The Baal Shem Tov writes: שכל הרפואות למד מפסוק ויקרא אל משה [all healing is learned from the first verse in Vayikra]. The א [aleph] in the word ויקרא [vayikra] is written smaller than the other letters in the Torah scroll. Mekor Mayim Chayim, commenting on the Baal Shem Tov, writes that the אל''ף זעירא [small aleph] is a reference to אין (Ayin), whose literal meaning is “nothingness”. As is often brought down in Kabbalistic writings, the act of creation is a process of יש מאין [something from nothing], or creatio ex nihilo—the instantaneous emergence of being from not being. According to Kabbalah, as well as Chassidut, this creative emergence is not to be considered a one time act, but rather as a continuous and constant process—the manifestation of a finite physical reality that requires continual creation.
The concept of אין (Ayin) relates to סוף אין (Ein Sof) [without end], which is how we refer to Hashem in His aspect of Infinity, outside the bounds of human logic, completely unknowable. As it is written in Tikkunei Zohar: לית מחשבה תפיסא בך כלל [no thought whatsoever can grasp You]. Within the spiritual infrastructure of mind and consciousness, אין (Ayin) is the plane (so to speak) where חכמה [wisdom] is formed and thereby flows to lower levels of human consciousness. As it is written in איוב [Job], וחכמה מאין תמצה [but where can wisdom be found]. This verse can also be read as wisdom is found in Ayin. As the Alter Rebbe writes in Likkutei Torah on Vaikra:
…זו הוא ענין אל״ף זעירא דויקרא. כי הנה אלף אותיות פלא שהוא מה שלמעלה מההשגה [this is the concept of the tiny aleph of Vayikra. The letters of the word אלף (aleph) can be permuted to be 1פלא (wonder), which is the space above the intellect.]
As an aside, חכמה is the Sefirah on the right side of the order of the Sefirot (below), which derives from כתר (Keter—where in Zohar אלף (aleph) is referred to as Keter), which means crown. חכמה, or wisdom, is undifferentiated intellect (the first spark of insight, as it were) which needs to be process and absorbed into בינה (bina), or understanding, for it to be then integrated and communicated. חכמה is also referred to as כח“מה, or the power of מה (what). In essence, מה (what) refers to this pre-verbal aspect of nothingness.
Mayim Chayim comments that the term for a sick person, חולה (sick), is drawn from the the name of Hashem which is מ״ט (equal to 49), represented by the gematria miliu of Hashem’s name (the Tetragrammaton), using the letter filling variation with alephs (see green column below), and additionally adding the four letters of the name (45 + 4 = 49). This would equate to the gematria of חולה (sick) is 49.
Mayim Chayim further writes that 49 is just shy of 50, which represents the 50 gates of understanding. Our constant objective should be to achieve this 50th gate, the general, holistic aggregation of Hashem’s name מה (what). The 50th gate is often referred to as אין (nothingness)—where חכמה (wisdom) and בינה (understanding) are linked, in such a way that we re-transform the יש (something) into אין (nothingness) through a complete humility and self-nullification. This is the level of humility that Moshe reached.
The Baal Shem Tov implies that any deviation from absolute humility (having a distinct sense of self and/or separateness from Hashem) is to some degree considered a sickness, or pathological. Rabbeinu Bachya comments on Vayikra stating the verse in משלי (Proverbs) עֵ֣קֶב עֲ֭נָוָה יִרְאַ֣ת יְהֹוָ֑ה עֹ֖שֶׁר וְכָב֣וֹד וְחַיִּֽים [the effect of humility is fear of the Hashem, wealth, honor, and life], namely, that עֵ֣קֶב עֲ֭נָוָה [what follows humility] implies that humility surpasses or supersedes wisdom, noting that lack of humility is linked to worry, and insatiability, for which הדאגה מקצרת החיים (worry shortens life, often through illness).
Rashi comments on the first verse ויקרא אל משה (Hashem called unto Moshe) saying הַקּוֹל הוֹלֵךְ וּמַגִּיעַ לְאָזְנָיו וְכָל יִשְֹרָאֵל לֹא שׁוֹמְעִין (the Voice went on and reached Moses’s ears only but all the other Israelites did not hear it). In the morning prayer we say, ברוך שאמר והיה עולם (blessed is He is spoke and the world came into being). Since everything, including all natural and physical reality, is truly Hashem’s “speech” (as it were), the Baal Shem Tov is teaching that humility is a prerequisite to truly hearing, and thus a higher state of consciousness.
פלא (wonder) is pronounced “Pe-le-h”, which phonetically as the sound traverses the articulates of speech, is the process of revelation from concealment—from lips to tongue to breath. אלף (aleph) is the reverse, from revelation to concealment.