A zav (a male that had three abnormal emissions) or zava (a women that sees blood three days in a row outside the regular seven-day nidah period) is required to observe seven clean days prior to becoming tahor. The Mishnah (10:3) records a debate regarding whether they must inspect and confirm that they are tahor on each of the seven days. According to R' Eliezer, as long as they check on the first and seventh day, it is sufficient. R' Yehoshua however argues that if they only checked on those days, then they have counted two days and would be required to check an additional five. Finally R' Akiva argues that in that case, only the second inspection would count. We shall try to understand R' Akiva's position.
The Bartenura explains that R' Akiva is concerned that perhaps that on one of the days that they did not check, they were tameh, which would have reset the count. This is Rashi's explanation.
The Mishnah Achrona however finds this explanation difficult. Consider R' Eliezer's position that the first and last days are sufficient. The Mishnah Achrona explains that the reason is because the inspections establish a chazaka -- presumed status -- that the individual has ceased the abnormal emissions. The principle of a chazaka is well understood and accepted. According to the Bartenura's explanation, why would R' Akiva disagree?
To strengthen this question, we shall turn our attention to the previous Mishnah that discussed the seven days of a niddah. Recall that on a biblical level, a niddah simply needs to stop bleeding before the seven days pass in order to the then immerse in a mikveh. (Note, this is not to be confused with the practical halacha today.) The Chachamim there understand that once she confirm she has stopped from the second day onward, no further checks are required -- the chazaka has been established. Similarly the Tana Kama understands that checking on the morning of day seven would be sufficient, despite hours remaining in the day. R' Akiva however does not appear to argue with the Chachamim in that Mishnah.
The Mishnah Achrona suggests, that were it not for the explanations of Rashi and the Bartenura, the following would be R' Akiva's reason. Counting each day is critical for the tahara of a zav or zava. As it is written, "If she ceases her flow, she must [count]{.ul} seven days for herself, and afterwards she can be purified." (Vayikra 16:28) According to R' Akiva, not counting a day would then be equivalent to seeing (dam or zov). This then also explains that position of R' Yehoshua. He agrees with R' Akiva that counting is necessary, but disagrees that missing a day would be equivalent to a tameh sighting.
The Nodah Yehuda (Tanina YD 127) however understands that the explanation of the Mishnah Achrona is Rashi's position. R' Akiva requires all days to be counted. When Rashi says that we are concerned that they might see on the days that they did not check, it is not that we are genuinely concerned for a sighting. Instead, since it is possible that on those days there could have been a sighting, those does cannot be considered counted, even there flow never occurred.
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