we clarified with Abaye that this case is refuah memeilah so what is the Gemara saying that we need Rav because since lechatchila for refuah we still have hana'ah, how is it lechatchila for refuah?
Mordechai Abisror, Long branch New Jersey
Dear Mordechai,
There are at least 2 ways to learn.
The Iglei Tal (brought in the Artscroll edition) explains that on Shabbos it's permitted to eat because it looks like regular food, even if he intends for Refuah- the Gemara calls it Refuah Memeila because people don't see open Refuah. (This goes for the Mishna of Kol haOchlin and Braisa of Shosin Zaisom haMitzri)
Then afterwards concerning what Bracha, if at all, to make the Gemara calls him intending for Refuah (which is true) and still a Bracha should be made, which is a Chidush.
According to the Metivta edition, Abaye explains that on Shabbos it's permitted to eat, but only if he intends for food alone, then it's called Refuah Memeila. But he wants Refuah it would be forbidden to eat on Shabbos. Afterwards, again, concerning whether a Bracha should be made and which Bracha, the Gemara explains the Chidush that a Bracha should be made even in a case that he intends for Refuah.
All the best, Reuven Weiner