Shabbos 133b - Stitching a Wound on Shabbos

It is fairly obvious that stitching a wound on shabbos is an issur d'oraysa. Although the melacha of tofer may not apply to human skin, but there is definitely an issur of chavala because each stitch makes a minor needle hole. Rav Shlomo Zalman (Minchas Shlomo 2:34:32) suggests that it may even be a Torah violation of Sewing. Being that we find in Rashi by bursting a pimple to make a pesach would be considered bo'neh (107a), it is also plausible that tofer applies to human skin. His reservation is that since the two parts of the skin are still alive and will ultimately grow together, it isn't considered detached so that the attaching through stitching would constitute a melacha of tofer.
R. Menachem Levine pointed out to me that the Nishmas Avrohom cites Rav Shlomo Zalman who a physician to stitch more than is necessary to close the wound, simply for the purpose of obtaining a more aesthetically pleasing result (the use of more stitches will make it heal nicer). The source of this ruling is based on the braisa that says that one who is doing a bris may cut the tzitzin that are not essential, so long as they haven't been פירש, meaning that they are still involved in the act of stitching. Just as by a bris, we allow one to cut more than is necessary for the bris to be kasher, and the rationale is as rashi explains דכולא חדא מילתא היא, so too when one needs to stitch for pikuach nefesh, they can stitch more than is absolutely necessary based on the same rationale. The license to cut ציצין שאינן מעכבין so long as one is still involved in the act, has nothing to do with הידור מצוה, rather it is because once he begins he has a right to do more than is absolutely necessary. The Nishmas Avrohom seemed to have misunderstood Rav Shlomo Zalman because he writes something about hidur mitzvah. The concept of hidur mitzvah is only necessary to explain why it may be even permitted to go back and cut once one has completed what they intended to do - פירש. Had this been the heter for cutting tzitzin even before one was פירש, it would certainly not be a source applicable to stitching a wound on shabbos.
I found that this approach of Rav Shlomo Zalman is printed in Minchas Shlomo 2:34:32,33. In the subcategory 32 (end of teshuva) he simply refers to the gemara by milah and draws a parallel to stitching more than necessary. In subcategory 33 he writes that the advantage of going back to cut ציצין שאינן מעכבין is for hidur, but he doesn't mean to say what the Nishmas Avrohom understood. The reason why it isn't considered a chilul shabbos to cut more than absolutely necessary is because it is all being done within the same act, not because one can be mechalel shabbos for hidur. But the reason we consider there to be an advantage to cut more tzitzin is because of hidur. Similarly for stitching, the heter is that it is all being done in the same act, but the reason we consider it to advantageous is because it will save him from lifelong embarrassment. In short, the heter is only based on it all being one act, but there needs to be a sevara why the extra stitches are considered one act and that is because just as for mila the hidur makes it considered the completion of the mitzvah, so too here the fact that there is a purpose in stitching more allows it to be considered the completion of what was started. That is why one would not be able to do extra stitches that would not accomplish anything, even if they haven't been פירש.

However, the assumption that stitching is necessary for pikuach nefesh seems very strange. Unless we're dealing with a gunshot wound or something extremely major, it is almost always possible to stop the bleeding without stitching by either pressure, or other forms of chemicals that help coagulate the blood. If so, it would not be permitted for someone who is capable of stopping the bleeding at home to travel to drive to a hospital on shabbos in order to stitch a wound. The aesthetic advantage to stitching would certainly not justify a chilul shabbos of a Jew (for a Jew to be driven by a goy would certainly be okay to help a child who is injured, and perhaps even for an adult who is injured). Furthermore, it should be forbidden for a Jewish physician to stitch an open wound on Shabbos if he has the ability to stop the bleeding without violating Shabbos. Actually, Rav Shlomo Zalman addresses this as well and says that the aesthetic consideration would only justify chilul of a goy, not of a Jew (subcategory 33).

Shabbos 128b - Squeezing Water Out of Hair

The gemara says that for a woman to transport oil using her hair would be better than carrying it in a jar because it would be a carrying with a shinuy thereby reducing the severity of the issur. The gemara asks that by carrying the oil absorbed in her hair, she will need to squeeze it out for the woman in labor to use thereby violating the prohibition of sechita so there is nothing gained by transporting the oil using her hair? The gemara answers אין סחיטה בשער meaning that there is no violation by squeezing the oil out of hair. Rashi seems to indicate that the question of the gemara is that squeezing the oil out of her hair would be a Torah violation. She would be avoiding the Torah violation of carrying but transgressing the Torah violation of squeezing so that nothing is gained! The gemara answers that since hair is hard and doesn't absorb (rashi), it would not be a Torah violation to squeeze the oil out of her hair.

It isn't clear from the gemara whether squeezing the oil out of the hair would still be a Rabbinic violation. It is possible that the gemara is saying that it is better to violate the issur d'rabonon of carrying with a shinuy and the issur d'rabonon of squeezing hair, rather than the Torah violation of carrying without a shinuy. But it is also possible that the gemara is saying that hair doesn't absorb so there is no issur at all to squeeze oil out of hair.

The Ran (Chiddushei Ha'Ran) proves from our gemara that it must at least be an issur d'rabonon. Being that carrying oil in hair is a greater shinuy than carrying on one's hand, why does the braisa prefer carrying the oil on one's hand over hair? It must be because carrying in the hair would require a second issur d'rabonon of squeezing. The Ran therefore holds that although there is no issur d'oraysa to squeeze hair, it is still assur d'rabonon because of מחזי כסחיטה therefore they were go'zer that if it is allowed one will come to squeeze.

The type of sechita that we are speaking about in this gemara is presumably the type of sechita that is related to מפרק which is a toldah of דש. The purpose of the sechita is to squeeze the oil for it's use, similar to the squeezing of a fruit for it's juice. It doesn't seem to be related to the sechita of מלבן since hair is not a garment for which there would be an issur of cleansing. When it comes to the type of sechita that is related to דש, we find a leniency when the liquid being squeezed out is ruined and wasted as it is squeezed out. The rationale is that when the liquid is wasted it is a מלאכה שא"צ לגופה and only assur m'drabonon (Shulchan Aruch 320:7). Based on this, the Shemiras Shabbos KiHilchasa (page 151) in footnote 64 cites Rav Shlomo Zalman as permiting on who's hair was wet to dry it with a towel. The rationale is that squeezing hair is only d'rabonon (and the fact that there is even an issur d'rabonon is not explicit in the gemara), and squeezing in a way where the liquid is wasted is only d'rabonon, therefore it is a double d'rabonon. Furthermore, he says that since the liquid is never ever realized or seen, it is immediately absorbed in the towel, it is not at all similar to the sechita that would be a tolda of דש.

However, the Rambam in Hilchos Shabbos (9:11) writes in the context of מלבן which is cleansing - 

שהסחיטה מצרכי כיבוס הוא כמו שההגסה מצרכי הבישול, ואין סחיטה בשער וה"ה לעור שאין חייבין על סחיטתו

The language of the Rambam seems to imply that sechita on hair would be related to cleansing and one could deduce from the Rambam that it would be an issur d'rabonon. The Biur Halacha 302:9 d.h. assur seems to assume that the issur is a melabein related issur and is assur m'drabonon. If this were the case, there would be no leniency for being הולך לאיבוד, but the shemiras shabbos cites poskim who reject this assumption. Furthermore, the language of the Rambam actually implies that on skin there is sechita d'rabonon but on hair there is no sechita at all.

Shabbos 124a - Moving A Kli That Is Designated For Issur

Based on Rava's approach 123b, we pasken that a כלי שמלאכתן להיתר can be moved for a permitted function, for the use of it's place, and even to protect the kli itself. But a כלי שמלאכתן לאיסור can only be moved for a permitted function such as breaking nutshells with hammer (as in the mishna 122b), and for the use of it's place, but not to protect the kli itself.

We usually assume that since a כלי שמלאכתן לאיסור can be moved לצורך גופו, meaning for a permitted use, it can be moved without thinking twice. Even if one would be able to accomplish the same thing with a כלי שמלאכתן להיתר, they can move a כלי שמלאכתן לאיסור for a permitted use. However, it is clear from the gemara that this is not correct. The gemara says that even כלים שמלאכתן להיתר cannot be moved for a very minor use such as the sticks that separate the breads on the shulchan since even if they aren't put there for shabbos, the bread will not get moldy. The gemara also says that they cannot be moved if there is a substitute that doesn't require moving any kli such as the case where they were able to skin the korban pesach as it was suspended on their arms.

The M.B. 308:12 writes that one can only move a כלי שמלאכתן לאיסור for a צורך גופו when there is no other kli that has a permitted use that can be moved for this purpose. In the Sha'ar Hatziyun 13 he cites the source for this directly from our gemara (it sounds like it is his chiddush and not found in other achronim). However, in our gemara we find that these limitations apply even to a כלי שמלאכתו להיתר, not just by a כלי שמלאכתו לאיסור. The M.B. seems to recognize this point and says that if we find these limitation by כלי שמלאכתן להיתר, that they can't be moved if the use isn't that necessary, or if there is a legitimate substitute to do the same thing without a kli, we should certainly apply these limitation to כלים שמלאכתן לאיסור. The problem is that by כלים שמלאכתן להיתר we don't find any limitation at all. The Shulchan Aruch 308:4 says that a כלי שמלאכתו להיתר can be moved for any purpose, but not for no need at all. How then can the M.B. cite our gemara as a source to limit כלי שמלאכתן לאיסור when the Shulchan Aruch for whatever reason doesn't apply these limitations to what the gemara is actually speaking about, namely a כלי שמלאכתו להיתר?

This can be explained based on the Ritva. The Ritva points out that our gemara indicates that not all purposes are considered צורך גופו, only very important uses for which there is no better substitute qualifies. He then asks, how can it be that we can move a כלי שמלאכתו להיתר even to protect the item itself, as Rava says on 123b, but cannot move it for a minor use. Wouldn't a minor צורך גופו use still be more permitted than the moving to protect the muktza item? The Ritva answers that this sugya is clearly going with the approach of Abaye 123b who explains the braisa to forbid moving a כלי שמלאכתו להיתר to protect the item itself. According to Abaye it would be forbidden to move it מחמה לצל and would only be permitted to move it for a significant צורך גופו not just a minor צורך גופו. But according to Rava who permits moving a כלי שמלאכתו להיתר even to protect the item, it is certainly permitted to move it for a minor צורך גופו.

But, even if we reject the limitations of the gemara by כלים שמלאכתן להיתר because of paskening like Rava and permitting things to be moved מחמה לצל, we are only compelled to reject it by כלים שמלאכתן להיתר, not by כלים שמלאכתן לאיסור. By a כלי שמלאכתו לאיסור, even we who follow Rava would apply the limitations and only permit the moving of it לצורך גופו when there is no alternative. Therefore, the M.B. is justified in learning from our gemara a limitation about moving a כלי שמלאכתו לאיסור for a minor צורך גופו even though these limitations are rejected by the Shulchan Aruch by a כלי שמלאכתו להיתר.