Literature Review

Buddhism, often being regarded as medicine itself, has its doctrines and practices aimed to cure suffering in life. Suffering is an inevitable truth of life. All sentient beings are subject to various kinds of affliction, and none can avoid it. Of these afflictions, some are psychological distresses, while others are physical illnesses. As the Buddha has proclaimed, his teachings are concerned with two things: suffering (dukkha) and its cessation (dukkhassa nirodhaṃ)^[1] (Majjhima Nikāya I. 140), as expressed in the Four Noble Truths. Many Buddhist discourses expound the causes of suffering and the ways to cease suffering. In many of these discourses, abundant material relating to freedom from mental suffering can be found; there are numerous teachings dealing with physical suffering as well.

Many Buddhist texts, as mentioned above, comprise medical knowledge which describes and discusses diseases (suffering) and treatments (ways to cease suffering). One of these is the Chapter on Medicine in the Vinaya Piṭaka.^[2] This is an important text in the Buddhist canon recording many cases of illnesses and remedies at the time of the Buddha. As we will examine, scholars use this text for their study, for it contains a lot of medical events which occurred during the time of the Buddha as well as various medicinal substances used by the monastic members. Being filled with medical facts, the Chapter on Medicine therefore is commonly studied for such information, though studies are still limited as shown in the following literature.

Research publications pertaining to the Chapter on Medicine can be put into three categories: (i) those which have examined or covered the whole Chapter on Medicine especially the medical data, (ii) those that have studied particular facets of the Chapter on Medicine, and (iii) those that have cited or mentioned material in the Chapter on Medicine while dealing with medicine or related topics (such as health, disease, etc.) in the Buddhist texts. The literature of these three groups of works will be reviewed one by one.

Scholars whose works have encompassed the whole Chapter on Medicine, or all the medical material in it, are Jan Jaworski (1927; 1931), Obinata Daijō 大日方大乘 (1965), Jyotir Mitra (1985), Kenneth Zysk (1991), Ṭhānissaro Bhikkhu (2007), Meena Talim (2009), and Amit Jha (2011).^[3] Jan Jaworski published two articles in 1927 and 1931, mainly translating the sections on medicine and on food in the Mahīśāsaka Vinaya respectively but without examining in detail the medical substances or cases. The author tried to compare the Mahīśāsaka sections with the Theravāda Bhesajjakkhandhaka but the comparison was short and general.

Obinata’s book, Bukkyō igaku no kenkyū 仏教医学の研究 (A Study of Buddhist Medicine) (1965), is a detailed study discussing Buddhist medical details, based on all available versions of the Vinaya Piṭaka except the Mūlasarvāstivāda Vinaya. It covers not only the medical cases and drugs found in the Chapter on Medicine, but also those found in other parts of the VPs. This work, however, has several shortcomings. Firstly, Obinata’s interpretations of the medical cases, though lengthy and with lots of modern medical information, lack justifications for the claims. He makes an assertion for a case, without clearly explaining why he interpreted it that way. Moreover, interpretations of some cases are incorrect. ^[4] Secondly, the modern medical information used in the book, which was published in 1965, is now outdated. Furthermore, Obinata interpreted the medical material only by means of modern medical knowledge, without taking into account the ancient Indian culture or medical lore. Those medical cases, however, occurred in ancient India (around the fifth century Before Common Era); without considering the ancient Indian medical knowledge and practice, his interpretation is less convincing. Lastly, while discussing a disease or a drug taken from a version of the Vinaya, Obinata transcribed the corresponding facts from other Vinayas, without making comparisons between these versions for any similarities or differences.

Mitra’s work A Critical Appraisal of Āyurvedic Material in Buddhist Literature with Special Reference to Tripiṭaka (1985) is a comprehensive examination of medical details from the Pāli canonical and para-canonical works, containing explanations taken from the Āyurvedic doctrines. It covers the Theravāda Bhesajjakkhandhaka, but the text is not discussed separately. Rather, the medical particulars of this text are scattered in the book according to the categories of diseases and treatments. Such data are studied along with medical facts extracted from other Buddhist texts. Thus this makes the medical data listed in the Bhesajjakkhandhaka difficult to identify.

Zysk studied the Theravāda Bhesajjakkhandhaka in detail. In his important monograph Asceticism and Healing in Ancient India (1991), he includes a good portion on the discussion of materia medica and medical treatments for certain diseases, which is based on the Bhesajjakkhandhaka and its commentary, although the main focus of his book is on the historical development of Indian medicine in the period of the eighth to the second century Before Common Era, in which Buddhist medicine played an important role. He compares the medical facts in the Bhesajjakkhandhaka with those in early Indian medical treatises (e.g. the Caraka Saṃhitā, the Suśruta Saṃhitā, etc.). His study, nevertheless, does not encompass the Bhesajjakkhandhaka’s parallels which are found in the other Vinaya canons.^[5]

Ṭhānissaro provides translations of the Vinaya passages and commentarial explanations on the medical details extracted from the Pāli Bhesajjakkhandhaka in Chapter Five of his book The Buddhist Monastic Code II: The Khandhaka Rules Translated and Explained (2007). This work, however, is merely a modern translation of the Theravāda materials and does not include any further discussion of the medical data listed in the source.

Talim’s book, Science of Medicine and Surgery in Buddhist India (2009), is based on the Pāli canonical and commentarial texts. It describes and expounds various facets of medicine and medical care (e.g., drugs, medical and surgical cases, gynaecological and obstetric problems, nursing, healthcare, etc.) and encompasses the medical drugs and cases of diseases recorded in the Bhesajjakkhandhaka. The author takes only into account the Theravāda sources, without including texts from other Buddhist schools (such as other extant VPs) or referencing the Āyurvedic treatises (such as the Caraka Saṃhitā etc.), although the book is informative.

Jha’s Traditional Indian Medicine with Special Reference to Buddhist and Tribal Medicine (2011) talks about Buddhist medicine in various traditions, such as the Indian, the Chinese, the Thai, and the Tibetan. It has a short section describing the medical facts found in the Theravāda Bhesajjakkhandhaka, with occasional explanations taken from the commentarial texts (Jha 2011, 145-159). This work is merely descriptive, and is not as detailed as the above works which are based on the Bhesajjakkhandhaka or other Pāli sources.

Some other scholars’ works have focused on certain medical aspects of the Chapter on Medicine. Nakamura Kazuaki 中村知見 (1997), in his article “初期仏教教団の薬品 Mahāvagga VI bhesajjakkhandhaka と Mūlasarvāstivāda vinayavastu bhaiṣajyavastu の薬品リストを中心に” (Medicines in early Buddhist communities–Mainly the drug lists in Mahāvagga VI Bhesajjakkhandhaka and Mūlasarvāstivāda Vinayavastu Bhaiṣajyavastu), identifies the medicinal plants mentioned in the Bhesajjakkhandhaka of the Theravāda Vinaya and the Bhaiṣajyavastu of the Mūlasarvāstivāda Vinaya. Kageyama Kyoushun 影山教俊 (2001) wrote an essay, “仏教教団ではどの様に癒しを行っていたか–律藏経典群から読みとれる疾 病誌について” (How was healing carried out in the Buddhist community–About the records of diseases which can be read in the Vinaya Piṭakas), depicting diseases and treatments (e.g. skin lesions, non-human-causing disease, eye problems, etc.) mentioned in the VPs, mainly drawing healing records from the various versions of the Chapter on Medicine. Inoue Ayase 井上綾瀨 (2007) has written an informative article, “｢パーリ律｣ 薬犍度の薬品について–樹脂の薬を中心に” (A medicine in the Pāli Vinaya’s Bhesajjakkhandhaka: Focusing on medical resins), identifying (with modern nomenclatures) the medicinal gum-resins mentioned in the Bhesajjakkhandhaka. These works are limited in scope because they focus only on particular details in the Chapter on Medicine, and do not provide complete descriptions or critical examinations of the various medical data (such as the remedies for certain diseases and the medicinal substances) in the text.

Another group of works includes those which discuss health or medical matters found in various Buddhist texts, and utilise or cite pieces of information (with varying degrees of detail) from one or more versions of the Chapter on Medicine. However, these works do not focus on the Chapter on Medicine and are not comprehensive studies of the medical data listed in the Chapter on Medicine. A. G. S. Kariyawasam’s essay “Bhesajja” in the Encyclopaedia of Buddhism (1971), which speaks about medicine in Buddhism, is mainly based on the Pāli scriptures, particularly the Bhesajjakkhandhaka, as well as being supplemented by information from the Mūlasarvāstivāda Bhaiṣajyavastu. J. R. Haldar’s book Medical Science in Pali Literature (1977), while examining medical sciences in the Pāli literature, has only a concise coverage of the details in the Bhesajjakkhandhaka. Cao Shibang 曹仕邦 published three separate articles, namely, “Sifenlü zhong youguan yiliao de ziliao 四分律中有關醫療的資料” (The information relating to medicine in the Dharmaguptaka Vinaya) (1980), “Shisonglü zhong youguan yiliao de ziliao 十誦律中有關醫療的資料” (The information relating to medicine in the Sarvāstivāda Vinaya) (1981), and “Mohesengqilü zhong youguan yiliao de ziliao 摩訶僧祇律中有關醫療的資料” (The information relating to medicine in the Mahāsāṃghika Vinaya) (1982). These works merely collect and outline the medical facts in the Dharmaguptaka Vinaya, the Sarvāstivāda Vinaya and the Mahāsaṃghika Vinaya, largely from the respective Chapters on Medicine. Fukunaga Katsumi 福永勝美, in his book Bukkyō igaku jiten: ho, yōga 仏教医学事典: 補・ヨ一ガ (Encyclopaedia of Buddhist Medicine: With a Supplement on Yoga) (1980), makes reference to the medical data in the Chapter on Medicine (as well as in other Buddhist texts) when describing drugs and treatments in different Buddhist texts. Katayama Ichiro 片山一良 (1981), in his article “初期仏教における文化変容: 薬の章” (Acculturation in early Buddhism: A chapter on medicine), studied acculturation of different cultural components in ancient India on the basis of the medical material in the Theravāda Vinaya. But this work does not actually examine such medical details. Hattori Toshirō 服部敏良’s book, Bukkyō kyōten o chūshin to shita shaka no igaku 仏教経典を中心とした釈迦の医学 (Buddha Śākyamuni’s Medicine in Buddhist Scriptures) (1982),^[6] adduces particulars from the Chapter on Medicine (e.g. various remedies for wind disease, fever, etc.) while discussing treatments of some diseases in Buddhist texts. Kuroda Genji 黑田源次 (1987) includes in his book Ki no kenkyū 氣の硏究 (A Study on Qi) a short chapter on medical drugs that were based on various Buddhist texts, and cites information from various Vinaya Piṭakas including the data in the Chapter on Medicine. Shi Wuyin 釋悟殷’s paper, “Fojiao de yiliao baojian–yi ‘Genben shuoyiqieyoubu pinaiye’ guanglü wei zhu 佛教的醫療保健–以《根本說一切有 部毗奈耶》廣律為主” (Healing and health maintenance in Buddhism–Mainly based on the Mūlasarvāstivāda Vinaya) (1996), discusses healing and health maintenance in the Mūlasarvāstivāda Vinaya and includes some cases of diseases and treatments in the Bhaiṣajyavastu (e.g. decoction for healing itch, salted sourgruel for wind disease, etc.) when dealing with these facts. Sugita Kidō 杉田暉道’s book, Yasashii bukkyō igaku: wagakuni saisho no tāminaru kea gaku やさしい仏敎医学: わが国最初のターミナル・ケア学 (Easy Buddhist Medicine: The First Study on Terminal Care in Our Country) (1997), briefly talks about diseases and treatments in the Buddhist scriptures (e.g. wind disease, autumnal illness, etc.), mentioning medical material in the Chapter on Medicine. Chen Ming 陳明 has several works examining ancient Indian medicine as well as Buddhist medicine.^[7]

In one of his articles, “Yindu fojiao yixüe gaishuo 印度佛教醫學概說” (An overview of Indian Buddhist medicine) (1999), he briefly expounds on Buddhist medical principles and practices (e.g. four great elements, three causes of illness, medical treatments, healing rituals, etc.), together with a brief overview of the medicinal substances found in the Vinaya literature including the Chapter on Medicine. In one of his monographs, Yindu fanwen yidian “Yili jinghua” yanjiu 印度梵文醫典《醫理精華》硏究 (A Study of an Indian Sanskrit Medical Text, the Siddhasāra) (2002), while studying the Siddhasāra,^[8] he compares the medical doctrines and medicinal substances in this text with those in various Buddhist discourses and discipline texts in the Chinese Buddhist canon, including the different versions of the Chapter on Medicine. Meng Haigui 孟海貴 (2000), in his essay “Fotuo, foshuo, foyi 佛陀 佛學 佛醫” (The Buddha, the Buddhist studies, the Buddhist medicine), embraces the Buddhist medical principles mentioned in the Discourse on the Buddha’s Exposition of Buddhist Medicine (Taishō Tripiṭaka 793) (e.g. four great elements and their associated illnesses, ten causes of sickness, etc.) and lists the medicinal substances recorded in the Mūlasarvāstivāda Bhaiṣajyavastu. Kageyama has one essay, “律藏経典群に見える仏教医学について–律藏とインド古典医学の比較から” (On Buddhist medicine in the Vinaya Piṭaka–By comparing Vinaya and classical Indian texts) (2000), chiefly comparing the medicinal substances (e.g. animal fats, roots, decoctions, leaves, etc.) in the Vinaya texts (mainly the Chapter on Medicine) with those in the Āyurvedic treatises (e.g. the Aṣṭāṅga Hṛdaya). Kageyama’s another article, “律蔵群に見えるインド仏教の医療観” (The Indian Buddhist perspectives on healing as seen in the Vinayas) (2007), describes the medical cases and remedies (e.g. autumnal disease, eye problem, etc.) found in the VPs (including the Chapter on Medicine). In the book Bukkyō igaku no michi o saguru 仏教医学の道を探る (Investigating the Way of Buddhist Medicine) written by Nanba Tsuneo 難波恒雄 and Komatsu Katsuko 小松かつ子 (2000), there is a chapter discussing briefly the nature and functions of the drugs mainly listed in the Chapter on Medicine. Shi Shunrong 釋舜融 (2003), in his essay “‘Sifenlü’ jiandupian zhong dui lao bing biqiu de guanhuai chutan 《四分律》犍度篇中對老、病比丘的關懷初探 (A preliminary investigation of the care for the aged or sick monks in the Skandhaka section of the Dharmaguptaka Vinaya), studied the details about caring for the monks who were aged or sick, and mentions the accounts of remedies (e.g. sevenday medicines for autumnal disease, nasal douching for headache, etc.) in the Bhaiṣajyaskandhaka. In his book Fojiao yu kexue: jiyu fozang wenxian de yanjiu 佛 教與科學: 基于佛藏文獻的研究 (Buddhism and Science: A Study Based on the Chinese Tripitaka) which explores Buddhism and sciences (2007), Ma Zhonggeng 馬忠庚 has written a lengthy chapter on Buddhism and medicine, citing a lot of the data on medicine, surgery, and drugs from the Chapter on Medicine. Rachita Chaudhuri’s Buddhist Education in Ancient India (2008) makes reference to the medical material (e.g. facts on drugs and remedies for diseases) in the Pāli Bhesajjakkhandhaka while depicting education on medical science and surgery in ancient India.^[9]

From the above review, several points can be noted: (i) the majority of the scholarly works are based on one or two versions of the Chapter on Medicine, mostly the Theravāda Bhesajjakkhandhaka, while the other versions are much less explored; (ii) the majority of the works are descriptive in nature, and they lack detailed comparison, analysis, or interpretation of the medical facts in the Chapter on Medicine; (iii) the studies often focus on particular scope(s) and hence are not comprehensive; (iv) in many short works the medical data in the Chapter on Medicine are cited and used for general discussions of Buddhist medicine, but they are not examined in detail; and (v) most of these works lack interpretations of the medical details in terms of modern knowledge or terminology. Therefore, it can be seen that extensive research of the Chapter on Medicine, which investigates ancient Indian medical lore, is wanting. A detailed examination and interpretation of such medical material–based on all versions of the Chapter on Medicine–is definitely needed.

Footnotes and references:

[1]:

The Pāli term dukkha (or duḥkha in Sanskrit) can be rendered as pain, sorrow, discomfort, suffering, ills, trouble, misery, distress, agony, affliction, woe, and so on (see Rhys Davids and Stede’s PaliEnglish Dictionary (Pali-English Dictionary), s.v. “dukkha”). The translation “suffering” is used here as a general term representing all kinds of dukkha.

[2]:

Names of this chapter vary in the Vinaya Piṭaka (Vinaya Piṭaka) of different schools, e.g. Bhesajjakkhandhaka/Bhaiṣajyaskandhaka for the Theravāda and Dharmaguptaka schools; Bhaiṣajyadharma(ka) for the Sarvāstivāda and Mahīśāsaka schools; Bhaiṣajyavastu for the Mūlasarvāstivāda school. There is no separate Chapter on Medicine for the Mahāsāṃghika school. The term Chapter on Medicine (or the abbreviation Chapter on Medicine) is used in this thesis as a general and collective one to denote this group of texts. Individual version will be specified with its name when necessary.

[3]:

Two works, though seemingly have covered the Chapters on Medicine, are not included for review. They are Frauwallner (1956) and Inoue (2013). The former is a short section in the book and the latter a journal article. They are not included for review because both of the works have only (very) briefly outlined the contents of the Chapters on Medicine without discussing the medical cases/drugs in these texts.

[4]:

For example, his interpretation of wind disease as common cold is apparently not correct if taking the Āyurvedic information into consideration. Detailed discussions and interpretations of this disease in terms of Āyurveda and modern medicine will be found at Section 5. 1. 2 in Chapter Five.

[5]:

An essay by Zysk (1988) has a similar method and content (in a more concise form) to his monograph.

[6]:

This book has a Chinese version edited by Qin Guanyue 秦關月 (1992).

[7]:

The term Buddhist medicine will be discussed later in the Special Remarks (Section 1. 3. 3) in this chapter.

[8]:

It is an ancient Indian medical text composed by Ravigupta in the second half of the seventh century Common Era, according to Chen (2002, 4, 8-9).

[9]:

There are yet other scholarly works which are about medicine in Buddhism or in Buddhist scriptures, but have their studies based on Buddhist texts other than the Chapter on Medicine or on historical documents–mostly the Chinese or the Tibetan literature of Mahāyāna or Vajrayāna Buddhism. Some examples are: Cao 1977, 1987; Cao 2006; Chen 2000, 2005, 2006; Chen and Chen 2002; Clifford 1984; Demiéville 1985; Garrett 2008; Gu and Zhou 2010a; Huang 2009; Huang 2004;Kageyama 2002; Kritzer 2014; Langenberg 2008, 2014; Liu and Han 1992; Liyanaratne 1996; Ma 2004; Mazars 2008; Naqvi 2011; Nihonyanagi 1994; Salguero 2010; Sen 1945; Sheng-yan 1969; Shi 1991; Shi 2010; Sugita and Fujiwara 2004; Tan 2013;Wang 2003; Xiao 2000a, 2000b, 2000c, 2000d; Yamanaka and Yamashita 2009; Zysk 1982, etc.