Draft. This siddur is waiting for a rav's review. For a halachic question, ask your rav.
Hebrew, then English. Open "What it means" under any line for the explanation.
רפואה
Title: Healing
Healing. (The title of this blessing.)
The Gemara (the rabbis' discussions built on the Mishnah) asks why this is the eighth blessing. Rabbi Acha (a sage of the Gemara) answers: a brit milah (circumcision) is held on the eighth day, and it needs healing, so the blessing for healing was set eighth.
Megillah 17bרְפָאֵנוּ יְיָ וְנֵרָפֵא הוֹשִׁיעֵנוּ וְנִוָּשֵׁעָה כִּי תְהִלָּתֵנוּ אָתָּה
Heal us, Hashem, and we will be healed; save us and we will be saved, for You are our praise.
"Heal us" comes from a verse in Yirmeyahu (the prophet Jeremiah): "Heal me, Hashem, and I will be healed" (17:14). The prayer makes it plural. The Shulchan Aruch (the main code of Jewish law) allows this: the rule against switching a verse between singular and plural is for reading it as a verse, not for using it as a prayer.
Shulchan Aruch, Orach Chaim 116:1; Yirmeyahu 17:14וְהַעֲלֵה אֲרוּכָה וּמַרְפֵּא לְכָל תַּחֲלוּאֵינוּ וּלְכָל מַכְאוֹבֵינוּ וּלְכָל מַכּוֹתֵינוּ
And bring a cure and healing for all our sicknesses, and for all our pains, and for all our wounds.
And bring a cure and healing for all our sicknesses, for all our pains, and for all our wounds.
Abudarham (a commentary on the prayers, Spain, about 1340) ties the words to verses. "Sicknesses" echoes Tehillim 103:3, "who heals all your sicknesses." "Pains" echoes Iyov (Job) 5:18, "He causes pain, and He also binds up."
Abudarham, Weekday Prayers, Amidah; Tehillim 103:3; Iyov 5:18To pray for a particular sick person, add your own plea here (the siddur prints one), then continue:
כִּי אֵל מֶלֶךְ רוֹפֵא נֶאֱמָן וְרַחֲמָן אָתָּה.
For God and King, a faithful and merciful healer are You.
For You are God and King, a faithful and merciful healer.
Abudarham ties "merciful" and "faithful" to Devarim (Deuteronomy) 28:59. In a list of punishments, that verse speaks of "bad" sicknesses and "ne'emanim" ones, the same word as "faithful." Rashi explains it there: sure to do the job they were sent to do. Against the bad sicknesses, God is a merciful healer. Against the ne'emanim ones, a faithful healer.
Abudarham, Weekday Prayers, Amidah; Devarim 28:59 with Rashiבָּרוּךְ אַתָּה יְיָ רוֹפֵא חוֹלֵי עַמּוֹ יִשְׂרָאֵל.
Blessed are You, Hashem, healer of the sick of His people Israel.
Abudarham ties the ending to Devarim 32:39, where God says: "I wounded, and I will heal."
Abudarham, Weekday Prayers, Amidah; Devarim 32:39For a sick person, add the plea printed after "our wounds": "May it be Your will, Hashem our God and God of our ancestors, to quickly send a complete healing from heaven ... to (name), son or daughter of (mother's name), among the other sick of Israel." Start the blessing first, then add it.
Siddur Sefard; Shulchan Aruch, Orach Chaim 119:1, with the RemaThe first line comes from Yirmeyahu (Jeremiah), a prophet people mocked. In the next verse they say to him: "Where is the word of God? Let it come." Radak (Rabbi David Kimchi, a medieval commentator from southern France) says the wound Yirmeyahu asks God to heal is not an illness. He points to Yirmeyahu 15:18, "Why is my pain endless, my wound incurable?", and says that pain and wound are the disgrace and the curse.
Radak on Yirmeyahu 17:14; Yirmeyahu 15:18 and 17:15When Moshe's sister Miriam was struck with a skin disease, he cried out to God: "El na refa na lah." That is five words in Hebrew (Bamidbar 12:13). Rabbi Eliezer (a sage of the Mishnah) heard his students complain that a prayer leader was too brief. He answered that the man was no briefer than Moshe.
Bamidbar 12:13; Berakhot 34aOur version asks God to "bring up" arukhah and marpe, two words for healing. They appear together in Yirmeyahu 33:6, where God says: "I am going to bring up healing and cure for her." The verb matters. Yirmeyahu 8:22 asks: "Is there no balm in Gilead? Is there no healer there? Why has healing not come up?" In 30:17 God promises: "I will bring up healing for you."
Yirmeyahu 8:22, 30:17 and 33:6; Siddur SefardThe blessing ends by calling God the healer of the sick. So is medicine optional? The Gemara answers from a verse. Shemot 21:19 says a person who injures someone must pay for his healing. The Hebrew doubles the verb: verapo yerape. The school of Rabbi Yishmael (early sages, from the time of the Mishnah) read that as: the Torah gave a doctor permission to heal (Bava Kamma 85a).
The Gemara also records an argument about how to pray before treatment. Rav Acha taught a prayer for someone about to be bled, a common treatment then. It says: You are a faithful healer, and Your healing is true, since people do not really heal, they are just used to it. Abaye objected: do not say it that way, because the Torah gave doctors permission. Rashi (the main Torah commentator, France, around 1100) explains Rav Acha's view like this: they should not have taken up medicine, only asked for mercy (Berakhot 60a).
The Ramban (Nachmanides, a Torah commentator who lived in Spain and died in the Land of Israel around 1270) describes an ideal. When the people are fully faithful, God keeps sickness away, and they do not need a doctor. But people became used to medicine. Once someone is sick and comes for treatment, the doctor should not refuse. Ibn Ezra (a Spanish commentator of the 1100s) reads the verse more narrowly. The Halleluyah prayer for Tehillim 146 tells his view.
The Shulchan Aruch (the main code of Jewish law, from the 1500s) rules without that hesitation. Healing is permitted, it is a mitzvah (a commandment), and it counts as saving a life. A doctor who holds back "sheds blood," even if someone else could treat the patient (Yoreh Deah 336:1).
So the sources do not set prayer against medicine. They differ on how to describe the doctor's role. Rav Acha, the Ramban and Ibn Ezra each describe it differently, and the Shulchan Aruch records the ruling.
Shemot 21:19,Bava Kamma 85a,Berakhot 60a,Ramban on Vayikra 26:11,Ibn Ezra on Shemot 21:19,Shulchan Aruch, Yoreh Deah 336:1The first line is a verse, and in the verse it is singular: "Heal me, Hashem, and I will be healed" (Yirmeyahu 17:14). The siddur turned "me" into "us." Abudarham (a commentary on the prayers, written in Spain around 1340) notices the change and asks whether it is allowed.
He cites an earlier rabbi's answer: there is a rule against changing a verse from singular to plural when you are reading it as Scripture. But a verse you use as a prayer is a prayer, and may be adjusted to the moment. Rabbeinu Yonah (a Spanish rabbi of the 1200s) adds a limit: if you say a whole psalm in order, do not change it. The Rosh (a leading rabbi in Germany and Spain, who died in 1327) agrees.
That settles the technical question. It does not say why "us" is better. The Gemara has a teaching that points the same way: "Anyone who asks for mercy for his friend, and needs the same thing himself, is answered first" (Bava Kamma 92a). It gives two proofs. God restored Iyov (Job) when he prayed for his friends. And Avraham prayed for the household of Avimelech, a king he had dealings with, to be healed, and right after that the Torah says God remembered Sarah (Bereishit 20:17 and 21:1). The Gemara says this about prayer in general. It does not mention this blessing.
The siddur still gives you room to name one person. The Rema (Rabbi Moshe Isserles of Krakow, whose notes on the Shulchan Aruch record Ashkenazi custom) writes, quoting Rabbeinu Yonah, that for a real personal need, like a sick person at home, you ask in the singular, not the plural (Orach Chaim 119:1). The printed paragraph does something related. It names one sick person, and then places that person "among the other sick of Israel."
So the siddur has two layers. The blessing asks for everyone. The paragraph inside it names one person.
Yirmeyahu 17:14,Abudarham, Weekday Prayers, Amidah,Bava Kamma 92a,Rema, Orach Chaim 119:1Nothing in these sources promises a cure. They show both answers, even for the same person praying.
Moshe cried out five words for Miriam. God's reply: she must stay outside the camp for seven days, and then she may come back (Bamidbar 12:13-15). Another time Moshe begged to enter the Land of Israel. God told him: "Enough. Do not speak to Me again about this" (Devarim 3:23-26).
King Chizkiyahu (Hezekiah) was told by the prophet Yeshayahu: "Set your house in order, for you will die and not live." He turned his face to the wall and prayed. God sent Yeshayahu back: "I have heard your prayer, I have seen your tears. I am adding fifteen years to your life" (Yeshayahu 38:1-5). In the Gemara he says he has a family tradition: even if a sharp sword is resting on a person's neck, he should not hold back from praying for mercy (Berakhot 10a).
Rabbi Chanina ben Dosa, a sage known for his prayers for the sick, would pray for patients and then say: "This one will live and this one will die." Asked how he knew, he said: "If my prayer flows smoothly in my mouth, I know it is accepted. If not, I know it is rejected" (Mishnah Berakhot 5:5). In the Gemara he adds that he is no prophet, only passing on a tradition (Berakhot 34b). Notice that his own sentence expects some patients to die.
These sources do not explain why one prayer is answered and another is not. What they give is an instruction: do not hold back from praying, even when it looks hopeless. The Asher Yatzar prayer looks at a related question, why people get sick at all.
Bamidbar 12:13-15,Devarim 3:23-26,Yeshayahu 38:1-5,Berakhot 10a,Mishnah Berakhot 5:5,Berakhot 34bShort ideas from the Chassidic masters, the Kabbalah and the Mussar teachers.
Rabbi Nosson of Breslov, the closest student of Rebbe Nachman of Breslov (a Chassidic master who died in 1810), starts from the Gemara (Megillah 17b): this blessing comes eighth because a brit milah (circumcision) is done on the eighth day, and it needs healing. He says the brit heals the soul, but only by passing through pain. So "Heal us and we will be healed" asks for two cures: the healing, and relief from the pain of the healing. Now read "and we will be healed" again.
וְזֶה בְּחִינַת רְפָאֵנוּ ה' וְנֵרָפֵא שֶׁמִּתְפַּלְּלִין עַל שְׁתֵּי רְפוּאוֹת, דְּהַיְנוּ לְרַפֹּאת כְּאֵב הָרְפוּאָה
Rabbi Nosson of Breslov, Likutei Halachot, Orach Chaim, Laws of Passover 8:6Rabbi Chaim Tyrer of Czernowitz, a Chassidic teacher whose book was first printed in 1820, explains why we say "Heal us" three times a day even when we are not sick. All of Israel is one person, he writes, and surely there is no day when someone in the Jewish people is not sick. Now say "Heal us" again with that "us" in mind.
אנו אומרין בכל יום שלושה פעמים רפאינו אף שאין כל אחד צריך לרפואה, מכל מקום כיון שכל ישראל אדם אחד הוא
Rabbi Chaim Tyrer of Czernowitz, Be'er Mayim Chaim, on Shemot 3:17Rabbi Tzadok HaKohen of Lublin, a Chassidic teacher in 19th-century Poland, says "Heal us" is on the surface about the body, but it is also about the soul: healing from the urge to do wrong. He leans on Rabbi Avun in the Yerushalmi (the Gemara of the Land of Israel), who reads "Hashem will remove from you all sickness" as that urge, which starts sweet and ends bitter. Not everyone reads the blessing this way: the Kaf HaChaim, a book of Jewish law, reports a debate over adding "of our souls" to it.
וזהו המכוון בברכת רפאנו רפואת הנפש מהיצה"ר שהוא חולי
Pri Tzadik, Chanukah 9; Yerushalmi Shabbat 14:3; Kaf HaChaim, Orach Chaim 116:2The practical laws. For a final ruling, ask your rav.
Here. The Gemara (Avodah Zarah 8a) says if someone at home is sick, you ask for them in this blessing. The Shulchan Aruch (the main code of Jewish law) quotes Rabbeinu Yonah (a medieval Spanish sage): for your own need, ask in the singular, even mid-blessing. For all the sick of Israel, use the plural, only at the end. The Arukh HaShulchan (a code from around 1900) says the Rambam and the Rosh (two leading medieval rabbis) do not require this and the law follows them, but it is good to follow Rabbeinu Yonah.
Avodah Zarah 8a; Shulchan Aruch, Orach Chaim 119:1; Arukh HaShulchan, Orach Chaim 119:3You do not have to. The Kaf HaChaim (a Sephardic law commentary from the early 1900s) cites a ruling: if you do not want to break into your Amidah to pray for the person, have them in mind when you say "Rofe cholei amo Yisrael" (Healer of the sick of His people Israel). He also cites a view to think of the person in this blessing and pray for them in words in Shema Koleinu, the blessing for hearing prayer, where the Shulchan Aruch says you may ask for any need.
Kaf HaChaim, Orach Chaim 119:1; Shulchan Aruch, Orach Chaim 119:1It depends on whether the person is there. The Gemara (Berakhot 34a) says no: Moshe prayed "God, please heal her" for his sister Miriam without naming her. The Mishnah Berurah (the standard commentary on the Shulchan Aruch, early 1900s) adds that this holds only when the person is in front of you. If not, say the name. The Arukh HaShulchan adds the father's or mother's name, so it is clear whom you mean. The prayer printed here has a place for the mother's name.
Berakhot 34a; Mishnah Berurah 119:2; Arukh HaShulchan, Orach Chaim 119:1Not in this blessing, says the Mishnah Berurah, citing the Pri Megadim (a commentary on the Shulchan Aruch). The permission is for someone who actually has a sick person. A request about the future, such as "let no one get sick," does not belong in the middle blessings. In Shema Koleinu, the same source says, you may ask even about the future.
Mishnah Berurah 119:1Yes. The Shulchan Aruch rules that the Torah gave the doctor permission to heal, that it is a mitzvah, and that it counts as saving a life. The Taz (a commentary on it) explains: real healing comes through prayer, but not everyone earns that, so we also heal by the ways of nature.
Shulchan Aruch, Yoreh Deah 336:1; Berakhot 60a; Taz on Yoreh Deah 336:1רפאני ה׳ וארפא הושיעני ואושעה כי תהלתי אתה
Heal me, Hashem, and I will be healed. Save me, and I will be saved. For You are my praise.
הוא בקש רפואה מן המכה והכאב ... והכאב והמכה כמו שפירשנו הוא הבזוי והקללה
He asked for healing from the wound and the pain... and the pain and the wound, as we explained, are the disgrace and the curse.
ומה ראו לומר רפואה בשמינית אמר רבי אחא מתוך שנתנה מילה בשמינית שצריכה רפואה לפיכך קבעוה בשמינית
And why did they put healing eighth? Rabbi Acha said: because circumcision was given on the eighth day and it needs healing, they set the blessing eighth.
אבל פסוק של תפלה שאין כוונת הצבור לקרותם אלא להתחנן דרך תפלה ובקשה הרי הן כשאר תפלות ורשאין לשנותן כפי צורך השעה
But a verse of prayer, where the congregation does not mean to read it but to plead in prayer and request, is like other prayers, and they may change it as the moment needs.
ויצעק משה אל ה׳ לאמר אל נא רפא נא לה
Moshe cried out to Hashem: Please, God, please heal her.
דבי רבי ישמעאל אומר ורפא ירפא מכאן שניתן רשות לרופא לרפאות
The school of Rabbi Yishmael taught: "He shall surely heal." From here, permission was given to the doctor to heal.
כיון שחלה החולה ובא להתרפאות כי נהג ברפואות והוא לא היה מעדת השם שחלקם בחיים אין לרופא לאסור עצמו מרפואתו
Once the sick person has fallen ill and comes to be healed, since he has followed the way of medicine and is not one of God's community whose share is in life, the doctor should not hold himself back from healing him.
נתנה התורה רשות לרופא לרפאות ומצוה היא ובכלל פיקוח נפש הוא ואם מונע עצמו הרי זה שופך דמים
The Torah gave the doctor permission to heal. It is a commandment and counts as saving a life. If he holds himself back, he is like one who sheds blood.
כל המבקש רחמים על חבירו והוא צריך לאותו דבר הוא נענה תחילה
Anyone who asks for mercy for his friend, while needing the same thing himself, is answered first.
אם שגורה תפלתי בפי יודע אני שהוא מקובל ואם לאו יודע אני שהוא מטורף
If my prayer is fluent in my mouth, I know it is accepted. If not, I know it is rejected.
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