bedrock of this siman — the gravity of ro'ah machmat tashmish, the distinction מקור / מכה / צדדין, the Rama's leniency (אין אנו נוהגין להוציאה), the paths of tolin and ne'emanut — the Chabad approach does not depart from the framework of the Shulchan Aruch and the Rama. Its distinctiveness shows in the rigor and delicacy with which so grave a case is handled, and in the systematic referral to the Rav (and the physician) for the real case. We attribute to it no specific provision (a regimen, a numbered ruling) that is not attested.

Lema'asse (Daat HaRav). According to the Chabad tradition, in these matters one follows the Tzemach Tzedek and the pisqei dinim transmitted in Chabad. For applying a real case — and above all the grave case of ro'ah machmat tashmish, which joins the medical and the halakhic — consult your Rav (or a Chabad Rav / Dayan / Yoetzet) AND a physician (gynecologist): this level presents the principle, it does not decide your situation, and never self-diagnosis.

4. ג' פעמים והקלקול — The Sequence, and "Ein Anu Nohagin Lehotzi'ah"

אִשָּׁה שֶׁרָאֲתָה דָּם מֵחֲמַת תַּשְׁמִישׁ מִיָּד... מְשַׁמֶּשֶׁת ג' פְּעָמִים, אִם בְּכָל ג' פְּעָמִים רְצוּפִים רָאֲתָה דָּם — אֲסוּרָה לְשַׁמֵּשׁ עִם בַּעַל זֶה, אֶלָּא תִּתְגָּרֵשׁ וְתִנָּשֵׂא לְאַחֵר... הַגָּה : וְיֵשׁ אוֹמְרִים שֶׁאֵין אָנוּ נוֹהֲגִין לְהוֹצִיאָהּ.

— שולחן ערוך יו״ד קפ״ז:א · מרדכי, תרומת הדשן, סמ״ג ; הגה : וי״א שאין אנו נוהגין להוציאה
The logic of the 3 times (the chazakah of the kilkul). Why three consecutive times? Because 3 times establish a חזקה: the blood is now attributed to the tashmish itself (a קלקול proper to this couple), and the concern of the makor takes hold. The Mehaber then describes a sequence: forbidden to this husband, she separates and marries a 2nd ; if same 3× with him → a 3rd ; if same with the 3rd → forbidden to all until a bedika that would establish the source.

"Ein kol ha-etzba'ot shavot" (Taz s.k. 2-3) and the Rama's leniency

The Taz (s.k. 2-3) explains the sequence of husbands by the principle אין כל האצבעות שוות ("not all fingers are alike") — husbands differ, and the blood may be tied to one and not another, hence the trial with a new husband. But the Rama rules, for our conduct, "י״א שאין אנו נוהגין להוציאה": the divorce is no longer forced. This is the major practical tendency today — the couple is not separated automatically ; it is accompanied by a Rav who will seek, through the bedika and the medical diagnosis, to establish the source and to permit.

Lema'asse (the 3 times and the leniency). The principle: seeing machmat tashmish 3 times in a row (and "immediately") creates a grave chazakah ; but per the Rama, one no longer forces divorce (ein anu nohagin lehotzi'ah), and one rather seeks the heter through diagnosing the source. Whether a case truly falls in this category, how to count the "3 times," and the couple's conduct — none of this is decided alone. Consult your Rav (or a Chabad Rav / Dayan / Yoetzet) AND a physician (gynecologist).

5. בדיקת שפופרת והאבחנה הרפואית — Makor or Tzedadin, Then and Now

כֵּיצַד בּוֹדֶקֶת — נוֹטֶלֶת שְׁפוֹפֶרֶת... וְנוֹתֶנֶת בְּתוֹכָהּ מִכְחוֹל וּבְרֹאשׁוֹ מוֹךְ, וּמַכְנֶסֶת אוֹתוֹ בְּאוֹתוֹ מָקוֹם עַד מָקוֹם שֶׁהַשַּׁמָּשׁ דָּשׁ ; נִמְצָא דָּם עַל רֹאשׁוֹ — בְּיָדוּעַ שֶׁהוּא מִן הַמָּקוֹר וַאֲסוּרָה ; וְאִם לָאו — מִן הַצְּדָדִין וּמֻתֶּרֶת. (וְאַף בִּזְמַן הַזֶּה יֵשׁ לִסְמֹךְ אַבְּדִיקָה זוֹ).

— שולחן ערוך יו״ד קפ״ז:ב · ב״י מהרמב״ם ; הר״ן, מהר״ם פדואה סימן י'
The mechanics (Taz s.k. 5 ; Emunat Shmuel). The Talmudic diagnosis is to isolate the צדדין (the walls) by means of a tube (שפופרת) into which one slides a מכחול wrapped in cotton (מוך), inserted "to where ha-shamash dash." If blood appears at the tip of the cotton → it is from the makor (the inside), and she is אסורה ; otherwise → from the tzedadin, and she is מותרת. The Taz (s.k. 5) details the apparatus, and the Emunat Shmuel (cited by the PT, s.k. 13) fixes its measure: the shefoferet is the שיעור אבר בינוני. The Mehaber rules: "af ba-zman ha-zeh," even today, one may rely on this bedika.

The continuity of the principle: today's medical diagnosis

The bedikat shefoferet of old and the modern medical diagnosis share one aim: to determine the source of the bleeding. Today, bleeding linked to relations ("contact" / post-coital bleeding) is first a medical question — a gynecologist looks for a cause at the level of the cervix, a polyp, an ectropion, fragility of the walls, etc. If the established source is a מכה or the צדדין (and not the מקור), that is often the path of the heter. The Rav and the physician work together: the physician establishes the fact (the source), the Rav derives the halakha. Never self-assessment.

Lema'asse (the bedika / the diagnosis). The principle: one permits if the source is established as from the tzedadin, one forbids if from the makor — and "af ba-zman ha-zeh" one relies on this diagnosis. In practice today, this diagnosis goes through a physician (gynecologist) and a Rav, never through oneself. Consult your Rav (or a Chabad Rav / Dayan / Yoetzet) AND a physician.

6. תולין — Veset, Makah, and the Rama's Sfek Sfeika

אִם יֵשׁ מַכָּה בְּאוֹתוֹ מָקוֹם — תּוֹלִין בְּדַם מַכָּתָהּ ; וְאִם דַּם מַכָּתָהּ מְשֻׁנֶּה מִדַּם רְאִיָּתָהּ — אֵינָן תּוֹלִים בְּדַם מַכָּתָהּ. הַגָּה : וְכָל זֶה בְּאִשָּׁה שֶׁיֵּשׁ לָהּ וֶסֶת קָבוּעַ... וְאִם אֵין לָהּ וֶסֶת קָבוּעַ וְהוּא סָפֵק — תָּלִינַן בְּמַכָּה מִכֹּחַ סְפֵק סְפֵיקָא.

— שולחן ערוך יו״ד קפ״ז:ד-ה · הגה : פסקי מהרא״י סימן מ״ז, הגהות ש״ד

Three ways to attribute the blood elsewhere (tolin)

"Chorim u-sedakim" and localized pain (seif 7). Seif 7 adds a factual indicator: if, examining all the חורים וסדקים (recesses), she finds blood at only a single spot, on the side → one attributes to a wound on that side ; and all the more so if she feels pain there on touch and nowhere else. The localized pain becomes a sign that the source is a makah (hence tzedadin), and not the makor — a reasoning that, today, the medical examination objectifies.

Lema'asse (the tolin). The principle: one may attribute the blood to a veset, to a makah, or be lenient through a sfek sfeika, according to fine conditions (veset kavua or not, blood meshuneh or not, certainty of the makor or not). These distinctions are questions of fact and of law not decided alone, and the makah itself belongs to a medical diagnosis. Consult your Rav (or a Chabad Rav / Dayan / Yoetzet) AND a physician.

7. נאמנות « מכה יש לי » — and "Bari Li She-eino Min ha-Makor"

נֶאֱמֶנֶת אִשָּׁה לוֹמַר מַכָּה יֵשׁ לִי בְּאוֹתוֹ מָקוֹם שֶׁהַדָּם יוֹצֵא מִמֶּנָּה ; וְכֵן אִם אוֹמֶרֶת בָּרִי לִי שֶׁאֵין דָּם זֶה בָּא מִן הַמָּקוֹר — נֶאֱמֶנֶת וּטְהוֹרָה.

— שולחן ערוך יו״ד קפ״ז:ו · מהרי״ו סימן כ״ה
The force of the ne'emanut (Mahari Weil). The Mehaber grants the woman a ne'emanut of her own: she is believed to say "מכה יש לי at that spot from which the blood comes," or "ברי לי that this blood does not come from the makor" → she is טהורה. It is a strong ne'emanut, an extension of the trust granted to the woman throughout Taharat haMishpacha (cf. siman 185). But it presupposes a real bari (a certainty, not a supposition), and, today, the existence of a makah is precisely what a physician can establish objectively.

Lema'asse (the ne'emanut). The principle: "I have a wound" / "I am sure it is not from the makor" has real halakhic value and can render tehorah. But this ne'emanut is exercised under the Rav's authority, and the reality of a makah belongs to the physician — it is not a self-diagnosis. Consult your Rav (or a Chabad Rav / Dayan / Yoetzet) AND a physician (gynecologist).

8. רפואה ובזמן הזה ובתולה — and the Medical Dimension

אִם תִּרְצֶה לְהִתְרַפְּאוֹת — צָרִיךְ שֶׁיְּהֵא קֹדֶם שֶׁתִּתְחַזֵּק... וְיֵשׁ מִי שֶׁמַּתִּיר אִם אָמַר לָהּ רוֹפֵא יִשְׂרָאֵל נִתְרַפֵּאת... וּבִזְמַן הַזֶּה אֵין מַתִּירִין עַל יְדֵי רְפוּאָה זוֹ. הַבּוֹעֵל אֶת הַבְּתוּלָה... מַחְזִּיקִין שֶׁהֵם דַּם בְּתוּלִים עַד שֶׁתְּשַׁמֵּשׁ פַּעַם אַחַת וְלֹא תִרְאֶה.

— שולחן ערוך יו״ד קפ״ז:ח-ט, יג · הרמב״ן וראב״ד ; תשו' מהר״ם פדואה סימן י' ; ב״י בשם הרשב״א

Refuah (seif 8) and ba-zman ha-zeh (seif 9)

What modern medicine changes — and does not change

Seif 9 closes an old path ("ba-zman ha-zeh ein matirin"), but seif 8 opens the role of the physician in treatment and cure. Modern medicine does not "permit" on its own: it diagnoses the source (cervix, polyp, ectropion, walls) and can treat the cause, which changes the fact on which the Rav rules. This is the sense of the medicine / halakha intersection of this siman: the physician establishes and treats, the Rav decides. One relies neither on the physician alone without a Rav, nor on the Rav alone without the medical finding.

The betulah (seif 13). A בתולה who bleeds at the first relations: one presumes דם בתולים (blood of virginity, not machmat tashmish) until one relations without bleeding ; then, if she sees again 3×, a chazakah of machmat tashmish. The Rama (in the name of the Maharam Padua, sim. 10) refines: even if the bleeding did not cease once, if there is no pain at all, she is "like all women" and one does not attribute to dam betulim. And a man who bleeds (pi ha-amah) → one attributes the blood to him (Rashba ; cf. siman ק״צ ס״כ).

Lema'asse (refuah / betulah). The principle: medical cure has a place (Jewish physician, even non-Jewish per the case), but certain old paths no longer hold "ba-zman ha-zeh" ; and for the betulah, the presumption of dam betulim and the question of pain frame the diagnosis. All this joins the medical and the halakhic and is never decided alone. Consult your Rav (or a Chabad Rav / Dayan / Yoetzet) AND a physician (gynecologist).

9. פסיקת הספרדים בזמננו — The Contemporary Sephardic Pesak

Note on method. The works cited below extend the principles of siman 187 for today's practice. They are cited as recognized streams of pesak, to be confirmed with a Rav — and, for this siman, with a physician — before any application.

The contemporary Sephardic pesak (the school of Rav Ovadia Yossef) starts from the Beit Yossef and the Shach. The practical reference is the Taharat haBayit of Rav Ovadia Yossef (and its abridgment Yalkut Yossef — Taharat haBayit, by Rav Yitzchak Yossef), which treats ro'ah machmat tashmish at length: the leniency (divorce is no longer forced, in the spirit of the Rama "ein anu nohagin lehotzi'ah"), reliance on diagnosing the source (bedika / medical examination) to permit the husband, and the value of the ne'emanut "makah yesh li." The spirit of this school tends to rely fully on the diagnosis, the woman's ne'emanut, and the paths of tolin to save the home where halakha permits.
Point of the simanSephardic orientation (to verify)
Machmat tashmish 3 timesDivorce no longer forced (Rama) ; one seeks diagnosis of the source. See Taharat haBayit / Yalkut Yossef.
Bedika / diagnosisOne relies on establishing the source (tzedadin / makah) — today through the physician — to permit. Modalities to the Rav.
Ne'emanut / tolinFull value of "makah yesh li" and of the paths of tolin (veset, makah, sfek sfeika), under the Rav's authority and with the medical finding.

10. פסיקת האשכנזים והממד הרפואי — The Ashkenazic Pesak and the Medical

Note on method. Same remark: these works extend the Rama and the nossei kelim ; they are cited as markers of pesak, to be confirmed with a Rav and a physician.

The Ashkenazic pesak starts from the Rama and the Shach, then from the great Niddah-specific commentary, the Sidrei Tahara, and the codifiers: the Chochmat Adam (and his Binat Adam) and the Aruch haShulchan (Yoreh De'ah), very developed on ro'ah machmat tashmish and diagnosing the source. The Noda BiYehuda is central here (via the Pitchei Teshuva, very rich on this siman): on a veset kavua fixed later, the shefa dam, the situation in pregnancy / nursing, and reading the results of the shefoferet. For the 20th century, the major practical reference is the Shevet haLevi of Rav Shmuel Wozner, often accompanied by the Badei haShulchan (the reference commentary on the Hilchot Niddah). And for the medical angle, the Nishmat Avraham (Rav Avraham S. Avraham) gathers the pesakim on contact bleeding, the gynecological examination, and diagnosing the source.
Point of the simanAshkenazic / medical orientation (to verify)
Bedika / diagnosisSidrei Tahara, Aruch haShulchan, Shevet haLevi on the source ; Nishmat Avraham for the medical examination and contact bleeding.
Noda BiYehudaVia the PT: a veset kavua fixed later, shefa dam, pregnancy / nursing, reading the shefoferet. To be brought to the Rav.
Ro'ah machmat tashmishSidrei Tahara, Shevet haLevi, Badei haShulchan ; a grave and medical subject, to the Rav AND the physician. Never alone.

Chabad within the pesak

For Chabad practice on this bedrock, one refers to the Tzemach Tzedek (whose Shut covers the laws of Niddah) and to the decisions transmitted in Chabad, with the care proper to the school in so grave a case. We attribute no specific ruling that is not verifiable ; for the detail, one turns to a Chabad Rav or a Dayan — and, on the medical side, to a physician.

11. סיכום מעשי — Summary and Tables

טבלה — The Axes of the Siman, in Practice

ConceptIn substanceReference
Machmat tashmish 3 timesChazakah of the kilkul → forbidden to this husband ; sequence of husbands ; Rama: "ein anu nohagin lehotzi'ah"Mehaber + Rama (seif 1) ; Taz s.k. 2-3
Bedikat shefoferetMakor (at the tip) → asurah ; tzedadin → muteret ; "af ba-zman ha-zeh"Mehaber (seif 2) ; Taz s.k. 5 ; PT s.k. 13
Samuch le-veset / makah / s.s.One attributes to the veset, the makah, or via sfek sfeika (per veset kavua)Mehaber + Rama (seif 4-5, 7)
Ne'emanut"Makah yesh li" / "bari li she-eino min ha-makor" → tehorahMehaber (seif 6) ; Mahari Weil
Refuah / ba-zman ha-zehTreatment before chazak ; Jewish/non-Jewish physician ; ba-zman ha-zeh some paths closedMehaber (seif 8-9) ; Ramban/Raavad
BetulahDam betulim presumed ; without pain → like all women (Maharam Padua)Mehaber + Rama (seif 13)

טבלה — Who Says What (Nossei Kelim of the Siman)

PosekDecisive contribution (corpus-anchored)
MehaberMachmat tashmish 3× → forbidden to this husband, sequence of husbands ; bedikat shefoferet ("af ba-zman ha-zeh") ; tolin (veset, makah) ; ne'emanut "makah yesh li" ; refuah ; betulah ; one who cannot immerse → she leaves.
Rama (הגה)"Ein anu nohagin lehotzi'ah" (divorce no longer forced) ; the conditions of tolin (veset kavua) and the sfek sfeika (seif 5) ; betulah without pain = like all women (Maharam Padua).
Tazs.k. 1 ("miyad") ; s.k. 2-3 (sequence of husbands, ein kol ha-etzba'ot shavot) ; s.k. 5 (mechanics of the shefoferet) ; s.k. 9 (dam makah meshuneh — as a rule one attributes).
Shach (Siftei Kohen)s.k. 1: the shiur of "miyad" (asham talui ; beyond it, tehorah).
Pitchei TeshuvaVery rich: Noda BiYehuda (a veset kavua fixed later ; shefa dam ; pregnancy/nursing ; reading the shefoferet) ; Emunat Shmuel (shefoferet = shiur ever beinoni) ; Shevut Yaakov (an elderly woman in pain).

טבלה — Daat HaRav and Contemporary Streams (to verify)

Chabad (Daat HaRav): the Tzemach Tzedek (Rabbi Menachem Mendel Schneersohn, 3rd Rebbe of Lubavitch) is Chabad's authority of reference on Niddah ; his Shut covers the Hilchot Niddah. The Chabad school joins stringency and the search for the real heter in these grave cases. For the detail of a case → Chabad Rav / Dayan (and physician). (No specific ruling is attributed here without a source.)
Sephardim: Taharat haBayit (Rav Ovadia Yossef) ; Yalkut Yossef — Taharat haBayit (Rav Yitzchak Yossef). They extend the Beit Yossef and the Shach: the Rama's leniency, diagnosing the source, the ne'emanut, the paths of tolin.
Ashkenazim & medical: Sidrei Tahara (key Niddah commentary) ; Chochmat Adam / Binat Adam ; Aruch haShulchan (YD) ; Noda BiYehuda (PT) ; Shevet haLevi (Rav Wozner) ; Badei haShulchan ; Nishmat Avraham (medical angle: contact bleeding, diagnosing the source).

Sefaria Links (Text and Nossei Kelim)

Shulchan Aruch YD 187: 187:1
Shach (Siftei Kohen): 187 s.k. 1
Pitchei Teshuva: 187 s.k. 1

👈 הלכה למעשה — The Golden Rule of This Level

  1. On the substance, retain the axes: the distinction makor / makah / tzedadin (the whole siman seeks the source), machmat tashmish 3 times and the Rama's leniency ("ein anu nohagin lehotzi'ah"), the bedikat shefoferet become a medical diagnosis, the paths of tolin (veset, makah, sfek sfeika) and the ne'emanut "makah yesh li."
  2. Daat HaRav (Chabad): one follows the Tzemach Tzedek and the pisqei dinim of Chabad, with the school's care and the search for the heter ; the detail is verified with a Chabad Rav / Dayan.
  3. Halacha lema'asse: Beit Yossef, Rama, Shach, Sidrei Tahara, Chochmat Adam, Aruch haShulchan, Noda BiYehuda, and the contemporary pesak (Taharat haBayit, Shevet haLevi, Badei haShulchan, Nishmat Avraham) — all on these same axes.
  4. This siman is halakhic AND medical: bleeding linked to relations is never diagnosed alone. The halacha lema'asse goes through your Rav (or a Chabad Rav / Dayan / Yoetzet) AND a competent physician (gynecologist) — never self-diagnosis.

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⚠️ This content is for study, on an intimate, grave, and medical subject (Taharat haMishpacha). The positions cited (Daat HaRav / Chabad, Sephardic and Ashkenazic streams) are markers, not a personal ruling, and authorize no self-diagnosis. For any practical application (לְמַעֲשֶׂה) — and absolutely for the case of ro'ah machmat tashmish — consult a qualified Rav (or a Chabad Rav / Dayan / a Yoetzet) AND a competent physician (gynecologist).

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