Methodology and Sources

In order to answer the above research questions and to achieve the aims of the research, an appropriate means is required. Suitable sources and method have to be employed. In this section, the sources for the present study will be described and the method will be elaborated. Following these, some special remarks pertaining to this research will be made.

Sources

When discussing medicine, the related issues–disease and healing–often have to be considered and explored. In the Buddhist canon, the Chapter on Medicine is the choice of material for this purpose. This text contains many cases of illnesses and treatments which occurred in the Buddhist monastic community at the time of the Buddha.

The Chapter on Medicine is a part of the Vinaya Piṭaka. More precisely, it is a part of the Skandhaka, which is a significant section in the Vinaya Piṭaka.^[1] There are five extant versions of the Chapter on Medicine. They are the Bhesajjakkhandhaka of the Theravāda Vinaya, the Bhaiṣajyaskandhaka of the Dharmaguptaka Vinaya, ^[2] the Bhaiṣajyadharmaka of the Sarvāstivāda Vinaya,^[3] the Bhaiṣajyavastu of the Mūlasarvāstivāda Vinaya,^[4] and the Bhaiṣajyadharmaka of the Mahīśāsaka Vinaya.^[5] In the first four Vinayas just mentioned, each respective Chapter on Medicine contains both information on materia medica and medical cases of illnesses with remedies, as well as on foods and drinks, whereas the Mahīśāsaka Vinaya has such data divided into two separate chapters–one on medicine (i.e. the Bhaiṣajyadharmaka) and another on food (known as the Āhāradharmaka). In the Mahāsāṃghika Vinaya, there is no distinct chapter named as the Chapter on Medicine, but the medical material is grouped and forms part of the whole Varga (i.e. the Skandhaka section), chiefly found in the fifth varga.^[6] For ease of discussion, this part of the Mahāsāṃghika Vinaya will be regarded as a version of the Chapter on Medicine. So, altogether there are six sources of the Chapter on Medicine available for this research. The Theravāda Vinaya is wholly in the Pāli language, whereas the Dharmaguptaka, the Mahīśāsaka, the Sarvāstivāda, and the Mahāsāṃghika Vinayas only remain in Chinese translation. The Mūlasarvāstivāda Vinaya exists in part in Sanskrit, as well as in Chinese translations, and presumably wholly in the Tibetan canon.^[7] For this present study, the Pāli, Sanskrit and Chinese sources will be used. The Tibetan version will not be included because of two reasons: one is that the important data relating to medical cases and drugs seem to be present in the Chinese and Sanskrit versions; another is that the present author’s Tibetan language skills are not yet adequate to examine this source in detail.

Two issues relating to the research materials have to be stated. The first is that, although the Chapter on Medicine is the main focus for this study, sometimes corresponding records for certain medical cases/treatments or medicinal substances mentioned in one or more Chapters on Medicine are placed in other parts of the Vinaya Piṭaka. Such records will be included for the purpose of complete accounts of those cases or drugs. These records will be specifically noted.

The second issue is that the main subject matters in this study will be the medicinal substances and the medical cases with their remedies. Apart from these data, there is much information on foods and drinks in the Chapter on Medicine. Traditionally, these foods and drinks are usually regarded as “medicines”–food/drink for before noon (Pāli: yāvakālika; Sanskrit: kālikāni;Chi: shiyao 時藥) and food/drink for afternoon and at night (Pāli: yāmakālika; Sanskrit: yāmikāni; Chi: feishiyao 非時藥)^[8] –for eliminating hunger and thirst as well as for maintaining physical health and functioning. However, hunger and thirst actually are natural and normal physiological needs, and they are not conditions beyond normality–that is, they are not actual illnesses. In this study, the main foci will be the drugs and the cases of illnesses with their treatments; foods and drinks for use before noon or afternoon/at night will not be included for discussion and interpretation.

Method

The approach of the present research will primarily be medical. Here “medical” refers to the examination of the medical facts in the Chapter on Medicine, namely, those medical cases and their treatments as well as those medicinal substances. Through studying the various versions of the Chapter on Medicine, these medical data will be analysed and interpreted.

This study will not pursue the historical, philological, philosophical, or anthropological aspects of the research materials. These aspects are not within the scope of this study, and are not within the present writer’s professional knowledge.

The method for this present study will be “interpretation”. But interpretation is such an ordinary process of human thinking, why is it specified as the method for this study? What exactly is it? What is so special about the method of interpretation used in this research? In order to understand the medical lore in the Chapter on Medicine, the medical details in the text have to be comprehended. This requires interpretation. According to the Oxford English Dictionary, the term “interpretation” means “the action of interpreting or explaining; explanation, exposition”, “an explanation given; a way of interpreting or explanation”, and “the action of translating; a translation or rendering of a book, word, etc.”^[9] The special ways of interpretation that this research will employ are actually adapted from Richard Palmer’s renowned book Hermeneutics: Interpretation Theory in Schleiermacher, Dilthey, Heidegger, and Gadamer (1969). This book gives a valuable discussion on interpretation. While clarifying “hermeneutics” through ancient and modern definitions, Palmer has identified three meanings of “saying”, “explaining”, and “translating” in ancient usage of the term hermeneutics, and six modern definitions corresponding to six theories of hermeneutics up to the time of writing his book (Palmer 1969, 12-45). The set of the three ancient meanings given by Palmer provides a pertinent model of the interpretative method for this present study. The six modern definitions, on the other hand, are expressions of various modern theories of hermeneutics which are more related to theology, philology and philosophy. They are not relevant to this research and such modern definitions will not be used in the present method.^[10]

The three ancient meanings of hermeneutics–saying, explaining, and translating–constitute the framework of the present method. With regard to saying, full narration of each of the drugs and/or medical cases will be expressed by means of the information taken from all relevant versions of the Chapter on Medicine (or from other parts in the VPs), so as to formulate a complete account of those drugs or cases. As for explaining, these drugs and medical cases will be explicated through the use of commentarial works (e.g. the Samantapāsādikā (Samantapāsādikā) (All-Pleasing, i.e. Buddhaghosa’s commentary on the Theravāda Vinaya Piṭaka), the Shanjian lüpiposha 善見律毘婆沙 (Virtuous-Seeing: A Commentary of the Discipline) (Taishō Tripiṭaka 1462), the Sifen lü shanfan buqüe xingshi chao (Commentary on Practices and Matters in the Dharmaguptaka Vinaya, by Deleting the Complex and Supplementing the Missing) (Taishō Tripiṭaka 1804), etc.) to illuminate what had happened or what had been used for treatment, as well as to get a better understanding of the medicinal substances and the diseases and their remedies. Furthermore, Āyurvedic treatises, such as the Caraka Saṃhita (Compendium of Caraka), the Suśruta Saṃhitā (Compendium of Suśruta), the Aṣṭāṅga Hṛdaya (Essence of Eight Limbs) etc.,^[11] and modern works on Āyurveda (such as Frank Ninivaggi’s Ayurveda: A Comprehensive Guide to Traditional Indian Medicine for the West (2010), and Sebastian Pole’s Ayurvedic Medicine: The Principles of Traditional Practice (2006)) together with the aid of dictionaries and encyclopaedias of Indian medicine/drugs, will be consulted so that a more thorough understanding of Buddhist medical details is possible. Since the medical cases in the Chapter on Medicine had their setting in ancient India, the use of traditional Indian medical knowledge in explaining such information is congruent. In respect of translating, as Palmer explains, translation “brings what is foreign, strange, or unintelligible into the medium of one’s own language” (Palmer 1969, 27). Likewise, the ancient medical information in the Chapter on Medicine will be “translated” into modern medical or scientific terminology. Modern biomedical knowledge–through all sorts of updated texts, research articles, dictionaries, encyclopaedias, etc.–will be utilised so that readers may apprehend the Buddhist medical facts in terms of modern medical language. Biomedical knowledge, amongst various types of medical knowledge, is chosen for such method of translation because nowadays in many parts of the world, both developed and developing areas, biomedicine is the dominant medical tradition and is widely known and practised.

The medical data in the above sources will be grouped into two domains for discussion: the medicinal substances and the medical illnesses (with their treatments). These two areas will be organised into two separate chapters–one on the drugs (Chapter Four) and another on the diseases and remedies (Chapter Five). Medical facts in these two chapters will be analysed and discussed in the above framework of method (i.e. narration, explanation, and translation).

Regarding the method for this study, several challenges may require discussions. They are the validity of the method, the reliability of the interpretation, and the problem of retrospective diagnosis.

The first challenge is: is this chosen method valid? As stated above, this study has a three-fold interpretation. The first is narration (or saying) by collecting and presenting the relevant records for a certain drug or illness. This has the purpose of providing a more informative account of that drug or disease. The second is explanation of the medical material in the Chapter on Medicine by means of commentarial as well as Āyurvedic knowledge. Thus this includes interpretation of the Buddhist medical information through Āyurvedic lore. The third is translation of the ancient medical facts into contemporary knowledge. Modern biomedical science is the appropriate means for this interpretation, for it is the dominant form of medicine known and used in most parts of the present-day world. Hence, in this study, the medical particulars in the Chapter on Medicine will be interpreted via two medical systems: Āyurveda and modern biomedicine. Interpretation of the knowledge of one medical tradition by that of another system is not uncommon. As shown in the above section of Literature Review, Zysk (1991) has compared the medical material in the Bhesajjakkhandhaka with that in the ancient Indian medical treatises (such as the Caraka Saṃhitā, the Suśruta Saṃhitā, and others);^[12] Obinata (1965) has interpreted the medical data in the Buddhist literature (mostly in the Vinayas) using the facts of biomedicine fifty years ago. So, the method of making use of knowledge of other medical traditions to compare with or interpret the ancient medical information in the Buddhist texts has already been employed in scholarship and is well accepted. For this study, the present method is thus a combination of the methods utilised by Zysk and Obinata.^[13] Yet it has another advantage: it first explains the medical details through Āyurveda, and this explanation provides a better base for further interpretation in terms of modern medical knowledge. In addition, this study should be the first to use this framework of interpretation–an interpretation through both Āyurvedic and modern biomedical doctrines.

For the second challenge, readers may ask whether the interpretations of the medical data of the Chapter on Medicine are reliable or not. They may argue that, by using such method, could the exact meanings of the medical facts be known, and would the interpretations be objective and correct enough? This study is, in fact, merely an attempt to elucidate and understand the information in the Chapter on Medicine. It is virtually impossible to know “exactly” what had happened more than two thousand years ago as recorded in the text. The material in the text is succinct, vague, and without much detail given. Exact exposition is difficult to achieve. Owing to this, elucidation with the help of other medical traditions (Āyurveda and modern medicine) would appear to be the only possible method.^[14] This study does not intend to provide “the truths”, but only possible explications of the medical particulars in the Chapter on Medicine. Furthermore, the interpretations in this study for the drugs and illnesses in the Chapter on Medicine are based on the information obtained in the Chapter on Medicine, as well as the Āyurvedic and modern medical knowledge. Like making any diagnosis, which is “a complex cognitive task that involves both logical reasoning and pattern recognition” (Richardson, Wilson, and Guyatt 2002, 103), an explanation has to rely on available data. Hence the interpretations in this study are not speculations; they are reasonable hypotheses.

The last challenge is the problem of retrospective diagnosis. Some medical historians have expressed objections to the identification of diseases of the past in terms of modern medicine, and have criticised such retrospective diagnosis. They reject the idea of interpreting ancient medical material through modern medical knowledge, due to (i) that the socio-cultural contexts of the concepts of disease are neglected;^[15] (ii) that diseases are taken as permanent entities, without considering changes of concepts of disease over time (and space); (iii) that modern medical knowledge is regarded as the best and most authentic for such interpretation;and (iv) that such diagnosis is a backward-projection of modern concepts on those of the past.^[16] In fact, the present study will involve interpretation of ancient medical cases in terms of modern medical knowledge. Hence it faces these difficulties of retrospective diagnosis. However, this study should overcome these difficulties because of the following reasons. Firstly, by interpreting the medical facts in the Chapter on Medicine with the aid of classical Āyurvedic texts, this study employs ancient Indian knowledge and hence the interpretation involves socio-cultural considerations. Secondly, modern Āyurvedic works that have illuminated the ancient lore of its own tradition in modern language are used as references. Any changes in the concepts of disease in the tradition over time should have been dealt with by the modern Āyurvedic scholars in these works. Thirdly, this study does not advocate that modern biomedicine is the best or the most authentic system for elucidating the ancient information. It is used as a means for expounding because it is so far the most widely practised and known medical system in the world (which in turn is due partly to the modern subjects of science and biology in school). Explication by means of modern biomedicine would then be most easily apprehended. Lastly, the interpretation in terms of modern medical knowledge is an attempt at understanding the Buddhist medical material of the Chapter on Medicine. It definitely does not claim to be an infallible projection of modern ideas onto the ancient information. This study just shows possible expositions for the drugs and illnesses in the Chapter on Medicine, and is not meant to impose modern concepts of medicine onto the old or traditional ones.

In short, by applying the three-fold interpretative method to the medical data of the Chapter on Medicine, this thesis aims to give a more complete picture of what medical information is there, as well as to achieve a better understanding of such material by careful analysis and interpretation.

Special Remarks

Before outlining the chapters of this thesis in the following section, there are yet a few things deserving special remarks. These relate to the use of some terms. In this study, since various texts in original languages will be consulted, Pāli terms will be used when texts written in Pāli are referred to, and Sanskrit ones will be expressed when Sanskrit or Chinese sources are employed.^[17] Chinese terms will generally be represented using pinyin (i.e. transcribing the Putonghua pronunciation).

Another term that requires clarification is “biomedicine”. In this thesis, this term is used instead of “Western medicine”. This is due to several reasons: (i) modern medicine is predominantly based on the bio-scientific paradigm, even though other fields such as psychological medicine, behavioural medicine, social medicine etc. are present; (ii) it is now used worldwide, not only in Western countries; and (iii) Western communities also employ other modes of treatment such as religious healing, folk and popular therapies indigenous to the West, and alternative Western remedies (e.g. osteopathy, homeopathy, chiropractic, naturopathy etc.) (Kleinman 1993, 16). Another term, “modern medicine”, will also be used to refer to biomedicine.

Yet another term is “Buddhist medicine”. Some scholars use this term.^{[18] [19]} Is Buddhist medicine a range of medical remedies, or a medical system/tradition? Some of these scholars refer to this term as the medical perspectives or practices found in Buddhist literature. For instance, Salguero expresses: “‘Buddhist medicine’ is a convenient shorthand for discussing Buddhist perspectives of disease, healing, and the body. … Embedded in Buddhist scriptures and practices, these ideas were spread …” (2010, 1-2). Naqvi appears to denote this term as “the practice of medicine and surgery by the Buddhists” and “the medical achievements of the Buddhists” (Naqvi 2011, xviii). However, East Asian scholars seem unanimously to apply this term as a special medical system. So, is there a system of Buddhist medicine? In early Buddhist literature, lists of diseases (classification of diseases) and depiction of causes of physical suffering (aetiology) are noted, as shown in the Girimānanda Sutta (Discourse to Girimānanda) of the Aṅguttara Nikāya (Aṅguttara Nikāya V. 108-112). Including the various therapies recorded in the Chapter on Medicine, it seems that there prevails a medical system in the early Buddhist literature which mostly conforms to the above characteristics of a medical system.^[20] However, looking at the Chapter on Medicine, it can be noted that the Buddha was prescribing various remedies for the sick monks, and it is reasonable to assume that the Buddha already possessed certain medical knowledge.^[21] Although this is not clearly reported in early Buddhist scriptures, the Buddha, when he was still a prince, could have received training in various skills, including medical knowledge, as his father (King Śuddhodana) aspired for his son to be a universal monarch and would have provided a supreme education for his son.^[22] Furthermore, according to Zysk, some Buddhist wandering ascetics (Pāli: samaṇa; Sanskrit: śramaṇa) certainly had learned the healing arts, and such knowledge could have been brought into the monastic community and recorded in the Vinaya literature (Zysk 1991, 27).^[23] Such Buddhist medical lore thus would have come from the then existing Indian medical tradition, which was incorporated into the Buddhist doctrine.^[24] The early Buddhist community seemed not to have had a unique medical system of its own, with its own special theory and practice.^[25] In this thesis, therefore, the term “Buddhist medicine” has the notion not of a distinctive medical system, but as medical lore preserved in early Buddhist literature.

Footnotes and references:

[1]:

In different VPs, this section has different names such as Skandhaka, Dharmaka, Vastu, or Varga. As Yamagiwa (1994, 107n3) has stated, not all the Skandhaka sections of the VPs have been transmitted under the term Skandhaka and so for ease of discussion this collective term will be used to refer to all existing Skandhaka texts.

[2]:

Fascicle (Chinese: juan 卷) 42-43 of the Sifen lü 四分律 (“Vinaya in Four Divisions”, i.e. the Dharmaguptaka Vinaya) (Taishō Tripiṭaka 1428).

[3]:

Fascicle 26 of Shisong lü 十誦律 (“Vinaya in Ten Recitations”, i.e. the Sarvāstivāda Vinaya) (Taishō Tripiṭaka 1435).

[4]:

Genben shuoyiqieyoubu pinaiye yaoshi 根本說一切有部毘奈耶藥事 (the Mūlasarvāstivāda

Vinaya) (Taishō Tripiṭaka 1448).

[5]:

Fascicle 22 of Mishasebu hexi wufen lü 彌沙塞部和醯五分律 (“Vinaya in Five Divisions”, i.e. the Mahīśāsaka Vinaya) (Taishō Tripiṭaka 1421).

[6]:

Fascicle 28 of Mohe sengqi lü 摩訶僧祇律 (the Mahāsāṃghika Vinaya) (Taishō Tripiṭaka 1425).

[7]:

See footnote 32 in Chapter Two for the discussion on whether the Tibetan version of the Mūlasarvāstivāda Vinaya is whole or not.

[8]:

See Samantapāsādikā IV. 839; Sifen lü shanfan buqüe xingshi chao 四分律刪繁補闕行事鈔

(Commentary on Practices and Matters in the Dharmaguptaka Vinaya, by Deleting the Complex and Supplementing the Missing) (Taishō Tripiṭaka 1804. 117c15 ff.).

[9]:

See Oxford English Dictionary, 3rd ed., s.v. “interpretation” [accessed July 29, 2012, http://www.oed.com/view/Entry/98211?redirectedFrom=interpretation#eid].

[10]:

The six modern definitions, according to Palmer (1969, 33), encompass “the theory of biblical exegesis; general philological methodology; the science of all linguistic understanding; the methodological foundation of Geisteswessenschaften;phenomenology of existence and of existential understanding; and the systems of interpretation, both recollective and iconoclastic, used by man to reach the meaning behind myths and symbols.” These modern definitions which are actually the theories of hermeneutics (more or less in chronological development) proposed by Friedrich Schleiermacher (1768-1834), Wilhelm Dilthey (1833-1911), Edmund Husserl (18591938), Martin Heidegger (1889-1976), Hans-Georg Gadamer (1900-2002), and Paul Ricouer (1913-2005).

[11]:

Descriptions of the classical Āyurvedic treatises, including their dating and provenance, will be given in Section 2. 3. 1 in Chapter Two.

[12]:

Zysk (1995) has written a separate article advocating the method of understanding Pāli medical texts by means of Āyurvedic treatises.

[13]:

Certain findings of Zysk and Obinata’s books are also referenced in our discussions and interpretations of drugs and diseases.

[14]:

Palmer (1969, 36) has expressed (while discussing biblical hermeneutics): “The text is not interpreted in terms of itself; indeed, this may be an impossible ideal. … In this sense hermeneutics is the interpreter’s system for finding the ‘hidden’ meaning of the text.” Thus interpretation of a text requires the assistance of a “system” of interpretation.

[15]:

Cultural approaches are now being increasingly emphasised in various scholarly fields, such as translation studies, linguistics, literary studies, and so on. “Cultural turn”–as discussed in Translation, History and Culture, edited by Susan Bassnett and André Lefevere (1990)–has become predominant in translation studies since the 1990s. It refers to the trend that “any study of translation needs to take into account the double context of both source and target cultures” (Bassnett 2005, 311).

[16]:

These arguments against retrospective diagnosis and their details can be found in Arrizabalaga 2002;Cunningham 2002; Unschuld 1985; Wilson 2000.

[17]:

It is believed that the early Buddhist texts (such as the Āgamas) in Chinese translation have come from Sanskrit originals or other Middle Indic Prakrit originals (see Kuan 2008, 172n11). It is beyond the scope of this study to explore the original languages of the various available VPs.

Sanskrit terminology will, for ease of discussion, be employed for non-Pāli sources.

[18]:

See, for example, Cao 2006; Chen 1999, 2000; Clifford 1984; Fukunaga 1980; Gu and Zhou 2010a,

[19]:

b; Kageyama 2000; Liu and Han 1992; Ma 2004; Naqvi 2011; Nihonyanagi 1994; Obinata 1965; Salguero 2010, 2014;Shi 1991; Sugita 1997; Sugita and Fujiwara 2004; Wang 2003; Wang 2011; Xiao 2000a, 2000b, 2000c, 2000d; Yin 2001; Zysk 1995, etc. It seems that East Asian scholars use the term “Buddhist medicine” more frequently than Western scholars.

[20]:

See p. 2 above for the discussions on medicine and medical system/tradition.

[21]:

There is also a possibility that prevailing medical knowledge was put in the mouth of the Buddha by the compiler(s) of the Vinaya canon, as mentioned by the present writer’s thesis supervisor, Professor Halkias.

[22]:

In the Pāli Tipiṭaka, there is virtually no information on the education of Prince Siddhattha. It is only mentioned in the later literature. In the Milindapañha (Questions of Milinda), Sabbamitta (who is believed to be Viśvāmitra in the Lalitavistara) is stated as the second teacher of the

Bodhisatta (i.e. Prince Siddhattha) (see Horner’s Milinda’s Questions (1999, 38-39)). In the Nidānakathā (Introductory Talk, i.e. the introductory chapter of the Jātaka commentary) (Rhys Davids 1977, 76), it is stated that the prince was supreme at archery and twelve-fold skills. In the Lalitavistara (Extensive Grace, i.e. the Puyao jing 普曜經 (Taishō Tripiṭaka 186) or the Fangguang da zhuangyan jing 方廣大莊嚴經 (Taishō Tripiṭaka 187) in the Chinese Buddhist canon), the Abhiniṣkramaṇa Sūtra (Discourse on Entering Ascetic Life, i.e. the Fo benxing ji jing 佛本行集經 (Taishō Tripiṭaka 190)), and the Saṃghabhedavastu (Matter on the Division of the Saṅgha) of Mūlasarvāstivāda Vinaya (Taishō Tripiṭaka 1450), the prince’s learning and even excellence of various kinds of knowledge and different skills before receiving proper training are expressed. See also Foucher 1963, 53-58; Khosla 1991, 77; Penner 2009, 23; Piyadassi 1987, 12; Thomas 1949, 46-47;Wickremesinghe 2002, 25-27.

[23]:

Zysk’s theory on the role of wandering ascetics in the history of ancient Indian medicine will be reported in Section 2. 1. 3 in Chapter Two. He puts forth his theory on the basis of various literary materials, such as the Vedic scriptures (e.g. Ṛg Veda, Atharva Veda, Saṃhitās, Brāhmaṇas, etc.), the Jaina literature, the early Buddhist Pāli canon, and the Greek record (Megasthenes’ account) (Zysk 1991, 21-37).

[24]:

For the discussion of the history of ancient Indian medicine before and up to the time of the Buddha, see Section 2. 1 in Chapter Two.

[25]:

Whether a Buddhist medical system was developed in the later history of Buddhism, for example in the period of Mahāyāna Buddhism, is beyond the scope of this study. It deserves further study and clarification.