American Journal of Medical and Clinical Research & Reviews

Revelation and the Conquest of Demonic Forces: A Critical Analysis of the Meor Eynayim's Radical Mystical Theology of Sinai

Julian Ungar-Sargon — 2026-01-10

This essay examines the radical mystical theology of revelation articulated in the Meor Eynayim, the seminal Hasidic commentary composed by Rabbi Menachem Nachum of Chernobyl (1730-1797). Through careful textual analysis of the parashat Yitro sections, this study argues that the Meor Eynayim fundamentally reconceptualizes Torah not as a corpus of texts requiring intellectual mastery but as an experiential mode of divine knowing—da'at—that emerges through and within the vessel of sacred fear (yirah). The essay demonstrates how this reconceptualization challenges conventional understandings of free will, repositions the encounter at Sinai as an ongoing cosmic drama, and provides a therapeutic framework for conquering what the text terms the "demonic forces" (sitra achra) that impede human flourishing. Drawing upon the work of Arthur Green, Elliot Wolfson, and other contemporary scholars of Jewish mysticism, this analysis situates the Meor Eynayim within broader kabbalistic and Hasidic trajectories while highlighting its distinctive contributions to Jewish theological anthropology. The essay concludes by exploring the implications of this mystical hermeneutic for contemporary approaches to religious experience, spiritual formation, and the healing arts.

International Diabetes Guidelines Face to Face

Anita L R Saldanha — 2026-01-15

Diabetes mellitus is diagnosed by HbA1c ≥ 6.5%, fasting plasma glucose ≥ 126 mg/dL, 2-hour oral glucose tolerance test glucose ≥ 200 mg/dL, or random plasma glucose ≥ 200 mg/dL with symptoms. Prediabetes is defined by HbA1c 5.7–6.4%, fasting glucose 100–125 mg/dL, or 2-hour oral glucose tolerance test glucose 140–199 mg/dL. Glycemic targets generally aim for HbA1c < 7%, with individualized goals based on age, comorbidities, and hypoglycemia risk. Recommended glucose targets include fasting levels of 80-130 mg/dL and postprandial levels < 180 mg/dL. Lifestyle management emphasizes at least 150 minutes of weekly physical activity, 5-10% weight loss, healthy dietary patterns, adequate sleep, and stress control. Metformin remains first-line therapy for type 2 diabetes, with Sodium-Glucose Cotransporter 2 inhibitors or glucagon-like peptide-1 receptor agonists preferred in patients with cardiovascular disease, heart failure, chronic kidney disease, or weight-loss goals. Insulin is indicated for severe hyperglycemia or treatment failure. Comprehensive care includes blood pressure control (<130/80 mmHg), statin therapy based on cardiovascular risk, routine screening for kidney disease, retinopathy, neuropathy, and foot complications, and adherence to adult vaccination schedules. Continuous glucose monitoring is increasingly recommended, and special populations such as pregnancy and type 1 diabetes require tailored glycemic targets and insulin-based management.

Erectile dysfunction in cirrhotic patients in Brazzaville

Ibobi Mauria Gilga — 2026-01-05

Objective: to determine the frequency of erectile dysfunction in cirrhotic patients in Brazzaville and to analyze the associated risk factors.

Patients and Methods: We conducted a prospective analytical study over a 7-month period, from April 1 to October 30, 2024, in three hospital centers specialized in the management of cirrhotic patients. All consenting cirrhotic patients aged 18 years and older were included. The variables studied were sociodemographic parameters, clinical and biological characteristics, and erectile dysfunction.

Results: A total of 80 patients were included. The mean age was 49.60 ± 14.45 years, ranging from 24 to 79 years. Among them, 88.75% had decompensated cirrhosis. Erectile dysfunction was found in 85% of patients. Age over 55 years (p < 0.0104), a WHO score ≥ 2 (p < 0.047), and Child-Pugh class C (p < 0.006) were associated with erectile dysfunction.

Conclusion: Erectile dysfunction is common among cirrhotic patients in Brazzaville, highlighting the need for systematic screening for erectile dysfunction in this population.

Shattered Vessels in the House of Healing: The Ethical and Psychological Devastation of Medicaid Cuts Through the Lens of Hermeneutic Medicine and Mystical Theology

Julian Ungar-Sargon — 2026-01-15

This article examines the ethical and psychological consequences of Medicaid funding cuts through the integrated framework of hermeneutic medicine, Jewish mystical theology, and liberation medicine. Drawing on the kabbalistic concept of shevirat ha-kelim (shattering of the vessels), the dialectic of tzimtzum (divine contraction) and Shekhinah consciousness, and the author's published work on therapeutic presence and sacred listening, this study argues that contemporary healthcare policy represents not merely fiscal reallocation but a profound ontological rupture in the covenant between society and its most vulnerable members. The displacement of millions from continuous primary care relationships constitutes what we term a 'therapeutic exile'—a systematic displacement of patients from sacred healing spaces into the fragmented, episodic realm of emergency medicine. This exile generates cascading psychological trauma: the erosion of narrative continuity, the pathologization of poverty, the internalization of systemic abandonment, and the moral injury inflicted upon clinicians who witness but cannot prevent the suffering of the uninsured. Through synthesis of clinical experience, contemporary phenomenology, and ancient wisdom traditions, this article proposes a reconceptualization of healthcare access as a moral-theological imperative and offers frameworks for clinician resilience and advocacy grounded in the understanding that authentic healing emerges only where sacred presence meets human vulnerability.

Psalms: Prayer, Praise, and Tikkun: Toward a Theology of Repair Through Sacred Language

Julian Ungar-Sargon — 2026-01-10

The Book of Psalms (Sefer Tehillim) stands at the center of Jewish devotional life, shaping religious psychology, liturgy, and spiritual imagination for over two millennia. Psalms are simultaneously literary, musical, therapeutic, communal, mystical, and theological. This essay argues that Psalms constitute a uniquely Jewish mode of prayer that transforms emotional life into sacred language, enacting a process of tikkun—repair or restoration—on the psychic, communal, and cosmic planes. Drawing on biblical scholarship, rabbinic theology, medieval and kabbalistic traditions, and modern psychology, this work examines the Psalms as a technology of meaning-making, identity formation, trauma recovery, and divine encounter. Particular attention is given to Rabbi Nachman of Breslov's Tikkun HaKlali—the ten psalms he designated as a comprehensive remedy—and its relationship to contemporary therapeutic practice. The paper integrates concepts of therapeutic tzimtzum, Shekhinah consciousness, and hermeneutic medicine to propose that Psalmic prayer functions as a form of what might be termed 'linguistic surgery'—operating on consciousness through sacred language to restore wholeness where fragmentation has occurred. The analysis concludes by exploring how the Psalms create a grammar of hope that sustains the Jewish imagination through exile and rupture, proposing that Psalmic prayer remains one of Judaism's most enduring engines of spiritual resilience.

Neither Object Nor Abyss: Relational Theology from Hasidism to the Twelve Steps to the Bedside

Julian Ungar-Sargon — 2026-01-10

Jewish theology sustains a persistent tension between two spiritual grammars: personal encounter with God as an addressable "Thou," and mystical union in which the self is attenuated or absorbed into an impersonal infinite. This essay argues that while rational Orthodoxy protects divine personalism through transcendence and restraint, and Kabbalah often radicalizes transcendence into theosophical or absorptive mysticism, Hasidism—particularly in its existential and devotional streams—reorients mystical depth toward relational responsibility rather than dissolution. Drawing on classical scholarship in Jewish mysticism and Hasidic studies, and extending these insights into the domains of clinical ethics and addiction recovery, the essay proposes that the I–Thou relation constitutes not merely a theology of prayer but an ethical discipline of presence. In therapeutic contexts, this discipline manifests as tzimtzum, sacred not-knowing, and the refusal of premature explanation—practices that preserve the irreducibility of the patient as subject. The twelve-step recovery tradition is examined as a parallel spiritual trajectory in which the "Higher Power" evolves from an external, interventionist deity toward an internalized source of wisdom and moral orientation. The I–Thou relation is thus reframed as a foundational ethic for relational medicine and transformative recovery, capable of sustaining meaning, responsibility, and human dignity under conditions of suffering and uncertainty.

The Blessing of Dementia: A Neurologist's Theological and Clinical Meditation on Forgetting as Sacred Return

Julian Ungar-Sargon — 2026-01-10

This article proposes a radical reframing of dementia from biomedical catastrophe to potential spiritual blessing, drawing upon five decades of neurological practice, Jewish mystical tradition, and contemporary personcentered care philosophy. Challenging the prevailing discourse that equates cognitive decline with loss of personhood, this work integrates the Talmudic teaching of Niddah 30b—wherein the angel's touch causes prenatal forgetting of divine Torah—with clinical observations of patients experiencing what may be termed 'sacred return' through dementia. The concept of tzimtzum (divine contraction) provides a theological framework for understanding how cognitive withdrawal may paradoxically create space for enhanced spiritual presence. Through analysis of Tom Kitwood's personcentered approach, mystical concepts of shevirat ha-kelim (breaking of vessels), and clinical case observations, this article argues that dementia represents not merely neurological degeneration but potentially a divinely ordained process of unburdening—a liberation from the cognitive scaffolding that separates the soul from direct encounter with the sacred. The implications for clinical practice, caregiver relationships, and theological anthropology are explored through the lens of hermeneutic medicine, proposing that patients with dementia may be read as sacred texts whose meaning deepens even as conventional communication fades.

The Sacred Abjection: Bodily Waste from Talmud to Kabbalah and Its Implications for Therapeutic Presence

Julian Ungar-Sargon — 2026-01-15

This paper examines the treatment of bodily waste products—urine, feces, and semen—within the Jewish tradition, tracing a trajectory from Talmudic halakhah through classical Kabbalah to Hasidic teaching, with attention to contemporary scholarly interpretation. Beginning with the rabbinic blessing Asher Yatzar and halakhic discussions of bodily purity, I demonstrate how what might appear as merely hygienic or purity-focused legislation contains profound theological anthropology. The Zoharic elaboration transforms bodily processes into cosmic dramas, while Lurianic Kabbalah provides the conceptual apparatus of tzimtzum (divine contraction), shevirat ha-kelim (shattering of vessels), and birur (sorting of sparks) that renders the engagement with waste spiritually significant. Hasidic masters, particularly Rebbe Nachman of Breslov and the Lubavitcher Rebbe, translate these cosmic categories into psychological and practical wisdom. Drawing on scholarship from Elliot Wolfson, Moshe Idel, Shaul Magid, and others, I argue that this tradition offers profound resources for reconceiving the therapeutic encounter as a form of sacred descent (yeridah le-tzorekh aliyah), transforming the clinician's engagement with patient suffering—including its most degraded manifestations—into spiritually meaningful labor.

Surrender as Ontological Revelation Rabbi Rami Shapiro's Recovery Theology in Dialogue with the Dialectic of Being and Non-Being

Julian Ungar-Sargon — 2026-01-10

This essay examines Rabbi Rami Shapiro's theology of surrender as articulated in Surrendered—The Sacred Art (2019) and Recovery—The Sacred Art (2009) in dialogue with the Kabbalistic dialectic of being (yesh) and non-being (ayin). Drawing upon the author's published work on powerlessness as ontological revelation, therapeutic tzimtzum, and the yechida as Higher Power, this analysis argues that Shapiro's "uncovery" framework and his Taoist-inflected understanding of surrender find both resonance and productive tension with the specifically Kabbalistic vocabulary of bittul (self-nullification), ayin (sacred nothingness), and the five-fold soul structure of Jewish mystical anthropology. While both approaches reject naive theism and locate the ground of recovery in interior depths rather than external intervention, they diverge on questions of theological particularity, practical methodology, and the relationship between surrender and recognition. The essay concludes by proposing a synthetic framework wherein surrender constitutes not merely a psychological relinquishment of control but an ontological revelation—the collapse of the illusory yesh of constructed selfhood into the generative ayin from which authentic being emerges.

Sacred Healing, Shattered Vessels: Breslov Tikkun HaBrit and Twelve-Step Recovery

Julian Ungar-Sargon — 2026-01-10

The struggle with compulsive behavior has been addressed by human communities throughout history, though the frameworks for understanding and treating such struggles have varied dramatically across cultures and eras. In contemporary Western society, twelve-step programs—particularly Sex Addicts Anonymous (SA) and Sex and Love Addicts Anonymous (SLAA)—have emerged as primary resources for those seeking recovery from sexual addiction. These programs, descended from Alcoholics Anonymous, offer a structured spiritual path toward sobriety and psychological healing. Yet within traditional Judaism, particularly in the mystical tradition of Breslov Hasidism, an alternative framework for addressing sexual compulsion has existed for over two centuries: the Tikkun HaKlali and its associated practices of Tikkun HaBrit (rectification of the covenant).