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Full download Atlas of Retinal OCT: Optical Coherence Tomography 1st Edition Darin Goldman file pdf all chapter on 2024
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Jay S. Duker MD
Director, New England Eye Center
Professor and Chairman
Department of Ophthalmology
Tufts Medical Center
Tufts University School of Medicine
Boston, MA, USA
Expertconsult
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Contents
v
Section 19: Infectious Uveitis.............................................119 PART 7: INHERITED RETINAL DEGENERATIONS
Chapter 19.1: Toxoplasmic Chorioretinitis.........119
Chapter 19.2: Acute Syphilitic Posterior Section 26: Retinal Dystrophies.........................................148
Placoid Chorioretinitis.....................................121 Chapter 26.1: Retinitis Pigmentosa....................148
Chapter 19.3: Tuberculosis................................124 Chapter 26.2: Stargardt Disease.......................149
Contents
vi
Preface
Optical coherence tomography (OCT) continues to occupy an can stand alone as an independent reference. We sought to
ever-expanding role in the ophthalmic community. OCT is widely include a breadth of retinal conditions with a focus on those most
available and forms a requisite portion of the comprehensive applicable to everyday clinical practice. However, a wide array
ophthalmic evaluation, particularly as it pertains to the retina. of pathology is included to also illustrate unique, less common
Although still a relatively young technology that continues to OCT findings. Each condition is illustrated with numerous, large,
evolve, OCT has become widely accepted. This acceptance is high-quality OCT images to highlight disease pathology and aid
due to its non-invasive nature, ease of image acquisition, and in disease identification. Additional imaging modalities, such as
wealth of information that it affords. The quantity of information fundus photographs and fluorescein angiograms, are included
conveyed within a typical OCT scan is immense, which can be to supplement OCT images where appropriate.
daunting to both the beginner and experienced clinician. Atlas of Retinal OCT provides the reader with a high quality,
Atlas of Retinal OCT grew out of the success of Handbook of easy-to-follow visual aid to incorporating OCT scans into the
Retinal OCT. The Atlas expands on the images and material in evaluation and care of your patients. The atlas is designed to
the handbook, while maintaining a similar and consistent layout make OCT more comprehensible for both the novice and expert
that will be familiar to the reader. This atlas was created to serve clinician. We hope that the reader finds this to be a handy and
as a supplement to the original text, although the atlas certainly practical addition to your everyday reference armamentarium.
vii
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Contributors
ix
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Acknowledgments
A project such as this requires contributions from many different also like to thank the many co-authors who have contributed
groups and individuals to be successful. First and foremost, to various chapters throughout the atlas. Additionally, thanks
the images used in this atlas would not be possible without are due to our fellows whose archive of cases and interesting
our many patients. We are very grateful to these individuals images were invaluable to this project. Specifically, we would like
who trust their care in our hands on a daily basis. Additionally, to thank Dr. Chris Or, who provided invaluable feedback on the
we rely on the talented photographers and technical staff at final chapters. Lastly, the professionalism and expertise of the
both the New England Eye Center at Tufts Medical Center and staff at Elsevier is unmatched. We want to thank the entire team
Retina Group of Florida to obtain the majority of the included at Elsevier who were critical to the completion of this project,
OCT images. Their expertise is reflected in the volume of high in particular Russell Gabbedy, Humayra Rahman Khan, Joshua
quality images available for inclusion in this project. We would Mearns, and Andrew Riley.
Dedications
To the memory of my dear sister Candice, whose love, strength
and determination live on in all that she touched. And to my
daughter, Rona, who has added immeasurable joy to our lives.
D.R.G.
xi
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SECTION 1: NORMAL OPTIC NERVE
REFERENCES
Retinal Nerve Fiber Layer Thickness (RNFL) Budenz DL, Anderson DR, Varma R, et al. Determinants of normal retinal
nerve fiber layer thickness measured by Stratus OCT. Ophthalmology.
OCT devices calculate RNFL thickness as the distance between 2007;114(6):1046–1052.
the internal limiting membrane and the outer aspect of the RNFL Cavallotti C, Pacella E, Pescosolido N, et al. Age-related changes in the
human optic nerve. Can J Ophthalmol. 2002;37(7):389–394.
(Fig. 1).
Duker JS, Waheed NK, Goldman DR. Scanning Principles. Handbook of Retinal
OCT. St Louis: Elsevier; 2014.
Ganglion Cell Complex Girkin CA. Differences in optic nerve structure between individuals of predomi-
nantly African and European ancestry: Implications for disease detection
The ganglion cell complex (GCC) consists of the thickness of and pathogenesis. Clin Ophthalmol. 2008;2(1):65–69.
three inner retinal layers: the NFL, the ganglion cell layer, and the
inner plexiform layer. The scan is centered at the fovea, and the
software presents the results as a color-coded map, comparing
to a normative database (Fig. 2).
1
ONH and RNFL OU Analysis: Optic Disc Cube 200¥200 OD OS
RNFL Thickness Map ! OD OS
350
Section 1: Normal Optic Nerve
RNFL Symmetry X
400
0
TEMP SUP NAS INF TEMP
200
100
S NA 95% 5% 1%
86 T N 72
I RNFL
Quadrants
RNFL Circular Tomogram 129
93
162 109
113 80
64 65 RNFL
Clock
80 70 Hours
174 74
137
FIG. 1. Normal peripapillary RNFL, neuroretinal rim thickness, and disc area measurements using SD-OCT.
2
GCC Right / OD
1.1
Thickness Map Signal Strength Index 73 NDB Reference Map
250 6 mm × 6 mm
150
T N
Fovea
100
50
FIG. 2. Normal color-coded ganglion cell complex (GCC) thickness using SD-OCT.
FIG. 3. Line scan of the ONH. FIG. 4. OCT angiograph image (3 × 3 mm) of the ONH.
3
SECTION 2: NORMAL RETINA
Time-Domain OCT
Carlos A. Moreira Neto | Carl Rebhun 2.1
The first OCT image, published by Huang et al. (1991), was REFERENCES
captured using a device that detected light echoes using time Huang D, Swanson EA, Lin CP, et al. Optical coherence tomography. Science.
1991;254(5035):1178–1181.
domain detection. In time domain OCT (TD-OCT) the reference Duker JS, Waheed NK, Goldman DR. Scanning principles. In: Handbook of
arm, with a physically moving mirror, and a sample arm undergo Retinal OCT. St Louis: Elsevier; 2014.
interference, which is used to generate an A-scan. Multiple
A-scans obtained linearly are combined to generate a cross-
sectional B-scan (Duker et al. 2014).
4
Spectral Domain OCT
Carlos A. Moreira Neto | Carl Rebhun 2.2
Summary Because the retinal pigment epithelium (RPE) is highly hyper-
reflective with OCT imaging, there is limited penetration of light
In spectral domain OCT (SD-OCT), a spectral interference beyond it, decreasing the resolution of the choroid (Schuman,
pattern between the reference beam and the sample beam is Fujimoto & Duker 2013). Normal mean central foveal thickness is
obtained simultaneously by a spectrometer and an array detec- approximately 225 ± 17 µm as measured by SD-OCT, although
tor. Unlike time domain (TD)-OCT, SD-OCT does not require this varies with age and retinal status.
a physically moving reference mirror, instead using frequency
information to produce interference patterns. This allows for REFERENCE
much faster acquisition and higher quality images than those with Schuman J, Fujimoto J, Duker J. Optical Coherence Tomography of Ocular
TD-OCT. Diseases. 3rd ed. Thorofare NJ: Slack Inc.; 2013.
The high resolution provided by SD-OCT allows for visualization
of the microscopic anatomy of the retina (Fig. 1) with more detail
than with TD-OCT.
Photoreceptors
Choriocapillaris outer segments
RPE/Bruch’s
complex
External
IS/OS/EZ Myoid limiting
zone membrane
S
3
T N
FIG. 1. Normal macula imaged using SD-OCT. IS/OS/EZ, Inner segment/outer segment/ellipsoid zone; RPE, retinal pigment epithelium.
5
Swept-Source OCT
Carlos A. Moreira Neto | Carl Rebhun 2.3
Summary penetration of the choroid (Fig. 1). In SS-OCT, a narrow-band
light source is rapidly swept through a wide range of frequencies.
Swept source OCT (SS-OCT) is a modified Fourier-domain and The interference pattern is detected on a single or small number
depth-resolved technology that offers potential advantages over of receivers as a function of time.
SD-OCT, including reduced sensitivity roll-off with imaging depth,
higher detection efficiencies, improved imaging range, and better
Inner
Ganglion
plexiform Outer cell
layer plexiform layer
Inner layer
nuclear Outer Nerve
layer nuclear fiber
layer layer
Choriocapillaris
Choroidal larger
vessels
External Myoid
limiting zone
membrane
IS/OS/ RPE/
EZ Bruch’s Choroid/
complex sclera
Photoreceptors junction
outer
segments
FIG. 1. Normal retina imaged using SS-OCT. EZ, ellipsoid zone; IS, inner segments; OS, outer segments; RPE, retinal pigment epithelium.
6
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no related content on Scribd:
כל פת שהמלח בו צריך נטילת ידים באחרונה שמא יש בו מלח סדומית או מלח
מפני זה חייבין ליטול ידים בסיף. שטבעו כמלח סדומית ויעביר ידיו על עיניו ויסמא
מפני שהם טרודים. ונמחנה פטוִר ם מנטילה ידים בתחלה. כל סעודה מפני המלח
במלחמה וחייבין באחרונה מפני הסכנה ׃
“All bread that has salt in it requires washing of hands after it; lest
perhaps it might be the salt of Sodom, or salt of the same nature,
and a man might pass his hand over his eyes and become blind. On
this account all are bound to wash their hands at the end of every
meal, because of the salt. But in a camp they are exempt from
washing at the beginning, because they are oppressed with the
fatigues of war, and are bound to wash after meal on account of the
danger.” (Ibid., 3.) Suppose, then, that a poor ignorant man, with the
best intention in the world, set about this washing, and made a
mistake with regard to the water, or the vessel, or the pouring, or the
position of his hands; or suppose that a soldier, in the hurry of a
camp, were to make this mistake, or omit the washing altogether,
and then have the ill luck to put his hands to his eyes, according to
the oral law, blindness would be the consequence. Any neglect or
defect in the morning ablution would be more fatal still.
יידקדק לערות עליהן ג׳ פעמים מפני שרוח רעה שורה על הידים קודם נטילה
ועל כן צריך למנוע מהגיע בידו קודם. ואינה סרה אד שיערה עליהן שלש פעמים
מפני שרוח רעה שורה עליהם ׃. ולעינים, ולאזִנ ם, ולחוטם, הנטילה לפה
“A man must be very careful in pouring water on his hands three
times for an evil spirit rests upon the hands before washing, and
does not depart until water be poured on them three times.
Therefore it is necessary, before washing, to abstain from touching
the hand to the mouth, and the nose, and the ears, and the eyes,
because an evil spirit rests upon them.” (Orach Chaiim., § 4.)
Now, is this the religion of the God of love, and mercy, and justice? Is
it at all like Him to give laws so subtle and multifarious in their
distinctions, that it is next to impossible for the unlearned man to
obey them aright, and then to attach to this non-observance such
calamitous consequences? If it be replied that the punishment is
visited only on those who transgress wilfully, then there are
thousands of Jews, perhaps in this very city, who live in the habitual
and wilful omission of this precept, and who have the use of their
eyes, just as well as the strictest Rabbinist. This fact, which no one
will dispute, proves beyond doubt, that the oral law has spoken
falsehood, and therefore throws utter discredit upon its testimony
respecting the tradition of the commandment itself. It is confessedly
not a commandment from God, but from the scribes.
כבר ביארנו שנטילת ידים וטבילתן מדברי סופרים ׃
“We have explained long ago, that the washing and bathing of the
hands are derived from the words of the scribes.” (Hilchoth Mikvaoth,
xi. 1.) That they had no Divine authority for the command is evident
from the subtilty and superstition of its ordinances; for we presume
that few will question the superstition of the threat of blindness to the
disobedient, or of the fable of the evil spirit resting upon the hands.
One such command, then, will go far to discredit the whole story of
an oral law, and to invalidate the character of its witnesses. They
were evidently superstitious men, no way elevated above the vulgar
prejudices or the times, not at all scrupulous in adding to the law of
God, and evidently aiming at a complete domination over the
consciences of their followers. It is hardly possible to believe that
they were not aware of the necessary result of the system, the
complete subjugation of the consciences of the multitude. The mass
of mankind has no leisure for the study of juristic distinctions, they
must, therefore, if they believe such to be Divine, cast themselves
upon the mercy of the learned, and there can be no doubt that those
who have the keys of salvation, will also possess no small degree of
influence and power in this world. But, whatever was the motive,
there can be no doubt about the severity with which the Rabbies
enforced this command. They exacted even from the poor
unfortunate, whom circumstances left only enough water to slake his
thirst, that he should sacrifice a port of it to this Rabbinical
purification.
אפילו אין לו מים אלא כדי שתייה נוטל ידיו במקצתן ואח׳׳כ אוכל ושותה מקצתו ׳
“Though he should only have enough water to drink, he is to wash
his hands with a part of it, and then to eat, and to drink the
remainder.” (Hilchoth Berachoth, vi. 19.) And not content with this
harsh requirement, they sentence the despiser of their commands to
excommunication.
וצריך ליזהר בנטילת ידים שכל המזלזל בנטילתם חייב נדוי ׳
“It is necessary to be very careful in washing of hands, for every one
who despises the washing of hands is guilty of excommunication.”
(Orach Chaiim., § 158.) And this same book confirms this decision
by a case which actually occurred of a man thus excommunicated,
and who dying in his excommunication had the usual indignities
offered to his corpse.
את מי נדו את אלעזר בן חצר שפקפק בנטילת ידים וכשמת שלחו בית דין והניחו
אבן גדולה על ארונו ללמדך שכל המתנדה ומת בנדויו בית דיו סוקלין את ארונו ׃
“Whom did they excommunicate? Eleazar ben Chatzar, who
despised the washing of hands; and when he was dead, the tribunal
sent, and had a great stone laid on his coffin, to teach thee that of
every one who is excommunicated and dies in his excommunication,
the coffin is stoned by the tribunal.” (Talmud, Berachoth, fol. 19, col.
1.) When they had the power they employed it to the full, and now
that they have it not, the oral law still threatens poverty and
extirpation to every transgressor.
כל המזלזל בנטילת ידים בא לידי עניות ׃ ואמר ר׳ זריקא אמר ר׳ אלעזר כל
המזלזל בנטילת ידים נעקר מן העולם ׃
“Every one who despises washing of hands sinks into poverty. R.
Zerika says, in the name of R. Eliezer, Every one that despises the
washing of hands is rooted out of the world.” (Orach Chaiim., ibid.)
Such is the toleration of the oral law towards Jews, accused of no
breach of God’s commandment, convicted of no denial of God’s
Word, guilty of no crime. And yet these same men, who are strict
even to persecution about one of their own institutions, allow that
which they consider the Word of God to be transgressed with
impunity, if it be expedient. They assert their belief, that the law of
Moses forbids the Jews to have clothing, like that of the Gentiles, to
shave or to wear their hair like the other nations, and yet they say
the transgression of this Divine command is lawful under the
following circumstances:—
ישראל שהיה קרוב למלכות וצריך לישב לפני מלכיהם והיה לו גנאי לפי שלא ידמה
להם הרי זה מותר ללבוש במלבושיהן ולגלח בנגר פניו כדרך שהן עושין ׃
“An Israelite who is near to Royalty, and is obliged to sit before
Gentile kings, and for whom it would be disgraceful not to be like
them, is allowed to dress and to shave as they do.” (Hilchoth
Accum., xi. 3.) But it is not to be wondered at, that those should
lightly esteem the Word of God, who are capable of confounding the
guilt of transgressing a mere human ceremony with the guilt of
transgressing a Divine command. The Talmud makes the sin of
neglecting this command as great as that of gross immorality.
כל האוכל לחם בלא נטילת ידים כאלו בא על אשה זונה וכו׳ ׃
“Every one who eats bread without washing of hands, is as guilty as
if he had committed fornication.” (Sotah, fol. iv., col. 2.)
The sum of all that has been said is, that the scribes and Pharisees
added a commandment not given by Moses, that they so refined
upon the conditions of its fulfilment as to make it almost impossible
for the unlearned not to transgress it, and yet denounced such heavy
penalties upon the transgressor as to make it an intolerable burden
to the conscientious; that when they had the power, they persecuted
all that refused obedience, and did not scruple to pronounce the guilt
of transgression as great as that of breaking one of the moral
commandments. They have presented as the religion of Moses a
system which is voluminous, superstitious, and intolerant; difficult to
the comprehension of the unlearned, terrific to their consciences,
and cruel to their persons. But when the poor were ground down and
oppressed under this weight of superstition and tyranny, God sent
them a deliverer in Jesus of Nazareth, who asserted the revealed
truth of God, and protested against this mental bondage. “Then
come together unto him the Pharisees, and certain of the scribes
which came from Jerusalem. And when they saw some of his
disciples eat bread with defiled (that is to say, with unwashen) hands
they found fault.... He answered and said unto them, Well hath
Esaias prophesied of you hypocrites, as it is written, This people
honoureth me with their lips, but their heart is far from me. Howbeit
in vain do they worship me, teaching for doctrines the
commandments of men.... And when he had called all the people
unto him, he said unto them, Hearken unto me every one of you and
understand: there is nothing from without a man that, entering into
him, can defile him: but the things which come out of him, those are
they that defile him.... For from within, out of the heart of men,
proceed evil thoughts, adulteries, fornications, murders, thefts,
covetousness, wickedness, deceit, lasciviousness, an evil eye,
blasphemy, pride, foolishness: all these things come from within, and
defile the man.” (Mark vii. 1-23.) Here the Lord Jesus asserts what is
alike the truth of God, and agreeable to the dictates of sound sense.
So Samuel said in the Old Testament.
האדם יראה לעינים ויהוה יראה ללבב ׃
“Man looketh on the outward appearance, but God looketh on the
heart.” (1 Sam. xvi. 7.) But the scribes and Pharisees treated the
Lord Jesus in the spirit of the laws which we have adduced above.
They persecuted him unto death, and to the death He willingly went
a martyr for the truth, and a sacrifice for the sin of the world. The
authors of the oral law had but a short triumph. He rose from the
dead, and his doctrine spread through the world, and everywhere
announced freedom from the bondage of superstition as well as a
hope of everlasting life. And the Jewish nation is at this hour enjoying
the fruits of His death and doctrine in their liberty from Rabbinic
domination. Many of you now hold some of those principles, the
assertion of which was the cause of His death. You believe that
moral duties are far beyond ceremonial observances. You believe,
many of you, that to eat with unwashen hands is no sin, and have
given up the practice. You transgress this commandment of the
scribes, and yet you are not excommunicated nor persecuted. For all
this you are indebted to Jesus of Nazareth. If the oral law had
triumphed, and the doctrine of Jesus been silenced, you would still
be living the victims of superstition or persecution. You would have
been afraid of being struck with blindness, or haunted with an evil
spirit, or even of being rooted out of the world. If a ray of Divine light
had visited your understanding, and you had protested against these
traditions, you would have had to feel the weight of Rabbinical
persecution, like Jesus of Nazareth. You would have been
excommunicated like Eleazar, and if God had given you strength to
remain faithful, would have died excommunicated, and have had a
stone upon your coffin. How is it that now you are free, that you can
think and act without any such fear? Is it because the Talmud has
altered? No, it is just what it was. The conscientious believers in the
Talmud are just the same as their fathers, and as conscientious men,
if they had the power, they would think it their bounden duty to treat
you, as their predecessors treated Eleazar. But the doctrine of Jesus
of Nazareth delivers you; and the followers of Jesus of Nazareth are
your protectors against the rigour of the oral law, and the intolerance
of your brethren. Should not this fact, then, lead you to examine into
the claims of that same Nazarene? How is it that if the principles of
Jesus of Nazareth should ever become universal, the world will be
universally happy; whereas if the principles of those who rejected
him become universal, the whole world will groan under superstition
and cruelty? What stronger testimony can there be to the justice of
his claims, and the injustice of his condemnation? Examine, then,
into the other evidence, and in the meanwhile protest against the
principles of the Talmud, and endeavour to deliver your brethren.
There are multitudes of Jews who still groan under the superstitious
laws respecting the washing of hands. In the book of daily prayer
published here in London, the ordinance of washing of hands is
acknowledged as Divine. On the 151st leaf, col. 2, you will find the
following blessing:—
ברוך אתה ה׳ אלהינו מלך העולם אשר קדשנו במצותיו וצונו על נטילת ידים ׃
“Blessed art thou, O Lord our God! King of the universe! who hath
sanctified us with his commandments, and commanded us to
cleanse our hands.” Now this is a positive untruth; God has not given
the commandment respecting the washing of hands. And yet here
your prayer-book solemnly tells him that he has. And this prayer-
book has also put a rubric to this benediction, “When the children
wash their hands in the morning, they are taught to say the following
blessing.” From which it appears that the Jewish children in England
are still taught to acknowledge the Divine authority of the Talmud, for
the only way in which that benediction can be defended, is by saying
that the oral law is Divine, and that its commandments were given by
God. It is therefore a holy and imperative duty on all those Israelites
who reject Talmudic superstition and intolerance to have this
benediction erased from their prayer-book, and to preserve the
children from the infection of that law which persecutes the living and
insults the dead.
No. XI.
RABBINIC ARTIFICES RESPECTING LEAVEN AT
THE PASSOVER.
This year, the Jewish and the Christian times for celebrating the
Feast of the Passover nearly coincide; and the coincidence ought to
remind us both of that happy period, when all the children of man, so
long divided, shall again be united into one great, holy, and happy
family; all rejoicing in the mercy and favour of their Heavenly Father,
and all loving each other in sincerity and truth. To that period we look
forward, and even now we use our humble endeavours to accelerate
its approach. Yea, one of the reasons, why we endeavour to lead
Israel to a rejection of the oral law, is because we firmly believe that
it is one of the main hindrances in the way of their happiness and
that of the nations of the world. We have no wish to rob you of any
one blessing promised in the Word of God. We would not deprive
you of one hope founded upon God’s promises. On the contrary, we
rejoice to think that notwithstanding all the vain traditions of the
Scribes and Pharisees, it has pleased God to keep alive in your
hearts the memory of his past mercy, and the hope of his future
goodness. To the consideration of these two points, the law of Moses
and your appointed prayers lead you at this season, and through the
mercy of God, and the love of some of your brethren, we of the
Gentiles have been brought to rejoice in similar considerations. Let
us then endeavour to anticipate the future, and rejoice together even
now, omitting on this solemn occasion a special discussion of the
oral law. If God’s mercy were all past, and only a matter of history,
we might and ought to feel grateful for the benefits bestowed upon
our fathers: our joy would, however, suffer a considerable diminution.
But this is not the case. In the midst of your grateful acknowledgment
for the wonders in Egypt, you can mingle a prayer for the future, and
say,
לשנה הבאה בירושלים ׃
“Next year in Jerusalem.”
, רחם נא י׳׳י אלהינו על ישראל עמך ועל ירישלים עירך ועל מזבחך ועל היכלך
ובנה ירושלים עיר הקודש במהרה בימינו והעלנו לתוכה ושמחנו בה ׃
“O Lord our God, have mercy, we beseech thee, upon Israel thy
people, and upon Jerusalem thy city, and upon thine altar, and upon
thy temple; and build Jerusalem, the holy city, speedily, in our days,
and bring us up into the midst of it, and make us glad therein.”
(Haggadah Shel Pesach.) And to this prayer we can say, “Amen”
with all our hearts. The future restoration and blessedness of Israel
is one of our fondest expectations; and whilst we contemplate the
circumstances and the glory of the first Exodus, the Word of the
living God leads us to look forward to that which is to come.
כימי צאתך מארץ מצרים אראנו נפלאות ׃
“According to the days of thy coming out of the land of Egypt will I
show unto him marvellous things,” is the promise by the mouth of
Micah the prophet (c. vii. 10).
והחרים יהוה את לשון ים מצרים והניף ידו על הנהר בעים רוחו והכהו לשבעה
והיתה מסלה לשאר עמו אשר ישאר מאשור כאשר היתה, נחלים והדריך בנעלים
לישראל ביום עלותו מארץ מצרים ׃
“And the Lord shall utterly destroy the tongue of the Egyptian sea,
and with his mighty wind shall he shake his hand over the river, and
shall smite it in the seven streams, and shall make men go over dry
shod. And there shall be a highway for the remnant of his people,
which shall be left from Assyria; like as it was to Israel in the day that
he came up out of the land of Egypt,” is the declaration of the
Prophet Isaiah (xi. 15, 16). Seeing that neither of these declarations
was fulfilled at the return from Babylon, nor at any period since, we
firmly believe that they shall be fulfilled in the time to come, and that
therefore the compilers of the Haggadah were fully warranted in
intermingling, with their Passover thanksgivings, a prayer for the
fulfilment of the promised mercies; and we do not scruple to say that
in this respect, the Jewish Rabbies have been right, whilst many
Christian interpreters have been wrong; though they might have
known and given a true explanation of all similar passages, if they
had only followed the plain words of their master, Jesus of Nazareth,
“Think not that I am come to destroy the law or the prophets.” (Matt.
v. 17.) We make this remark to show that we do not condemn the
Rabbies inconsiderately; but that we are willing to do them all justice,
where their opinions agree with the Word of God. Their expectation
of the future restoration of Israel is well founded, and their faith in the
promises relating to it worthy of all imitation. Oh, that the whole
nation had more of it—that their hearts were more directed to the
land of their forefathers—that their thoughts were more full of the
Divine promises. Then they would cry more earnestly to God, and
He would “hear their groaning, and remember his covenant with
Abraham, Isaac, and Jacob,” as he did at the deliverance from
Egypt. The careless and the ungodly deceive themselves with the
idea, that when God’s time comes, the deliverance will take place
without any endeavour of theirs. Let them read the law of Moses,
and they will find that though God had promised to bring their fathers
out of Egypt, the deliverance itself was preceded by a time of prayer
and crying unto God. To Abraham he had said,
... ידוע תדע כי גר יהיה זרעך בארץ לא להם ועבדום וענו אותם ארבע מאות שנה
ודור רביעי ישובו הנה וגו׳ ׃
“Know of a surety that thy seed shall be a stranger in a land that is
not theirs, and shall serve them; and they shall afflict them four
hundred years.... But in the fourth generation they shall come hither
again,” &c. (Gen. xv. 13, 16.) But this promise was no warrant for
their remaining careless, and at ease; it was on the contrary a basis
for earnest prayer and supplication, and a plea for mercy. And,
therefore, when the time drew near, we read,
יואנחו בני ישראל מן העבודה ויזעקו ותעל שועתם אל האלהים מן העבודה ׃
“And the children of Israel sighed by reason of the bondage, and
they cried, and their cry came up unto God, by reason of the
bondage.” And God himself gives this as one reason why he came to
deliver them.
ועתה הנה צעקת בני ישראל באה אלי ׃
“Now, therefore, behold the cry of the children of Israel is come unto
me.” (Exod. iii. 9.) Here, then, all Israelites, who desire the fulfilment
of God’s promises should learn that state of mind, which is a pre-
requisite to the interposition of their great deliverer. Israel can no
more be delivered now than of old, unless they earnestly desire
deliverance. To what purpose should He deliver and restore those,
who care nothing about the land of their forefathers, nor about the
glory of the nation—who say, We are very comfortable and happy
here, and all we desire is to be like the other nations (—)נהיה כגוים
what good would it do to us to return to the land of Israel? God’s
promises are not to such grovelling and unbelieving spirits. Along
with his promise of mercy, he gives a command for continual
supplication,
ואל תהנו דמי לו עד יכונן ועד ישים את ירושלים, המזכירים את יהוה אל דמי לכם
תהלה בארץ ׃
“Ye that make mention of the Lord, keep not silence, and give him no
rest, till he establish, and till he make Jerusalem a praise in the
earth.” (Isaiah lxii. 6, 7.) And in Ezekiel, after the declaration, “This
land that was desolate is become like the garden of Eden; and the
waste, and desolate and ruined cities, are become fenced, and are
inhabited,” &c., he adds—
כה אמר אדני יהוה עוד זאת אדרש לבית ישראל לעשות להם ׃
“Thus saith the Lord God, I will yet for this be inquired of by the
house of Israel, to do it for them.” (Ezek. xxxvi. 37.) Upon which
Rashi remarks—
אתפתה להם בתפלתם בדושם אותי על זאת ׃
“I will be made favourable to them through their prayer, when they
seek me with regard to this.” Hence prayer is commanded; in Hosea
we are told, that without prayer deliverance is impossible.
אלך אשובה אל מקומי עד אשר יאשמו ובקשו פני ׃
“I will go and return to my place, till they acknowledge their offence,
and seek my face.” (Hosea v. 15.) Let the children of Israel return