✦ ❖ ✦ D A A T · L E V E L 3 — S Y N T H E S I S / R E V I E W ✦ ❖ ✦
Siman 191 — Blood Found While Urinating
דם הנמצא במי רגליה
דם מכה from the bladder or kidney (טהורה), sitting or standing and the ספל, the shared vessel, the chronic case with pain, the בדיקת המוך, bleeding without pain, and stones (חול)
Structured review, master grid, fast memorization — to the Rav and a physician
Source: Shulchan Aroukh, Yoreh De'ah קצ״א — 1 seif
Nossei kelim: ש״ך (Shach) · ט״ז (Taz) · פתחי תשובה (Pithei Teshuva) · סדרי טהרה (Sidrei Tahara)
Compiled by: הרב יוסף חיים סממה · DAAT
For students who have mastered Levels 1 and 2
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📑 Outline of the synthesis
- The axiom: the blood of the urine is דם מכה, not דם המקור — טהורה
- The 3 reflex questions: from where · with or without pain · was the בדיקה done
- The master grid: sitting/standing, ספל, pain, מוך and stones
- The 5 golden rules
- Mnemonic — the "MOKH" memory aid
- The 4 classic pitfalls
- Recap of the 7 rules of the single seif — one line each
- Final flashcard
1. The axiom: the blood of the urine is דם מכה, not דם המקור — טהורה
The starting point:
Siman 191 does not deal with the blood of the נדה proper, but with blood found together with the urine. The question is: does this blood come from the מקור (the womb, which would render her טמאה) or from a wound (מכה) elsewhere? The Mehaber (single seif) rules: a woman who urinates and blood comes out with the urine, standing or sitting, is טהורה — for this blood is דם מכה from a wound in the חלחולת (the lower passage / bladder) or the כוליא (the kidney), and not from the חדר. וְאַף עַל פִּי שֶׁהִרְגִּישָׁה: even if she felt her body shudder, this is only the הרגשה of the urine (מי רגלים), which does not come from the מקור.
| Source of the blood | Status | What proves it |
|---|
| Blood coming out with the urine (חלחולת / כוליא) | טהורה — it is דם מכה | הרגשת מי רגלים ≠ הרגשת דם; medical diagnosis; בדיקת המוך |
| Blood from the מקור (the חדר) | טמאה — it is דם נדה | real הרגשה of blood; no identified wound |
| Grains of sand / gravel (חול וחצץ) | טהורה — it is not blood | kidney stones; the same in the urine |
💡 The marker: this siman does not ask "how much" but where the blood comes from. As long as the blood comes out with the urine, we attribute it to a wound of the urinary tract (דם מכה) and not to the מקור. But this is precisely a domain where the diagnosis belongs to a physician (urologist / gynecologist) and the decision to a Rav: never judge urinary bleeding on one's own.
2. The 3 reflex questions
■ WHERE DOES THE BLOOD COME FROM? (מכה / מקור) — does it come out with the urine (→ דם מכה from the חלחולת or the כוליא, טהורה) or is it blood from the מקור (→ טמאה)? The הרגשה felt here is only that of the urine, not of blood.
↓ we look at the pain
■ WITH OR WITHOUT PAIN? (כאב) — a chronic urinary condition with pain on urinating → יָדַיִם מוכיחות of a wound: permitted in every case. Without pain, checking afterward → if no blood in the urine: טמאה; if blood in the urine AND on the עד: מחלוקת → יש להחמיר.
↓ we look at the proof
■ WAS THE בדיקת המוך DONE? (מוך) — for the machmirim: בדיקה before urinating, מוך נקי on the מקור inside, urinate, wipe, remove the מוך. A clean מוך → great proof that the blood is not from the מקור (והכי נהוג).
⚖ The vessel and the diagnosis
We rule טהורה — when the criterion runs through the vessel — only if the blood is in the ספל in which she alone urinates (we then know it comes from her). If a man and a woman urinate into it, the blood is not attributed to the מקור: טהורה in every case. But in practice, the qualification "wound of the bladder / kidney" presupposes a medical diagnosis; every conclusion is taken with the Rav and the physician.
3. The master grid: sitting/standing, ספל, pain, מוך and stones
An absolute must to memorize. Basis: Mehaber (single seif) read with the Rama, the Taz (s.k. 1-4), the Shach (s.k. 1) and the Acharonim (Sidrei Tahara, Pithei Teshuva s.k. 7).
| Situation | Decisive criterion | Result |
|---|
| Blood coming out with the urine, sitting or standing (Mehaber) |
דם מכה (חלחולת / כוליא), not from the מקור |
🟢 טהורה, even with הרגשה (of the urine) |
| Standing & the ספל: in a stream (מקלחת) into the vessel, blood inside (Rama, י״א) |
The blood is inside the vessel |
🟢 טהורה |
| The blood runs onto the rim of the vessel (שפת הספל) |
מקור צר → the blood returns to it |
🔴 טמאה |
| Standing, not in a stream into the vessel (custom: והכי נהוג) |
Standing → always טמאה |
🔴 טמאה (custom) |
| A vessel into which a man and a woman urinate |
Blood not attributable to the מקור |
🟢 טהורה in every case |
| Blood regularly in the urine WITH pain (chronic condition) |
יָדַיִם מוכיחות of a wound |
🟢 טהורה in every case (even when wiping) |
| Without pain: no blood in the urine, blood on the עד |
Nothing ties it to a wound |
🔴 טמאה for certain |
| Without pain: blood in the urine AND on the עד |
מחלוקת (טמאה / טהורה by תמצית) |
🟡 יש להחמיר |
| Grains of sand / red gravel (חול וחצץ) |
Kidney stones, not blood |
🟢 טהורה |
📌 Key reading: first ask where the blood comes from (with the urine = מכה, טהורה), then look at the position and the ספל (the rim, שפת הספל, changes everything), then the pain (יָדַיִם מוכיחות), then the בדיקת המוך as proof, and finally distinguish blood from stones (חול). None of these conclusions is decided alone: to the Rav and the physician.
4. The 5 golden rules
- Blood coming out "with the urine" is דם מכה. A wound of the חלחולת or the כוליא, not from the מקור → טהורה, even with הרגשה (which is only that of the מי רגלים).
- Position & ספל (Rama). Sitting → permitted; standing → in a stream into the vessel with the blood inside → טהורה, but on the rim (שפת הספל) → טמאה; standing not in a stream → טמאה (והכי נהוג).
- The pain proves the wound. Blood regularly in the urine with pain → יָדַיִם מוכיחות → permitted in every case, even the blood found while wiping afterward.
- The בדיקת המוך is the master proof. מוך נקי on the מקור before urinating; removed clean → great proof that the blood is not from the מקור. After 3 times clean → permitted thereafter without בדיקה (חזקת דם מכה).
- Blood vs stones. Grains of sand / red gravel (חול וחצץ) are not blood but kidney stones → טהורה; never confuse them with bleeding.
5. Mnemonic — the "MOKH" memory aid
"M-O-K-H" — after the בדיקת המוך, the proof of the siman
- Makah (מכה): the blood of the urine comes from a wound of the חלחולת / כוליא, not from the מקור → טהורה.
- On which side? (sitting / standing & ספל): blood inside the vessel → טהורה; on the rim (שפת הספל) → טמאה.
- Ke'ev (כאב, the pain): blood regularly with pain → יָדַיִם מוכיחות → permitted.
- Hoxakha (the proof, the מוך): a clean בדיקת המוך, and after 3× → חזקת דם מכה; stones (חול) ≠ blood.
The ladder of position and vessel (Rama)
- sitting → permitted (the blood comes out with the urine)
- standing, in a stream into the ספל → blood inside the vessel → טהורה
- on the rim (שפת הספל) → טמאה (the מקור is narrow, the blood returns to it)
- standing, not in a stream → טמאה (והכי נהוג)
6. The 4 classic pitfalls
❌ Pitfall 1 — Judging urinary bleeding on one's own: finding blood while urinating is not a case to decide by oneself. The siman assumes one knows whether the blood comes from a wound of the urinary tract — which is the domain of a physician (urologist / gynecologist) — and the halakhic qualification belongs to a Rav. The practical rule: to the Rav and the physician, never a self-decision.
❌ Pitfall 2 — Confusing דם מכה and דם המקור: not all blood is equal. The blood of a wound (מכה) of the bladder or kidney, emerging with the urine, leaves her טהורה; blood from the מקור (the חדר) renders her טמאה. The הרגשה does not decide on its own: here it is only that of the מי רגלים, not of blood. The distinction is confirmed by the diagnosis and the בדיקה.
❌ Pitfall 3 — Forgetting the בדיקת המוך: for the machmirim, one permits (a woman with a וסת) only by means of the בדיקת המוך: check in חורין וסדקין beforehand, insert a מוך נקי on the מקור inside, urinate, wipe well, then remove the מוך. A clean מוך = great proof (והכי נהוג); after 3 times clean → חזקת דם מכה. To skip this בדיקה is to lose the central proof.
❌ Pitfall 4 — Taking stones for blood: if she then finds only grains like sand / red gravel (חול וחצץ), and likewise in the urine, this is not blood but the sand of the kidneys (stones) → טהורה. Do not treat kidney stones as nidda bleeding.
For the halacha le-ma'aseh, consult your Rav — and, for the diagnosis, a physician.
7. Recap of the 7 rules of the single seif — one line each
| Rule | Topic | The essential |
|---|
| 1 | Base rule — דם מכה | Blood coming out with the urine, standing or sitting → טהורה: דם מכה from the חלחולת or the כוליא, not from the מקור. Even with הרגשה: it is only the sensation of the urine (מי רגלים). |
| 2 | Sitting / standing & the ספל (Rama) | י״א that one permits only sitting; standing, in a stream (מקלחת) into the vessel with the blood inside → טהורה, but on the rim (שפת הספל) → טמאה (מקור צר, the blood returns and comes out); י״א even sitting, only in a stream and blood inside the vessel; standing → always טמאה (והכי נהוג). |
| 3 | Shared vessel | One permits only if the blood is in the ספל into which she alone urinates (we know it comes from her); if a man and a woman urinate into it → טהורה in every case. |
| 4 | Chronic case with pain | A woman who regularly sees blood in her urine and feels pain on urinating → permitted in every case (יָדַיִם מוכיחות of a wound that pains her); even blood found after urinating, while wiping → טהורה. |
| 5 | The בדיקת המוך (machmirim) | י״א to permit (a woman with a וסת) only with בדיקה: check beforehand in חורין וסדקין; insert a מוך נקי on the מקור inside; urinate; wipe well; remove the מוך — clean = great proof (והכי נהוג). After 3 times clean → permitted thereafter without בדיקה (חזקת דם מכה). |
| 6 | Without pain | Without pain, checking after urinating: if there is no blood in the urine → certainly טמאה; if there is blood in the urine AND on the עד → מחלוקת (טמאה / טהורה by תמצית) → יש להחמיר. |
| 7 | Stones (חול) | If she then finds only grains like sand / red gravel (חול וחצץ), and likewise in the urine → טהורה: it is not blood but the sand of the kidneys (stones). |
8. Final flashcard
| Question | Reflex answer | Source |
|---|
| Blood with the urine, sitting or standing? | טהורה — דם מכה (חלחולת / כוליא), even with הרגשה | Mehaber (single seif) |
| Standing: in a stream into the ספל, blood inside? | טהורה; on the rim (שפת הספל) → טמאה | Rama; Taz s.k. 1-2 |
| A vessel into which a man and a woman urinate? | טהורה in every case | Mehaber; Shach s.k. 1 |
| Blood regularly in the urine with pain? | Permitted in every case (יָדַיִם מוכיחות) | Rama; Pithei Teshuva |
| How to prove it (a woman with a וסת)? | בדיקת המוך; clean 3× → חזקת דם מכה | Rama (machmirim); Sidrei Tahara |
| Without pain, blood in the urine AND on the עד? | מחלוקת → יש להחמיר | Mehaber; Acharonim |
| Only grains of sand / red gravel? | טהורה — kidney stones, not blood | Mehaber (single seif) |
| Who decides in practice? | The Rav (halacha) and the physician (diagnosis) | Nishmat Avraham (the medical angle) |
⚖ The reflex in 3 questions
- Where does the blood come from? With the urine → דם מכה (טהורה); from the מקור → טמאה. The הרגשה here is only that of the urine.
- Position, ספל, pain? Standing/sitting and the rim of the vessel change everything; the pain (יָדַיִם מוכיחות) permits; the clean מוך proves.
- Blood or stones? Grains of sand (חול) = stones, not blood. And always: the decision is taken with the Rav and the physician.
For the halacha le-ma'aseh, consult your Rav — and a physician for the diagnosis.
🎓 Recap of the study path
| Level | Content | Acquired |
|---|
| 🌱 Level 1 — Base |
Text of the single seif, vocalized translation, clear tables and practical cases |
Overall understanding |
| ⚡ Level 2 — Lamdan |
Yesod of דם מכה בחלחולת/כוליא vs דם המקור, the machloket on עומדת/יושבת & הספל, יָדַיִם מוכיחות and חזקת מכה, דם vs חול |
In-depth study |
| ✨ Level 3 — Synthesis |
Master grid, golden rules, mnemonic, pitfalls, recap of the 7 rules |
Practical mastery + review |
| 🏛️ Level 4 — Daat HaRav (Chabad) & Halacha lema'asse |
The Tzemach Tzedek of Lubavitch and the Chabad mesorah; the psak of the Acharonim (Sidrei Tahara, Chochmat Adam, Aruch haShulchan, Taharat haBayit, Shevet haLevi, Nishmat Avraham for the medical angle) |
Daat HaRav + halacha lema'asse |
💡 Suggested next steps:
- Re-read Siman קצ״א in the original Choulhan Aroukh (Hebrew) with the Shach and the Taz
- Study the adjacent Simanim: 187 (כתמים and wounds), 188 (the color of the blood), 190 (blood that separated from the נדה), 196 (the בדיקה and the הרגשה)
- Delve into the yesod of דם מכה and the distinction מקור / חלחולת / כוליא
- Discuss personal cases with a Rav (hematuria, cystitis, stones) — the halacha le-ma'aseh is decided with a Rav, and the diagnosis with a physician
📖 Sources of this siman on Sefaria:
~ ~ ~ ~ ~
DAAT · הרב יוסף חיים סממה
תלמיד חכם · מעביר שיעורים בהלכה ובחסידות
סימן קצ״א · Level 3 — Synthesis / Review · דם הנמצא במי רגליה
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