Toxicology (Agadatantra)

Toxicology (agadatantra or viṣagaravairodhikapraśamana or daṃṣṭrā) is one of the eight branches in ancient Indian medicine. This discipline deals with all sorts of poisons and venoms, as well as their treatments. Accounts of snakebite and poisoning are found in the Chapters on Medicine. In this section, data on snakebite and those on poisoning will first be narrated in separate tables; then Āyurvedic knowledge on toxicology will be furnished, followed by that in modern medicine.

Cases of snakebite are present in the Vinayas. There is a particular one found in all extant Vinaya Piṭakas, in which a monk was bitten by a snake. The monk is reported dead in most of the records, showing that the snake would probably have been a venomous one. This fact is confirmed by the accounts in the Mahīśāsaka, Sarvāstivāda, and Mūlasarvāstivāda Vinayas that the monk was bitten by a venomous snake.

This case is found in the Dharmaguptaka Bhaiṣajyaskandhaka and the Mūlasarvāstivāda Bhaiṣajyavastu, but is put elsewhere in other Vinayas. In order to have a more comprehensive examination of the snakebite cases and their treatments, all relevant accounts found in the Chapters on Medicine, as well as all records of that particular case will be listed in the following table.

Theravāda:—“At that time a certain monk was bitten by a snake. [The monks] informed this matter to the Exalted One. ‘I allow, monks, to give the four great foul things: faeces, urine, ashes, [and] clay.’”^[1]

“At that time a certain monk was bitten by a snake [and] he had died. [The monks] informed this matter to the Exalted One. ‘Monks, that monk certainly did not suffuse the four families of the snake-kings with the mind of loving-kindness. Monks, indeed, if that monk would suffuse the four families of the snake-kings with the mind of loving-kindness, monks, that monk [who] was bitten by a snake surely would not die. What are the four snake-king families? The snake-king family of Virūpakkha, the snake-king family of Erāpatha, the snake-king family of Chabyāputta, [and] the snake-king family of Kaṇhāgotamaka. Monks, that monk certainly did not suffuse these four snake-king families with the mind of loving-kindness. Monks, indeed, if that monk would suffuse these four snake-king families with the mind of loving-kindness, monks, that monk [who] was bitten by a snake surely would not die. I allow, monks, to suffuse these four snake-king families with the mind of lovingkindness [and] to make a self-protective charm for self-care [and] selfguard. And monks, it should be made thus: “For Virūpakkhas, I have loving-kindness; for Erāpathas, I have loving-kindness; for Chabyāputtas, I have loving-kindness; for Kaṇhāgotamakas, I have lovingkindness. For those without feet, I have loving-kindness; for those with two feet, I have loving-kindness; [for those] with four feet, I have lovingkindness; [for those] with many feet, I have loving-kindness. One with no feet, don’t harm me; one with two feet, don’t harm me; one with four feet, don’t harm me; one with many feet, don’t harm me. All creatures, all breathing beings, and all living beings are the whole. May all auspicious ones see. Don’t approach, any evil. The Buddha is immeasurable. The Dhamma is immeasurable. The Saṃgha is immeasurable. Those creeping animals are having limits: snakes, scorpions, centipedes, spiders, lizards, [and] mice. Shelter is made by me. Protective charm is made by me. May the living beings go back. I bow down to the Exalted One. I bow down to the seven perfectly Enlightened One.” I allow, monks, to release blood.’”^[2]

Dharmaguptaka:—“At that time the Buddha was in Rājagṛha. The monks were cutting firewood [for use in] the bathroom. A snake came out of a hollow wood. [It] bit and killed a monk. Then the Buddha, with the mind of lovingkindness, addressed the monks: ‘That monk did not cultivate the mind of loving-kindness towards those eight dragon-king snakes. Because of that, [he] was killed by the snake. What are the eight [dragon-king snakes]? Piloulecha dragon-king 毘樓勒叉龍王 (Virūpākṣa dragon-king?), the next is called Ganing 伽寧 (Kālika?), the next is called Gautamaka, the next is called Shipomiduoluo 施婆彌多羅 (Śivamitra?), the next is called Duosheyiluoponi 多奢伊羅婆尼 (Takṣaka-Elāpattra?), the next is called Gapiluoshiboluo 伽毘羅濕波羅 (Kambala-Aśvatara?),^[3] the next is called Dhṛtarāṣṭra dragon-king. If the monk had the mind of lovingkindness for those eight dragon-king snakes, [he] would not have been bitten and killed. If this monk had the mind of loving-kindness for all living beings, [he] also would not have been bitten and killed by that snake.’ The Buddha allowed for composing a mantra of the mind of loving-kindness for self-protection: ‘Loving-kindness to Piloulecha, loving-kindness to Ganing, loving-kindness to Gautamaka, lovingkindness to Shipomiduoluo, loving-kindness to Duosheyiluoponi, lovingkindness to Gapiluoshibolou, loving-kindness to Dhṛtarāṣṭra; the mind of loving-kindness to all dragon-kings, heavenly musicians [and] evil demons. ^[4] Now I cultivate the mind of loving-kindness, [which] removes and destroys all poisons and evils; from this, calmness and recovery are attained. Poisons are cut off, poisons are extinguished, [and] poisons are removed. Homage to the Exalted One.’ The Buddha said: ‘[I] allow cutting open [the wound] with a knife, releasing the blood, [and] anointing [the wound] with medicine. [I] also allow keeping a big needle-knife^[5] .’”^[6]

Mahīśāsaka:—“A monk wanted to start a fire in the bathroom and [he] cut firewood. A snake came out of a hole in a wood and bit [the monk’s] foot. He immediately died. The monks told the Buddha about this [matter]. The Buddha said: ‘That monk did not know the names of eight kinds of snake. [He had] no benevolent mind towards [them]. He also did not say the mantra, and was [thus] harmed by the snake. Eight kinds of snake are: Dhṛtarāṣṭra snake, Dache snake 怛車蛇 (Takṣaka?), Yiluoman snake 伊羅漫蛇 (Elāpattra?), Shepozi snake 舍婆子蛇 (Chabyāputta?), Ganmoluo’ashiboluohe snake 甘摩羅阿濕波羅呵蛇 (Kambala-Aśvatara?), Pilouluo’acha snake 毘樓羅阿叉蛇 (Virūpākṣa?), Gautamaka snake, [and] Nandopananda^[7] snake. The mantra for snakes is: “I have loving-kindness for all dragon-kings, [who are] in heaven and in the world. By this mind of loving-kindness of mine, all poisons of anger are extinguished. I, with the power of wisdom, use [lovingkindness] to kill this poison. Poison with taste [or] poison without taste–be destroyed and get into the earth.”’ The Buddha said: ‘If that monk used this mantra for self-protection, [he] would not have been harmed and killed by the venomous snake.’ Again there was a monk bitten by a snake. The monks told [this] to the Buddha. The Buddha said: ‘You do chanting for him with this mantra [so as] to cause him to be safe and stable.’ [The monks] received the instruction [and] went to do chanting for that [monk] who immediately recovered. Again, everywhere, there were monks bitten by snakes. [They] informed this to the Buddha. The Buddha said: ‘[I] allow performing chanting and ritual for curing according to what is suitable.’”^[8]

Sarvāstivāda:—“Again there was a monk–because of cutting firewood for having a [warm] bath–a venomous snake came out of a rotten wood and bit the monk’s finger. The monk had this thought: ‘This venom certainly enters [my] body.’ [He] immediately cut [that] finger by himself. Because of that, [his] finger broke.... The Buddha said: ‘From now on, [if] there is such a reason, [I] allow wrapping around the finger with a string [and] pricking [the finger] with a knife for releasing the venom.’”^[9]

Mūlasarvāstivāda (Sanskrit):—“The occasion was in Śrāvastī. The community of monks with the Buddha as the chief was invited by a certain householder for a dry hot bath. At that time the Venerable Svāti was newly come, young, renounced lately, [and] had come to this teaching and monastic discipline for not long.... He had begun to split firewood. While [he was doing that], he was bitten at the right big toe by a venomous snake coming out of a certain hollow putrid wood. Because of the venom, he had become unconscious [and] had fallen on the ground. He frothed at the mouth. He distorted [his] face, and rolled [his] eyes.... The monks informed this matter to the Exalted One. The Exalted One said: ‘Medical treatment should be undertaken after asking a physician.’ The physician was [then] asked by the monks [and] he said: ‘Noble ones, please offer a foul food.’ ^[10] The monks informed this matter to the Exalted One. The Exalted One said: ‘[Foul food] should be given on account of the physician’s instruction.’ The monks did not know what kind of foul food [to give]. The physician was asked by them [and] he said: ‘Noble ones, your teacher is indeed omniscient. The Exalted One is all-seeing. He surely will know.’ The monks informed [this] to the Exalted One. The Exalted One said: ‘Monks, foul food is: faeces, urine, ash, and clay. There, faeces is [that] of the recently born young animals, and urine of them. Ash is [that] of five trees: [that] of mountain ebony, [that] of kamībala (wood apple tree?),^[11] [that] of bodhi tree, [that] of cluster fig tree, [and that] of banyan tree. Clay, which is without water [and] four finger-breadths in the ground, should be drawn out. Thus it is the foul food.’ Thereupon, foul food was given to the Venerable Svāti by the monks. Even so he did not become well. The monks informed this matter to the Exalted One. The Exalted One said: ‘You will be able, Ānanda, having learned and studied the Great Peacock Spell [in] my vicinity, to give protection to the monk Svāti...’ Then the Exalted One said this Great Peacock Spell at that time: ‘Namo Buddhāya. Namo Dharmāya. Namaḥ Saṃghāya. Tadyathā amale vimale nirmale maṃgale hiraṇye hiraṇyagarbhe bhadre subhadre samantabhadre śrībhadre sarvārthasādhani paramārthasādhani sarvānarthapraśamani sarvamaṅgalasādhani manase mahāmānase acyute adbhute atyadbhute mukte mocani mokṣaṇi. Araje viraje amṛte amare amaraṇi brahme brahmasvare pūrṇe pūrṇamanorathe mukte jīvate rakṣa svātiṃ sarvopadravabhaya-rogebhyaḥ svāhā.’ ‘Yes, Venerable Sir.’ The Venerable Ānanda, having learned and studied the Great Peacock Spell [in] the Exalted One’s vicinity, had undertaken recitation of such a spell to the monk Svāti. [Svāti] had become free from the venom, just as the former [Svāti].”^[12]

Mahāsāṃghika:—“Furthermore, the Buddha lived in Śrāvastī. It has been elaborated as above. At that time there were two monks [who] stayed in a forest. Then a monk was bitten by a snake [while] smearing the room [with mud]. … Then [he] at once passed away. The monks, on this account, went to and informed the Buddha. … The Buddha told the monks: ‘If that [monk], [with] the mind of loving-kindness, called the names of the four great dragon-kings, [he] should not have died. Who are the four [dragonkings]? “Dhṛtarāṣṭra dragon-king, dragon-king of Yiluo country 伊羅國龍王 (Elāpattra?), Shanzi dragon-king 善子龍王 (Chabyāputta?), Heibai dragon-king 黑白龍王 (Kaṇhāgotamaka?)–I have loving-kindness. [For] living beings without legs, I have loving-kindness. [For] living beings with two legs, I have loving-kindness. [For] living beings with four legs, I have loving-kindness. [For] living beings with many legs, I have loving-kindness. Living beings without legs, don’t harm me. Living beings with two legs, don’t harm me. Living beings with four legs, don’t harm me. Living beings with many legs, don’t harm me. All living beings should attain freedom of taints [as well as] all virtuousness. [Living beings should] see each other with the mind of loving-kindness, and do not raise malice [to each other]^[13] .” If [that] monk has called the names of these four great dragon-kings, [he] should not have died.’”^[14]

There are also a few accounts of poisoning: intake of poison and being poisoned. Such cases were treated by using foul things such as dung and clay. The records are as follows:

Theravāda:—“At that time a poison was drunk by a certain monk. ‘I allow, monks, to cause [him] to drink dung.’”^[15]

“At that time a certain monk had a sickness [due to being] given a poisonous drink. ‘I allow, monks, to cause [him] to drink stirred mud turned up by the plough-share^[16] .’”^[17]

Dharmaguptaka:—“At that time there was a monk who was sick due to poison. The physician instructed [him] to consume putrid medicine.”^[18]

“At that time a monk was sick due to poison. The physician instructed [him] to consume mud [taken] from a farmland. The Buddha said: ‘[I] allow [the mud] to be placed in a receptacle, mixed with water, filtered, accepted and then drunk.’”^[19]

Mahāsāṃghika:—“If [one] is poisoned, [and] the physician says ‘[you] should consume the faecal fluid,’...”^[20]

The Samantapāsādikā has annotations on the case where the monk was given a poisonous drink and the treatment employed:

“‘A sickness [due to being] given a poisonous drink’ is an illness originated from a drink [which is] making [the person become] dependent. ^[21] The meaning [of] ‘stirred mud turned up by the ploughshare’ is: for tilling with a plough, [there is] mud stuck on the ploughshare. Having mixed [this mud] with water, I allow to cause [the sick one] to drink [it].”^[22]

From the above information, we can notice that treatments for poisoning cases are of two kinds: empirical and religious. Empirical remedies include the use of foul things (including putrid medicines), bloodletting, anointing the wound with medicine, pricking the wound for releasing the venom, and so on. Religious therapy involves the practice of loving-kindness and chanting of protective charm or spell.

According to Āyurveda, there are two types of natural poisons: immobile (sthāvara) and mobile (jaṅgama). The former refers to those relating to plant parts, latex, minerals, and so on; the latter are those of animals and insects (Caraka Saṃhitā Cikitsāsthāna 23. 9-13; Suśruta Saṃhitā Kalpasthāna (Kalpasthāna) 2. 3-5; 3. 4-5; Aṣṭāṅga Hṛdaya Saṃhitā Uttarasthāna 35. 4-5).^[23] There is also a type of artificial poisons (gara-viṣa), which is formed by mixing various substances (Caraka Saṃhitā Cikitsāsthāna 23. 14; Aṣṭāṅga Hṛdaya Saṃhitā Uttarasthāna 35. 6-7). Entering the body, poisons vitiate blood, damage humours, body tissues, vital points, and organs (especially the heart), and lead to death (Suśruta Saṃhitā Kalpasthāna 2. 1923; Aṣṭāṅga Hṛdaya Saṃhitā Uttarasthāna 35. 9-10). Abundant information on treatments of poisoning can be found in Āyurvedic texts. Various measures are used, including both magico-religious and empirical approaches, such as: chanting mantras, wearing amulets; excision of wounds affected by poison and releasing the poison by squeezing or sucking; cauterisation of the wound; sprinkling of cold water or cold bath with medicated water; emesis and purgation;anti-poisonous medicines (in which urine of cows or goats, fluid of cow dung, earth, or alkaline ashes are often utilised) applying at the wound or as collyrium, nasal drug, smoke, or medicated gruel or decoction for consumption;bloodletting (by means of leech, horn, or venesection); consuming special medicines to protect the heart; intake of alkaline medicines (prepared from ashes of plants); and so on (Caraka Saṃhitā Cikitsāsthāna 23. 35-37).^[24] Hence, all empirical and religious remedies described in the Buddhist sources are mentioned in the Āyurvedic texts for curing poisoning cases.

Snakebites are one of the important emergency cases in the world, though not all are afflicted by venomous snakes. There are about two hundred venomous snakes in the world, which are divided into three main groups: Viperidae (which has two subgroups of Viperinae and Crotalinae), Elapidae, and Hydrophidae. Moreover, some Colubridae species are mildly venomous (Rawlins and Vale 2012, 925). Venoms of these snakes are complex mixtures of proteins that not only cause local effects (such as swelling and/or tissue necrosis at the bitten site), but also systemic and life-threatening effects by affecting almost all organ systems (especially cardiovascular, respiratory, neuromuscular, and haematological systems) (Gold, Dart, and Barish 2002, 349-351). First-aid management of the bitten patient should be application of a firm pressure bandage over the wound site and immobilisation of the affected limb, so as to delay the spread of the venom. The snake involved should be identified if possible. The patient is then sent immediately to the nearest medical facility. Previous measures–such as applying a tourniquet at or proximal to the bitten site, incision of the bitten wound, suction of venom from the wound, or any manipulation of the wound–are nowadays discouraged by toxicologists because trauma to the underlying tissues of the wound by these actions may cause more damage especially if performed by unskilled people. Careful monitoring of the patient’s vital signs and blood coagulation is necessary, and supportive measures should be given. Antivenoms may be required if systemic effects of venom develop, but with caution of allergic reactions. The wound should be cleaned and managed accordingly, such as removal of necrotic tissue, skin grafting, administration of antibiotics, antitetanus prophylaxis, and so on (Gold, Dart, and Barish 2002, 351352; Olson 2012, 1545; Rawlins and Vale 2012, 926).

Poisoning can be due to self-administration (because of improper use of drugs or suicidal attempt), inappropriate administration by physician, accidental ingestion, feeding by another to cause harm, and occupational poisoning (usually via inhalation or skin contact). Substances involved can be diverse, such as various medications (e.g. neurological and psychiatric drugs, cardiovascular drugs, analgesics), illicit substances, pesticides or insecticides, household products (e.g. detergents, disinfectants), ethanol or methanol, carbon monoxide, natural poisons of plants or animals, traditional medicines, and so on. Treatment is mainly supportive by means of ventilatory and circulatory care and support. Management also involves care for other possible problems such as hyper-or hypothermia, arrhythmias, convulsions, coma, stress ulcers and bleeding, skin blisters, rhabdomyolysis (destruction of skeletal muscle fibres with excretion of myoglobin in the urine), and so forth. Specific antidotes for certain drugs or substances may be used. Measures for reducing poison absorption and increasing poison elimination are employed. The former includes removal of substance contact (e.g. on skin, eyes) and gut decontamination (by induced emesis, ^[25] gastric lavage, activated charcoal, and whole bowel irrigation). The latter comprises certain special therapies such as multiple-dose activated charcoal, urine alkalinisation, haemodialysis, and haemodiafiltration (Rawlins and Vale 2012, 909-913).^[26]

In this section, records of snakebite and poisoning found in the Vinayas have been examined. For these poisoning cases, both empirical remedies (such as using foul things like dung, urine, ashes, and mud, releasing venom from a bitten wound, bloodletting and so on) as well as religious means (including the practice of loving-kindness and chanting of a protective charm or spell) were employed. Such approaches of therapy are also noticed in Āyurveda for curing poisoning. In modern medicine, none of these ancient remedies are used. Cures nowadays involve appropriate first-aid management, quick transfer to a medical centre, careful monitoring of vital signs and blood condition, supportive care of major organ functions, measures for dealing with complications, use of an antivenom or an antidote if necessary, wound management, special measures to reduce absorption of toxins and/or to enhance their elimination.

Footnotes and references:

[1]:

Theravāda Vinaya Piṭaka I. 206: “tena kho pana samayena aññataro bhikkhu ahinā daṭṭho hoti. bhagavato etam attaṃ ārocesuṃ. anujānāmi bhikkhave cattāri mahāvikṭāni dātuṃ gūthaṃ muttaṃ chārikaṃ mattikan ti.”

[2]:

Theravāda Vinaya Piṭaka II. 109-110: “tena kho pana samayena aññataro bhikkhu ahinā daṭṭho kālaṃkato hoti. bhagavato etam atthaṃ ārocesuṃ. na ha nūna so bhikkhave bhikkhu cattāri ahirājakulāni mettena cittena phari. sace hi so bhikkhave bhikkhu cattāri ahirājakulāni mettena cittena phareyya na hi so bhikkhave bhikkhu ahinā daṭṭho kālaṃ kareyya. katamāni cattāri ahirājakulāni. Virūpakkhaṃ ahirājakulaṃ, Erāpathaṃ ahirājakulaṃ, Chabyāputtaṃ ahirājakulaṃ, Kaṇhāgotamakaṃ ahirājakulaṃ. na ha nūna so bhikkhave bhikkhu imāni cattāri ahirājakulāni mettena cittena phari. sace hi so bhikkhave bhikkhu imāni cattāri ahirājakulāni mettena cittena phareyya na hi so bhikkhave bhikkhu ahinā daṭṭho kālaṃ kareyya. anujānāmi bhikkhave imāni cattāri ahirājakulāni mettena cittena pharituṃ attaguttiyā attarakkhāya attaparittaṃ kātuṃ. evañ ca pana bhikkhave kātabbaṃ: Virūpakkhehi me mettaṃ, mettaṃ Erāpathehi me, Chabyāputtehi me mettaṃ, mettaṃ Kaṇhāgotamakehi ca,| apādakehi me mettaṃ, mettaṃ dvipādakehi me, catuppadehi me mettaṃ, mettaṃ bahuppadehi me.| mā maṃ apādako hiṃsi, mā maṃ hiṃsi dvipādako, mā maṃ catuppado hiṃsi, mā maṃ hiṃsi bahuppado.| sabbe sattā sabbe pāṇā sabbe bhūtā ca kevalā sabbe bhadrāni passantu, mā kiñci pāpam āgamā.| appamāṇo buddho appamāṇo dhammo appamāṇo saṅgho, pamāṇavantāni siriṃsapāni ahivicchikā satapadī uṇṇanābhisarabū mūsikā. katā me rakkhā katā me parittā, paṭikkamantu bhūtāni, so’haṃ namo bhagavato namo sattannaṃ sammāsambuddhānan ti. anujānāmi bhikkhave lohitaṃ mocetun ti.” This account is not within the Theravāda Bhesajjakkhandhaka.

[3]:

According to Vogel (1972, 191-192), the two nāgarājas (snake-kings), Kambala and Aśvatara, are often coupled together in ancient Indian lore.

[4]:

乾闥婆 is gandharva (heavenly musician). 羅剎娑 is rākṣasa (evil demon).

[5]:

According to Kangxi zidian (The Kangxi Dictionary), 鈹 means a big needle (Zhang et al. 2005, 1228). It is used for breaking open carbuncles, according to Cihai (The Ocean of Words) (Shu et al. 2005, 1373). Thus 鈹刀 should be a kind of knife or instrument which acts as a big needle.

[6]:

Taishō Tripiṭaka 1428. 870c22-871a8: “爾時佛在王舍城。諸比丘破浴室薪，空木中蛇出螫比丘殺。時世尊慈念，告諸比丘：「彼比丘不生慈心於彼八龍王蛇，以是故為蛇所殺。何等八？毘樓勒叉龍王，次名伽寧，次名瞿曇冥，次名施婆彌多羅，次名多奢伊羅婆尼，次名伽毘羅濕波羅，次名提頭賴託龍王。比丘若慈心於彼八龍王蛇者，不為螫殺。若此比丘慈心於一切眾生者，亦不為彼蛇所螫殺。」佛聽作自護慈念呪：「毘樓勒叉慈、伽寧慈、瞿曇冥慈、施婆彌多羅慈、多奢伊羅摩尼慈、伽毘羅濕波羅慈、提頭賴吒慈，慈念諸龍王、乾闥婆、羅剎娑，今我作慈心，除滅諸毒惡，從是得平復，斷毒滅毒除毒，南無婆伽婆。」佛言：「聽刀破出血以藥塗之，亦聽畜鈹刀。」”

[7]:

Nanda and Upananda are two nāgarājas. In the Buddhist legend they are often paired together and finally they are considered as one nāgarāja (Vogel 1972, 192).

[8]:

Taishō Tripiṭaka 1421. 171a16-b2: “有一比丘欲燃浴室中火破薪，蛇從木孔中出，螫脚即死。諸比丘以是白佛，佛言：「彼比丘不知八種蛇名，不慈心向，又不說呪，為蛇所害。八種蛇者：提樓賴吒蛇、怛車蛇、伊羅漫蛇、舍婆子蛇、甘摩羅阿濕波羅呵蛇、毘樓羅阿叉蛇、瞿曇蛇、難陀跋難陀蛇。呪蛇者：『我慈諸龍王，天上及世間，以我此慈心，得滅諸恚毒。我以智慧力，用之殺此毒，味毒無味毒，破滅入地去。』」佛言：「若彼比丘以此呪自護者，不為毒蛇之所傷殺。」復有比丘被蛇所螫，諸比丘白佛，佛言：「汝以此呪呪彼，令得安隱。」

受教往呪，彼即得差。復有諸比丘處處為蛇所螫，以是白佛，佛言：「聽作呪術，隨宜治之。」” This account is not within the Mahīśāsaka Bhaiṣajyadharmaka.

[9]:

Taishō Tripiṭaka 1435. 269b19-27: “復有比丘為作浴破薪故，毒蛇從朽木中出囓比丘指。比丘作是念：「此毒必入身。」即自斷指，由是指撅。...佛言：「從今有如是因緣，聽以繩纏指，以刀刺出毒。」” This account is not within the Sarvāstivāda Bhaiṣajyadharmaka.

[10]:

See Buddhist Hybrid Sanskrit Dictionary, s.v. “vikṛta”.

[11]:

According to a footnote to this Sanskrit term in the Gilgit Manuscripts (III. 1. 286n2), kamībala is written as kapi-da-ka (ཀ་པི་ད་ཀ་) in the Tibetan version. But both kaṃībala and kapidaka are not identifiable. A close term to the latter is kapitthaka, which is wood apple (Feronia elephantum) (A Sanskrit-English Dictionary, s.v. “kapitthaka”; Dash 2008, 306).

[12]:

Gilgit Manuscripts III. 1. 285-287: “śrāvastyāṃ nidānam | anyatamena gṛhapatinā buddhapramukho bhikṣusaṃgho jentākenopanimaṃtritaḥ | tena khalu samayenāyuṣmān svātirnavāgatastaruṇo 'cirapravrajitaḥ acirāgata imaṃ dharmavinayam | … sa kāṣṭhaṃ pāṭayitumārabdho yāvadanyatamasmātpūtidārusuṣirānniṣkramyāśīviṣeṇa dakṣiṇe pādāṅguṣṭhe daṣṭaḥ | sa viṣeṇa saṃmūrchito bhūmau patito lālā vāhayati mukhaṃ ca vibhaṇḍayati akṣiṇī ca samparivartayati | … etatprakaraṇaṃ bhikṣavo bhagavata ārocayanti | bhagavānāha | vaidyaṃ pṛṣṭvā cikitsā kartavyeti | bhikṣubhirvaidya pṛṣṭaḥ | sa kathayati | āryā vikṛtabhojanamanuprayacchateti | etatprakaraṇaṃ bhikṣavo bhagavata ārocayanti | bhagavānāha | dātavyaṃ vaidyopadeśeneti | bhikṣavo na jānate kīdṛśaṃ vikṛtabhojanamiti | tairvaidyaḥ pṛṣṭaḥ | sa kathayati | āryā yuṣmākameva śāstā sarvajño bhagavānsarvadarśī sa eva jñāsyatīti | bhikṣavo bhagavata ārocayanti bhagavānāha | vikṛtabhojanaṃ bhikṣava uccāraḥ prasrāvaśchāyikāṃ mṛttikā ca | tatra uccāraḥ acirajātakānāṃ vatsakānāṃ teṣāmeva ca prasrāvaḥ | chāyikā pañcānāṃ vṛkṣāṇām | kāñcanasya kamībalasyāśvatthasyodumbarasya nyagrodhasya| mṛttikā pṛthivyāṃ caturaṅgulam-apanīyoddhartavyā iti vikṛtabhojanamiti | tato bhikṣubhirāyuṣmataḥ svātervikṛtabhojanaṃ dattam | tathāpi na svasthībhavati | etatprakaraṇaṃ bhikṣavo bhagavata ārocayanti | bhagavānāha | śakṣyasi tvamānanda mamāntikānmahāmāyūrīṃ vidyāmudgṛhya paryavāpya svāterbhikṣo rakṣāṃ kartuṃ … | atha bhagavāṃstasyāṃ velāyāmimāṃ mahāmāyūrīṃ vidyāṃ bhāṣate sma | namo buddhāya namo dharmāya namaḥ saṃghāya | tadyathā amale vimale nirmale maṃgale hiraṇye hiraṇyagarbhe bhadre subhadre samantabhadre śrībhadre sarvārthasādhani paramārthasādhani sarvānarthapraśamani sarvamaṅgalasādhani manase mahāmānase acyute adbhute atyadbhute mukte mocani mokṣaṇi | araje viraje amṛte amare (amaraṇi) brahme brahmasvare pūrṇe pūrṇamanorathe mukte jīvate rakṣa svātiṃ sarvopadravabhayarogebhyaḥ svāhā | evaṃ bhadantetyāyuṣmānānando bhagavato'ntikānmahāmāyūrīṃ vidyāmudgṛhya paryavāpya svāterbhikṣoḥ svastyayanaṃ kṛtam | nirviṣaśca saṃvṛtto yathā paurāṇaḥ |”

[13]:

The Taishō Tripiṭaka has it here as “應得無漏一切賢聖善。心相視莫興惡意”, but older editions of Chinese Buddhist canon have it as “應得無漏一切賢善慈心相視莫興惡意”. My translation is based on the older editions.

[14]:

Taishō Tripiṭaka 1425. 389a10-28: “復次佛住舍衛城，廣說如上。爾時有二比丘阿練若處住。時一比丘塗房為蛇所螫...即便命終。諸比丘以是因緣往白世尊。...佛語諸比丘：「彼若慈心稱四大龍王名者，應不至死。何等四？持國龍王、伊羅國龍王、善子龍王、黑白龍王，我有慈。無足眾生我有慈，兩足眾生我有慈，四足眾生我有慈，多足眾生我有慈。無足眾生莫害我，兩足眾生莫害我，四足眾生莫害我，多足眾生莫害我。一切眾生應得無漏一切賢聖善，心相視，莫興惡意。設使比丘稱是四大龍王名者，應不致死。”

[15]:

Theravāda Vinaya Piṭaka I. 206: “tena kho pana samayena aññatarena bhikkhunā visaṃ pītaṃ hoti. anujānāmi bhikkhave gūthaṃ pāyetun ti.”

[16]:

The translation of “sītāloḷiṃ pāyetuṃ” is adopted from Anuruddha 2004, 939.

[17]:

Theravāda Vinaya Piṭaka I. 206: “tena kho pana samayena aññatarassa bhikkhuno gharadinnakābādho hoti. anujānāmi bhikkhave sītāloḷiṃ pāyetun ti.”

[18]:

Taishō Tripiṭaka 1428. 871a8: “爾時有比丘病毒，醫教服腐爛藥。”

[19]:

Taishō Tripiṭaka 1428. 871a11-13: “爾時病毒比丘，醫教服田中泥，佛言：「聽以器盛水和之漉然後受飲。」”

[20]:

Taishō Tripiṭaka 1425. 504c15: “若被毒，醫言：「應服大便汁。」...” This is not within the Chapter on Medicine parallel in the Mahāsāṃghika Vinaya.

[21]:

See Pali-English Dictionary, s.v. “vasī°”. Anuruddha (2004, 371) interprets this as a sickness caused by a drink given by a charmer.

[22]:

Samantapāsādikā V. 1092: “gharadinnakābādho ti vasikaraṇapānakasamuṭṭhitarogo. sitāloḷin ti naṅgalena kasantassa phāle laggamattikaṃ udakena āloḷetvā pāyetuṃ anujānāmī’ti attho.”

[23]:

In Āyurvedic texts, three kinds of snakes are mentioned. They are classified by their appearance, quality of venom, and the bite wound caused by them. None of the names of the snake types or families mentioned in the above Buddhist sources are found in these medical texts (Caraka Saṃhitā Cikitsāsthāna 23. 123129; Suśruta Saṃhitā Kalpasthāna 4. 9-13; Aṣṭāṅga Hṛdaya Saṃhitā Uttarasthāna 36. 1-6).

[24]:

In the Āyurvedic treatises, there are chapters discussing poisoning and its treatments. For details, see Caraka Saṃhitā Cikitsāsthāna 23; Suśruta Saṃhitā Kalpasthāna 2-8; Aṣṭāṅga Hṛdaya Saṃhitā Uttarasthāna 35-38.

[25]:

Emesis can be induced, for example, by syrup of ipecac. But nowadays this method is not encouraged because of the risk of pulmonary aspiration and of the delayed use of more effective treatments. Ingestion of faeces, faecal fluid or mud in the Buddhist sources might aim at induced emesis.

[26]:

Some poisons and/or their by-products are eliminated via the liver and bile into the bowel. They may be soluble in lipids and would then undergo the enterohepatic reabsorption process. Thus they are difficult to be excreted. As Genius (2011, 11) points out, certain clays can act as absorbents in the bowel, reduce this enterohepatic reabsorption of lipophilic substances and toxins, and enhance the elimination of the toxins. This may explain why mud was used as a remedy for poisoning in ancient India as shown in the Buddhist accounts and in Āyurvedic texts.