Diabetes & Arba Kosos
One of the important Mitzvos of the Seder is drinking the Arba Kosos, the Halachos of which are elucidated at the beginning of Perek Arvei Pesachim (117b). Rashi explains that the four Kosos correspond to the four expressions of Geula.
Most people fulfill this Mitzva with relative ease and enjoyment. However, there are those – particularly diabetics – for whom the Mitzvos of Arba Kosos (and Matza) pose a serious challenge and who need to carefully prepare so that they can fulfill the Mitzvos of the Seder. Pregnant women who are advised to refrain from drinking alcohol and women with gestational diabetes who must restrict their carbohydrate intake and do not even drink grape juice may also have significant difficulty fulfilling the Mitzva of Arba Kosos.
In this essay we intend to provide a broad overview of the topic to offer guidance and practical Halacha.
- The Type of Wine
The Shulchan Aruch (O.C. 472:11-12) rules that it is a Mitzva to procure red wine, unless the white wine available is of a higher quality. A person also fulfills his obligation if he uses pasteurised wine (Yayin Mevushal) and Kunditon.
Red wine is preferable either because it reminds us of the blood of the Jews in Mitzrayim or because it is considered a more distinguished beverage. As stated, the Shulchan Aruch rules that if the white wine is of a higher quality, it is preferable. The Poskim add that if a person dislikes the taste of red wine, he may choose to drink white wine instead (though some recommend that he color it with some red wine, in which case he should pour the white wine into the red to avoid violating the Melacha of Tzvia – coloring).
Although there is a preference for non-Mevushal wine, the Mishna Berura (ibid. 39) rules that if the available non-Mevushal wine is inferior, a person may drink the Mevushal. It is preferable to use non-Mevushal wine to fulfill the opinion of the Rambam (Hilchos Shabbos 29:14) who rules that the wine for Kiddush must be fit for the Nesachim (libations) on the Mizbe’ach. The Shulchan Aruch (O.C. 272:12) cites the Rambam’s view. Therefore, although the Minhag is not in accordance with the Rambam, it is preferable to take his view into account. It follows that grape juice, which is pasteurised, is not as suitable as wine for fulfilling the Mitzva.
There is an additional reason that grape juice is inferior to wine with regard to Arba Kosos. The Arba Kosos are supposed to be drunk Derech Cherus – in a manner of liberty and freedom. Tosfos and the Rashbam (Pesachim 108b) rule than in order to fulfill the Mitzva of Simchas Yom Tov a person is obliged to drink “Yayin haMesame’ach” – wine with an alcoholic content which gladdens the heart. Therefore, the same should be applied to Arba Kosos – in order to fulfill the condition of Derech Cherus a person must drink Yayin haMesame’ach (Pri Megadim, Mishbetzos Zahav, end of O.C. 472 and Pri Chadash O.C. 483 citing the Maharchash). Rav Moshe Feinstein zt”l disqualified grape juice for Arba Kosos for these reasons.
Nevertheless, it is widely understood that those who find it difficult to drink wine, or those who will find it difficult to fulfill the other Mitzvos of the Seder because of the wine, may use grape juice instead. Rav Ovadia Yosef zt”l (Chazon Ovadia, 2, p125) related that it was preferable for him to use grape juice as he could not drink wine “Derech Cherus”. This was also the custom of the Brisker Rav zt”l, the Tchebiner Rav zt”l (as attested by Rav Moshe Sternbuch Shlit”a – Teshuvos v’Hanhagos 2:243), and the Chazon Ish zt”l (Sidur Pesach k’Hilchaso 3, footnote 25 citing R’ Chaim Kanievsky Shlit”a). Their position is particularly applicable to women who have no obligation to drink wine to fulfill Simchas Yom Tov (see O.C. 529).
To understand the basis of this Halacha we will examine the words of the Shulchan Aruch (O.C. 472:10):
A person who does not drink wine, either because it causes him harm or because he dislikes it, must force himself to drink it to fulfill the Mitzva of Arba Kosos.
The Shulchan Aruch’s source is the Gemara in Nedarim (50) which relates that R’ Yehuda b’R’ Ilai and R’ Yona would “bind their heads until Shavuos” due to the Arba Kosos!
The Mishna Berura explains that the “harm” referred to by the Shulchan Aruch is the discomfort of drinking wine and the headache that results. It does not mean to include a person who will become bedridden due to drinking Arba Kosos, as that could not possibly constitute Derech Cherus (Sha’ar haTziyun).
Rav Elyashiv zt”l pointed out that the argument that causing a person to become bedridden does not constitute Derech Cherus should also apply to a person who dislikes wine and who forces himself to drink it. It is therefore difficult to understand why the Shulchan Aruch expects a person who dislikes wine to force himself to drink it.
In any case, these arguments serve as the basis to permit those who find it difficult to drink wine, to use grape juice instead. If possible, the grape juice should be mixed with wine.
Regarding those with diabetes – it may be better to drink dry wine than grape juice which is replete with fruit sugars. We will discuss this in greater detail below.
- Raisin Wine
Raisin wine is inferior even to grape juice for Arba Kosos. The Shulchan Aruch (O.C. 272:6) rules that a person may make Kiddush on raisin wine, but the Rema qualifies that the raisins must have retained some moisture before they were soaked. If raisin wine is acceptable for Kiddush, it would also be acceptable for Arba Kosos (Radvaz 1:479, Taz O.C. 472:10, and Mishna Berura ibid. 37 in the name of the Acharonim). However, since it has no alcoholic content, it is inferior to wine.
How is raisin wine prepared?
Raisins that are still moist enough to squeeze out some liquid should be checked carefully to be sure that they are free of Chametz. They should then be soaked in hot water with a detergent and rinsed several times. Following the rinsing, they should be placed in hot water – with an equal ratio of water to raisins – and left for at least three days (see Taz O.C. 202:10 and Magen Avraham ibid. 27), or boiled up again (as explained by the Kneses haGedola O.C. 1 and others). When soaking the raisins, one should press them daily and, at the end of the soaking, squeeze them for the wine. The volume of water in respect to the raisins must be such that the beverage has a taste of wine (Biur Halacha 272, s.v. “Mekdashin”). Raisin wine made in this manner is acceptable for Arba Kosos.
- Chamar Medina
If a person is unable to drink wine or grape juice, he may use Chamar Medina – an important beverage that is widely consumed in that country. This is codified by the Shulchan Aruch (O.C. 272:9):
In a place where wine is uncommon, some say that one may make Kiddush on beer or other beverages aside from water. Other say that one may not do so.
What constitutes Chamar Medina?
The Gemara (Pesachim 107a) cites date beer as an example of Chamar Medina. Beer produced from more expensive fruits would certainly qualify as Chamar Medina – in fact, any type of beer may be used according to the Beis Yosef (O.C. 272). The Rema (O.C. 182:2) asserts that beer is the best form of Chamar Medina.
Unfortunately, the alcohol content in beer presents an issue for diabetics. We therefore need to consider other forms of Chamar Medina.
There is a dispute among the Poskim as to whether coffee, tea, or milk constitute Chamar Medina. The Halachos Ketanos (1:9) maintains that a beverage can only be considered Chamar Medina if it quenches thirst and intoxicates. Therefore, coffee, tea, and milk would not qualify (see Birkei Yosef 296:2). The Mishna Berura (ibid. 25) rules that milk is not Chamar Medina because it is not drunk as a beverage [though today that is no longer the case]. The Maharsham (Da’as Torah, O.C. 296:2) rules that there is room to consider milk as Chamar Medina (where it is customarily used as a beverage) as it is slightly intoxicating. The Aruch haShulchan (O.C. 272:14) rules similarly. Rav Moshe Feinstein zt”l (Igros Moshe, O.C. 2:75) concluded that milk and tea should only be considered Chamar Medina in very pressing circumstances. Rav Ovadia Yosef zt”l held that only beer is acceptable as Chamar Medina, but not coffee, tea, or fruit juice.[Some Poskim disqualify Chamar Medina for Arba Kosos, as “Ein Shira Ela Al haYayin” – songs and praises of Hashem should only be made on wine. However, this is not the position of the Rema (O.C. 283) as evident from the Mishna Berura (272:37).]
Therefore, it is preferable that a diabetic not use Chamar Medina as Arba Kosos and, as will be discussed below, he should be Yotzai Kiddush through somebody else who is drinking wine.
Those who follow the Ashkenazic custom of reciting a Bracha on each of the Arba Kosos should not do so when using Chamar Medina. Since Shehakol is recited rather than haGafen, a Bracha is only appropriate for the first and third Kosos.
- Diluting Wine
If a person finds it difficult to drink wine, he may dilute it with water. He must ensure that the mixture comprises [at least] 51% wine and that it tastes like wine. (However, he must clarify how much the wine was already diluted by the producer.) There may even be room to be lenient and dilute it by up to two-thirds if the mixture retains the taste of wine.
- The Shiur of Arba Kosos
The Kos must hold a Revi’is of wine (Shulchan Aruch, O.C. 472:9, and Mishna Berura ibid. 29), which is the volume of an egg and a half including the shell. There are two well-known views of the Shiur. According to the Tzlach (Pesachim 116b), Gra (Ma’asei Rav 74), Chazon Ish, and many Poskim, the eggs today are half the size of those of the times of Chaza”l. Therefore, the Shiur of Revi’is is the volume of three eggs, which is 150 cc (slightly more than 5 fluid ounces). The Mishna Berura (271:68, and Biur Halacha ibid. 13) rules that for Mitzvos d’Oraisa one should adopt this position, but for Mitzvos d’Rabbanan a person may adopt the smaller Shiur of one-and-a-half eggs. Since Arba Kosos is a Mitzva d’Rabbanan, one may be lenient, though it is better to be stringent if possible. A diabetic should certainly adopt the smaller Shiur (though for Kiddush – which is based on a Mitzva d’Oraisa – it is better to use the larger Shiur. Therefore, a diabetic should be Yotzai Kiddush from somebody else who is using a large Shiur, and then drink a smaller Shiur.)
It is preferable to drink the entire Revi’is (Shulchan Aruch, O.C. 472:9 and Mishna Berura ibid. 30). Unlike Kiddush during the year, which only obligates a person to drink the majority of a Revi’is, the Arba Kosos have an additional requirement of “Shesiya” – drinking the Kos. However, it is sufficient to drink the majority of a Revi’is Bedieved (and certainly in the case of a Choleh), though it is necessary to drink the majority of the Kos. It is recommended to use a small Kos so that one needn’t drink more than is necessary.
For example, if a diabetic is instructed by his doctor not to drink more than 164 cc of wine at the Seder, he should drink the majority of a Revi’is for each Kos – 44 cc. He should use a Kos that holds precisely a Revi’is so that by drinking the majority of the Kos he doesn’t drink more than he is permitted.
If he is able, it is preferable to drink an entire Revi’is for the fourth cup, so that he will be able to recite a Bracha Acharona. If not, he should be Yotzai the Bracha Acharona from others (Rav Yehoshua Neuwirth zt”l cited by the Nishmas Avraham 472).
- A Person Unable to Drink Wine
Some say that if a person has been instructed by his doctor to avoid drinking wine, he may rely on the Rishonim (Tosfos, Pesachim 99b s.v. “Lo Yifchesu”) who hold that a person can fulfill the Mitzva of Arba Kosos via the mechanism of Shomea k’Oneh. He should listen to somebody else recite the Bracha (who intends to be Motzi him), and, if he can, drink a little of the wine.
- Summary & Instruction for Diabetics
- It is important to point out that a diabetic can sometimes be considered a Choleh sheYesh Bo Sakana. He shouldn’t ignore this and should consult with his doctor before the Seder as to what he should do.
- The Seder also includes the Mitzvos of Matza and Shulchan Orech, which can also prove harmful to a diabetic because of the carbohydrate content. It is important to remember that Min haTorah it is enough to eat only one Kezayis of Matza (and take the Matza’s carbohydrates into account).
- During Shulchan Orech, he should avoid any foods and drinks that are harmful to him.
- It is preferable to drink dry wine rather than grape juice which is full of fruit sugars.
- He can dilute the wine by a half.
- He may use a Kos which contains 86 cc and drink most of its contents for each of the Kosos – 44cc. In general, this will allow a diabetic to fulfill his obligation.
- If his doctor has forbidden him to drink any wine at all, he can make raisin wine (see above).
- Bedieved, he may use Chamar Medina. He should consult his Rav about what constitutes Chamar Medina today. We should point out that many drinks that could constitute Chamar Medina contain a large amount of sugar.
- If he is unable to use raisin wine or Chamar Medina, he should be Yotzai the Arba Kosos through Shomea k’Oneh (and drink a little of the wine, if possible).
- If he is unable to do any of the above, he is exempt from the Mitzva of Arba Kosos. Even a Choleh she’Ein Bo Sakana is exempt from Arba Kosos, and this would certainly apply to a diabetic.
- Some Poskim advise diabetics who are dependent upon insulin injections (that are dosed according to their blood sugar and carbohydrate intake) to eat and drink normal Shiurim of matza and wine at the Seder and inject themselves with insulin corresponding to their blood sugar and the carbohydrate load.
 Shemos 6:6-7
 A type of spiced wine
 These opinions are all cited in Piskei Teshuvos 472.
 See also Shulchan Shlomo (1, 272:2) and Chazon Ovadia (1:1:6).
 See also the Rema O.C. 182:2
 The Poskim consider beer produced from wheat or barley as the best form of Chamar Medina – though it is obviously Chametz.
 Rav Moshe did not discuss using milk or tea for Arba Kosos, however, considering that he disqualifies grape juice for Arba Kosos, it is likely that he would similarly have disqualified milk or tea. Those who are lenient with regard to grape juice, may likewise consider milk or tea as Chamar Medina.
 See the Sefer v’Aleihu Lo Yibol (p176) citing Rav Shlomo Zalman Auerbach zt”l and Chazon Ovadia 1:1:4.