Contributions of this Study

The present study, by researching into ancient Indian medicine in early Buddhist scriptures, has come up with certain interesting findings and contributions pertaining to both areas of Buddhism and Indian medicine.

The findings and interpretations on the medical data in the Chapters on Medicine contribute to our knowledge of Buddhism in several aspects. The Buddha’s certain attributes–viz., compassion, flexibility, and practicality–are specifically perceived through the medical details. From the accounts of remedies for diseases, we can discern that the Buddha immediately allowed various drugs, cures and tools to be used by the sick monastic members for relieving their sicknesses. This illustrates the Buddha’s compassion for the sick. Moreover, his permissions for remedies and drugs, which sometimes amounted to the relaxation of the normal strict rules for monastic members who were sick, also evidences his flexibility in terms of the saṅgha’s disciplinary rules. When one treatment did not work, the Buddha at once allowed another one. This demonstrates his practicality. Hence, the findings in this present study have attested to the Buddha’s virtues as a leader of a religious group. This helps us better appreciate our historical Buddha.

The discussion on the arising and ceasing of illness in Chapter Three indicates the Buddhist perspective on this issue: illness is a conditioned phenomenon. Its arising depends on other factors, particularly ignorance, craving, and the six sense-bases; and its cessation on the elimination of these factors through the practice of the Noble Eightfold Path, which involves the control of bodily actions and speech, and mental cultivation. Scholars (e.g. Paonil (2003, 101)) have explained illness in terms of the principle of dependent arising and pointed out ignorance, craving, and clinging as the major factors; but they have not emphasised the six sense-bases as an important factor which is shown in the discourses (in the Saṃyutta Nikāya and the Saṃyukta Āgama as discussed on pages 108-109 in Chapter Three). The present study notes this important information and calls attention to this factor of illness. The knowing of this factor has an implication for healing: the six sense-bases should be restrained during sickness. For ordinary people, removal of ignorance and craving for relieving illness is not easy. However, restraining the six sense-bases for such a purpose is comparatively easier to be achieved and practicable. When we are sick, we can do practices–such as the four establishments of mindfulness, the seven enlightenment factors, and so on as taught in the discourses–to control the sensebases. This removes one of the important factors of illness and could help relieve the sickness, according to the principle of dependent arising. Moreover, such restraining of the sense-bases during sickness may be applied more concretely, for example, as simple diet, celibacy, quiet life, and so forth. This would be conducive for recovery.

In addition, the enumeration of the eight aetiological factors in the discourses further brings out the Buddhist principle of conditionality in relation to illness–i.e., occurrence of disease is dependent on other factors. Freedom from sickness, on the other hand, also requires removal of disease-causing factors and/or utilisation of healing factors such as drugs and therapies.

The concise elaboration on mind-body relationship in Chapter Three clarifies Buddhism’s disapproval of mind-body dualism and underlines the mutual dependence of physical health and mental health. It also points out that physical wellbeing is essential for mental development and even liberation. This significant concept can correct the misconception of some Buddhist practitioners that only mental cultivation is necessary for practice, while physical condition can be ignored. This proposition can be verified by the Buddha’s immediate allowance for treatment when a monk or nun was sick, for physical illness can interfere with spiritual practice and development.

The present study furnishes Vinaya information by translating the primary sources. Medical data in the researched Chapters on Medicine and Buddhist exegeses, with the exceptions of the Theravāda Bhesajjakkhandhaka (as in The Book of Discipline) and a small portion of the Pāli commentarial notes on medical information, have not yet been translated from the original languages (especially those in classical Chinese and Sanskrit) into English. By rendering them into English, many Vinaya particulars on medical lore as well as on the monastic way of living in ancient India are made available to readers who are not familiar with such languages.

Another area of contribution of this study is about ancient Indian medicine. Abundant medical data on śramaṇ-ic medicine have been complemented. Zysk (1991) has indicated that medical knowledge of this phase had been preserved by wandering recluses, especially from the Buddhist community. His work, however, was based primarily on Theravāda materials. Our study has furnished many more medical details of this phase of ancient Indian medicine from the available Chapters on Medicine of other Vinaya Piṭakas.

Moreover, the present research has examined all available versions of the Chapter on Medicine except the Tibetan version of the Mūlasarvāstivāda Bhaiṣajyavastu. Compared to other research publications (e.g. Mitra (1985), Talim (2009), Zysk (1991), etc.) which have largely focused on one or two versions of the Chapter on Medicine, the present work gives a more comprehensive view of the drugs and diseases mentioned in the various versions of this text. It has also revealed similarities and differences between different Chapters on Medicine. For example, differences in lists of drugs and in details of the illness accounts can be observed between the Chinese and the Sanskrit versions of the Mūlasarvāstivāda Bhaiṣajyavastu. These may be due to possible textual corruptions in the past, or to different editions of the text coming from different branches/ monasteries of the school. Furthermore, differences in the drug lists among the Chapters on Medicine, apart from possible corruptions in the transmissions of the texts, may also be due to the availability of various medicinal substances in the areas situated by individual Buddhist schools.^[1] The inclusion of the various versions of the Chapter on Medicine in the study also brings to light the medical details specific to certain Buddhist schools. For instance, beer was used for treating fever as mentioned in the Sarvāstivāda Bhaiṣajyadharmaka;yellow myrobalan treated with cow’s urine was consumed for curing jaundice as in the Theravāda Bhesajjakkhandhaka; the specified ocular disease baiyi as well as the treatment of rubbing the big toes for relieving headache were mentioned in the Dharmaguptaka Bhaiṣajyaskandhaka; and so on. Such unique medical data in the respective schools are intriguing and deserve further investigation. Thus, intriguing findings in medical information can be discovered by encompassing and comparing the various Chapters on Medicine in the study.

Chapter Three of this thesis, while discussing concepts of health and disease and medical principles mentioned in early Buddhist texts, summarises relevant information from early Buddhist discourses, disciplinary texts, and commentaries. Compared with other works on similar topics (e.g. Paonil, 2003, 96-126; Ratnapala 1993, 177-191), this chapter provides a more comprehensive overview and cites numerous references from primary sources, including Chinese texts, making the discussions on such topics more informative and thorough.

The method employed in this research–the three-fold interpretative method–is unusual, and ought better to clarify the medicinal substances and diseases in the Chapters on Medicine. It not only supplies more information from the available Chapters on Medicine, but also more detailed and reliable interpretations based on Āyurvedic and modern biomedical knowledge. Most of the scholars, e.g. Zysk (1991), Mitra (1985), Talim (2009), and others, examined the medical data in primary sources (mainly the Pāli Bhesajjakkhandhaka) and explained them with the help of Āyurveda in their works. Only Obinata (1965) explicated the medical facts by means of modern medicine, though the medical knowledge in this work is now outdated and his expositions were sometimes incorrect. Interpretation based on knowledge of both medical traditions has not been available to date, and the present study is probably the first to do this. This interpretation should give greater illumination of the data so that readers can comprehend the detail better. Moreover, this method can be applied to investigate medical particulars in other Buddhist texts too.

Another advantage of this study is related to the organisation and identification of the drugs and diseases. The medicinal substances under investigation were organised into categories in Chapter Four, and the diseases were arranged according to medical specialties in Chapter Five. This has made the less organised data in the Chapters on Medicine more systematic. In this way, it should be more convenient for readers to study these drugs and illnesses. Moreover, the present study has made a great effort in identifying the drugs and diseases from their original names as given in the primary sources. Though not all of them are discernible, most of the medicinal substances and sicknesses are made known in their modern scientific or medical terms. This facilitates present-day readers to further explore them if they wish.

Certain analyses/interpretations of the medical facts in this study are worthy of remark. The first one is the autumnal disease. As explained in Section 5. 1. 1, the illness, with clinical features pointing to a bowel problem, could be an infective gastroenteritis due to a virus or bacterium. The second one is the biomedical understanding of the three humours. While wind humour is maintained to be related to the nervous system by contemporary Āyurvedic scholars, bile humour would probably pertain to the digestive-metabolic function, and phlegm humour or waterelement seems likely to be associated with the endocrine-immune systems, as discussed in Section 5. 1. 3. The third one is the interpretation of the disease paṇḍuroga/pāṇḍuroga (“yellow disease”) as “jaundice”. Although the term is usually rendered as anaemia by present-day Āyurvedic scholars, we have preferred to interpret it as jaundice in Section 5. 1. 7, for this can embrace certain types of anaemia. It is because jaundice is aetiologically divided into three groups (viz. haemolytic jaundice, hyperbilirubinaemia, and cholestatic jaundice) in modern medicine, and haemolytic jaundice can be caused by various kinds of haemolytic anaemia. Thus, the interpretation of the term as jaundice could encompass certain anaemias. Then, the fourth one is the consumption of mud and other foul things (urine, dung, and ash) for curing poisoning cases. The use of such substances may be due to their effects on induced emesis and/or enhanced elimination of toxins by acting as an absorbent and reducing reabsorption of toxins in the bowel, as explained in Section 5. 2. The last one is the elaboration of the case of insanity. This case, healed by eating raw meat and drinking blood, could be due to vitamin B12 deficiency as discussed in Section 5. 6. These interpretations presented in Chapter Five, which are based on careful analyses of the medical details in the Chapters on Medicine, hence provide new explanations of the diseases mentioned in the texts.

Footnotes and references:

[1]:

See footnote 151 on p. 192.