Ophthalmology (Sālākiya)

There are abundant data on eye disease in the Chapters on Medicine/Vinayas. Many eye medicines are recorded. In most of these accounts, the eye disease is not wellspecified; often it is just mentioned as eye disease or painful eye. Only in the Dharmaguptaka Bhaiṣajyaskandhaka is a specific term given: baiyi 白瞖 (or 白翳). Besides, different Vinayas have their lists of ophthalmic medicines. Information on the containers for holding these drugs, the tools for applying them, and the rules on utilisation and storage of them is also provided in the Chapters on Medicine.

These facts are collected in the following table.

Theravāda:—“At that time a certain monk had an eye disease.... Then the Exalted One, having given a dhamma talk against this background, addressed the monks: ‘I allow, monks, the collyrium: black collyrium, essence collyrium,^[1] stream collyrium, red chalk, [and] lampblack.’ There was a need of powdered collyria. … ‘I allow, monks, sandalwood, Indian valerian, kāḷānusāriya,^[2] Himalayan silver fir, [and] nut grass.’ At that time the monks laid aside the ground collyria in small bowls and cups. [The collyria] were strewn over with grass powders and dust. … ‘I allow, monks, a collyrium-box.’ At that time the monks belonging to a group of six held various collyrium-boxes: [which] were made of gold [and] made of silver. People criticised, voiced their anger, and condemned [them]: ‘Just as the householders enjoying sense-desires.’ They informed this matter to the Exalted One. ‘Monks, various collyrium-boxes should not be held. Whoever would hold, there is an offence of wrong-doing. I allow, monks, [the collyrium-box] made of bone, made of tooth, made of horn, made of reed, made of bamboo, made of wood, made of lac, made of fruit,^[3] made of copper, [or] made of saṅkhanābhi.’ At that time the collyrium-boxes were not covered. They were strewn with grass powder and dust. … ‘I allow, monks, a lid.’ The lid fell off. ‘I allow, monks, having bound with a thread, to tie [the lid] to the collyrium-box.’ The collyrium-box fell down. ‘I allow, monks, to sew [the collyrium-box] with a thread.’ At that time the monks anointed [collyrium] with finger. The eyes became painful. … ‘I allow, monks, a collyrium-stick.’ At that time the monks belonging to a group of six held various collyrium-sticks [which] were made of gold [and] made of silver.... ‘Monks, various collyrium-sticks should not be held. Whoever would hold, there is an offence of wrong-doing. I allow, monks, [the collyrium-stick] made of bone … made of saṅkhanābhi.’ At that time the collyrium-stick had fallen on ground [and] became rough. … ‘I allow, monks, a container for the collyrium-stick.’ At that time the monks carried about [their own] collyrium-box and collyrium-stick by hand. … ‘I allow, monks, a bag for the collyrium-box.’ There was no shoulder-strap. … ‘I allow, monks, the shoulder-strap [and] the thread for tying.’”^[4]

Dharmaguptaka:—“At that time a monk was sick [and he] had a need of an eye medicine. The Buddha said: ‘[I] allow the use. Herein, eye medicines are tuoposhena 陀婆闍那 (smoke-collyrium?)^[5] [and] qiluoshena 耆羅闍 那 (red chalk?).^[6] A monk with a reason of illness should use [them] for the duration of one’s life.’ At that time a monk’s eye had baiyi 白瞖 (corneal scar or pterygium?)^[7] arisen. [He] had a need of human blood. [He] informed the Buddha. The Buddha said: ‘[I] allow the use.’ At that time a monk was afflicted with baiyi in eye. [He] had a need of human bone. The Buddha said: ‘[I] allow the use.’ At that time a monk was afflicted with baiyi in eye. [He] had a need of fine soft hairs. [The Buddha said:] ‘[I] allow burning [the fine soft hairs] to powder [which] is [then] applied into the eye.’ At that time Pilindavatsa was afflicted with painful eye. [He] got a beryl blade. ^{[8] [9]} The Buddha said: ‘[I] allow keeping and utilising [it] for the purpose of treating eye disease.’”^[10]

Mahīśāsaka:—“There were monks afflicted with eye [disease]. The physician said: ‘[You] grind a [piece of] human forehead bone, [and] apply [the powder] into the eyes.’ The monks said: ‘The Buddha does not allow us to take a dead person’s bone. [Please] tell [us] yet another prescription.’ The physician said: ‘Yet there is not another treatment.’ The monks had this thought: ‘If the Exalted One gives permission to take a [piece of’ dead person’s bone when [we are] sick, [our] illness can be relieved.’ [They] informed the Buddha about this. The Buddha said: ‘[I] allow taking a [piece of] bone as large as two fingers at a concealed place, grind [it], and apply [the powder] into the eyes.’”^[11]

“There was a monk afflicted with eye [disease]. The Buddha said: ‘[I] allow making an eye medicine.’”^[12]

Sarvāstivāda:—“The Buddha was in Śrāvastī. At that time the elder Pilindavatsa had a painful eye. The physician said: ‘Anoint the eye with essence collyrium.’^[13] [Pilindavatsa] replied: ‘The Buddha has not allowed us to anoint the eye with essence collyrium.’ The monks informed the Buddha about this matter. The Buddha said: ‘[I] allow anointing the eye with essence collyrium.’ This elder had the essence collyrium placed in a bowl, a shallow bowl,^[14] a water-jar, [and] a small water-jar.^[15] [He] enclosed it in a bag [and] hung it on an ivory peg. While taking the medicine, [it] flew and smudged the wall and the bedding. It became stinky and dirty in [his] lodging. The Buddha said: ‘[You] should place [the essence collyrium] in a small box.’ Though it was placed [in a box], there was no lid. Soil and dust fell into the medicine. When [the medicine was] used, it hurt the eye more. The Buddha said: ‘[You] should make a lid.’ During moving, the lid fell off. The Buddha said: ‘The lid and the mouth [of the box] [should] be made to fit [together].’ At that time the monks used a bird quill, a chicken quill, [and] a peacock tail [feather shaft] to apply the medicine to the eye. The pain of eye was even enhanced. The Buddha said: ‘Use a stick.’^[16] The elder Upāli asked the  Buddha: ‘What material should be employed to make the stick?’ The Buddha said: ‘[Material] such as iron, or copper, or shell, or ivory, or horn, or wood, or ceramic.’”^[17]

“The Buddha was in Śrāvastī. At that time the elder Pilindavatsa [was afflicted with] a painful eye. Then the physician instructed: ‘Blend medicines [and] make pills; [then] burn [the pills] on fire [and] consume the smoke.’ Upāli asked the Buddha: ‘What things [should be] employed to make the medicine?’ The Buddha said: ‘Only except the costus root,^[18] blend all the other scented substances. Put [the medicine] in fire, take the smoke by hand, and then swallow [the smoke].’ Then [Pilindavatsa] could not take the smoke by hand. The Buddha said: ‘Make a pipe.’ Then the pipe was [made] too long [and Pilindavatsa] could not get the smoke. The Buddha said: ‘Don’t make [the pipe] long.’ Furthermore, [the pipe] was made short [and] hence the hand was burned. The Buddha said: ‘Don’t [make the pipe] too short.’ Then, also, the pill medicine was [placed] at one place [while] the pipe at [another] place. It was difficult to take [the pill medicine and the pipe]. The Buddha said: ‘[You] should keep a bag for placing [them].’ When placing [them in a bag], the pipe damaged the medicinal pills. The Buddha said: ‘The inside [of the bag] should add a partition.’ Having added a partition, the mouth [of the bag] was not tied [and] the pipe fell on the ground. The Buddha said: ‘Should tie the mouth [of the bag].’”^[19]

“The Buddha was in Śrāvastī. The elder Pilindavatsa was afflicted with a painful eye. Then the physician instructed: ‘[You] should have a nasal douche with fat.’ Then the monk used [his] finger to drip [fat] into [his] nose, or used animal hairs to get fat and drip [into nose]. While dripping, [the fat] did not smoothly flow into [the nose]. The eye became even more painful. [He] informed the Buddha about this matter. The Buddha said: ‘Make a tube for douching.’ The tube was made [too] large [and] the nose [could] not take [it]. Again [the tube] was made small, [and it] was useless [by having the fat] spilt and lost. [He] informed the Buddha about this matter. The Buddha said: ‘Don’t make [the tube] large [and] don’t make [it] small; [the size of which] can take one pala or one and a half pala.^[20] [If you] want to spit [the fat], use [your] hand to hold [it].’ Because of holding [the spat fat] by hand, [he] then wanted to vomit. The Buddha said: ‘[I] allow using a ragged robe to hold [it].’”^[21]

Mūlasarvāstivāda (Sanskrit):—“The occasion was in Śrāvastī. At that time a certain monk had an eye disease which had become evident. He had approached the presence of the physician [and said:] ‘Good Sir, I have an apparent eye disease. Please point out the medicine.’ That [physician] said: ‘Noble one, please make use of collyrium. You will become healthy.’ ‘Good Sir, are we the ones enjoying sense-desires?’ ‘Noble one, this is the medicine for you. It is not possible to become healthy otherwise.’ The monks informed this matter to the Exalted One. The Exalted One said: ‘With the physician’s prescription, collyrium should be used.’ They did not know [which collyrium to use]. [Then] the physician was asked by those [monks and] he said: ‘Noble one, your teacher is omniscient. Please go to him [and] ask him.’ The monks informed this matter to the Exalted One. The Exalted One said: ‘The five collyria are: flower collyrium,^[22] essence collyrium, powder collyrium, pill collyrium, [and] sauvīrakacollyrium.’^[23] It had been used by that [monk]. He had become well. The remaining collyrium had been put aside and utterly lost by him in whatever place.... The monks informed this matter to the Exalted One. The Exalted One said: ‘The collyrium should not be kept in whatever place by a monk.... By the monks who are the bearers of the collyrium, the collyria should be kept just like this: the flower collyrium should be kept in a bowl, the essence collyrium in a casket; the powder collyrium, the pill collyirum and the sauvīra[-collyrium], having bound [in] a bag, should be kept on an ivory peg on the wall.^[24] ...’”^[25]

Mūlasarvāstivāda (Chinese):—“The occasion was in Śrāvastī. Then there was a monk afflicted with eye [disease]. He therefore went to the physician’s place [and] asked: ‘Good Sir, I am at present afflicted with eye [disease]. [Please] prescribe medicine for me.’ The physician replied: ‘Noble one, it is proper to use collyrium; then [your illness] should be relieved.’ The monk replied: ‘How could I be a person fond of sense-desires?’ The physician replied: ‘Noble one, this is a good medicine for treating eye [disease]. Apart from this, other medicines cannot heal that.’ On this account, at that time the monks went to [and] informed the Buddha. The Buddha said: ‘If the physician says “this is the medicine for treating eye [disease and] other [medicines] cannot heal,” [then] one should use collyrium.’ But that monk did not know what collyrium to use. [He] thus asked the physician. The physician replied: ‘Noble one, your teacher is endowed with omniscience. [You] should go ask him.’ Because of this reason, the monks then went to [and] informed the Exalted One. The Buddha said: ‘There are five kinds of collyrium: one, the flower collyrium; two, the juice collyrium; three, the powder collyrium; four, the pill collyrium; [and] five, the Sauvīra pebble collyrium. ^[26] All these five kinds [of collyrium] are able to cure eye [diseases]. It is why, if a monk is afflicted with an eye [disease], [he] should use collyrium. Only then the [eye disease] can be relieved.’ After the [eye] illness had relieved, all the leftover collyrium was therefore abandoned.... [That sick monk], on this account, went to and informed the Exalted One. The Buddha said: ‘Monk, if there is residual collyrium, it should not be just abandoned without storing [it].... That collyrium should be placed at a secure place. Flower collyrium is to be placed in a copper container, juice collyrium in a small case, [and] powder collyrium in a bamboo tube. Then each of these is placed in a bag, or is wrapped by something, or is hung on a stake [which is] nailed on the wall....’”^[27]

Mahāsāṃghika:—“[Regarding] the eye medicine:... The Buddha dwelled in Śrāvastī, at Jīvaka Kumārabhṛta’s Mango Grove. Then the monks had painful eyes.... The Buddha said: ‘From now on, [I] allow using eye medicines, with the exception of kongqing 空青 (azurite, malachite, or blue vitriol?). ^[28] If the physician says: “Venerable Sir, this painful eye requires anointing with kongqing-powder [and it will] then be relieved. Further, there is no other treatment.” If that is so, [one] can anoint [the eye with kongqing]. Having anointed [with it], [he] is not allowed to live among the community. [He] should stay in a small lodging at border region. Having recovered, [he] should wash [it off and] can return to the community.’ This is known as the eye medicine. [Regarding] the tube[container] for eye medicine: The Buddha dwelled in Śrāvastī. Then the monks held leaves for holding eye medicine. The Buddha knew [this] and purposely asked: ‘Monks, what kind [of thing] is this?’ [The monks] replied: ‘This is eye medicine.’ The Buddha said: ‘Eye medicine is a valuable thing. [It] should be placed in a tube[-container].’ Then the monks made gold [and] silver tube[-containers] for placing the eye medicine. The Buddha said: ‘[I] do not allow using gold, silver and all precious [materials]. [You] should use a container of copper, iron, pewter, bamboo, [or] reed; a quill; or even [a piece of] leather for wrapping [the medicine].’ This is known as the tube[-container] for medicine. [Regarding] the stick for [applying] eye medicine: The Buddha dwelled in Śrāvastī. Then there was a monk [who] held [a piece of] bamboo as the stick for [applying] eye medicine. The Buddha knew [this] and purposely asked: ‘Monk, what kind [of thing] is this?’ [The monk] replied: ‘The Exalted One, this is a stick for [applying] eye medicine.’ The Buddha said: ‘Eye is a soft thing. [You] should use a smooth thing as the stick.’ At that time there was a monk [who] then used gold [and] silver to make [the stick]. The Buddha said: ‘[I] do not allow [using] gold, silver and all precious things for making [the stick]. [You] should use copper, iron, tooth, bone, sandalwood, [or] hard wood for making [it]. [It should be] rubbed to make [it] smooth and lustrous, even by [means of] using finger-tip.’ This is known as the teaching on the stick for [applying] eye medicine.”^[29]

We discern from the above data that eye diseases seemed to have been common in ancient India. Such diseases were treated by various types of collyrium that were chiefly mineral substances. There were special treatments such as smoking therapy (which may be related to the “smoke-collyrium” mentioned in the Dharmaguptaka information) and nasal douching described in the Sarvāstivāda sources.

A large passage in the Samantapāsādikā explains the different collyria and the tools used for such medicines:

“‘Collyrium’ is a term comprising all [collyria]. ‘Black collyrium’ is a kind of ointment, or that which is boiled with all requisite ingredients. ‘Essence collyrium’ is made from different requisite ingredients. ‘Stream collyrium’ is a collyrium coming into existence in the river, stream, and so forth. ‘Red chalk’ by name is the golden ochre. ‘Lampblack’ was taken from the flame of a lamp. ‘Sandalwood’ is anything which has red sandalwood and so on. Indian valerian and so forth are commonly known. Even others [like] blue water-lily and so forth are indeed suitable. ‘[A need] of powdered collyria’ [means a need] of that which should be pounded together with the collyrium.^[30] Indeed, no powdered collyria are unsuitable. ‘Made of bone’ [means]: having set aside the human bone, the remaining [things which are] made of bone. ‘Made of tooth’ [refers to] the tooth of elephant and so on;[that is,] everything [which is] made of tooth. With regard to ‘made of horn’, there is really not [a horn] which is inappropriate. [Those] made of reed and so forth are also perfectly appropriate. The meaning [of] ‘container for the stick’ is: wherever [the monks] insert the stick–[be it] a rod having a hole, or a bag–I [the Tathāgata] allow [it]. ‘A shoulderstrap’ [means] the shoulder-strap on the bag [for holding] the collyrium-box.”^[31]

In Āyurveda, eye diseases occupy an important place. In the classical medical treatises, there are many chapters covering different eye diseases and their treatments (Suśruta Saṃhitā Uttarasthāna 1-19; Aṣṭāṅga Hṛdaya Saṃhitā Uttarasthāna 8-16). Many diseases are listed affecting different parts of the eye. The Caraka Saṃhitā has mentioned ninety-six eye diseases, whereas the Suśruta Saṃhitā has seventy-six. These diseases afflict the eyelids, junctions (i.e. the boundaries of different parts of the eye), sclera, cornea, pupil, or the whole eye (Caraka Saṃhitā Cikitsāsthāna 26. 131 and the translators’ notes to this passage; Suśruta Saṃhitā Uttarasthāna 1. 43-45). Eye diseases are due to aggravation of the humours and blood by their respective factors (such as diets, activities, inappropriate treatments, emotions, and so on) and exogenous causes such as trauma. Aggravated humours circulate in the blood vessels, go upwards, and get localised in different parts of the eye causing diseases (Caraka Saṃhitā Cikitsāsthāna 26. 129-130; Suśruta Saṃhitā Uttarasthāna 1. 20, 26-29; Aṣṭāṅga Hṛdaya Saṃhitā Uttarasthāna 8. 1-2). Numerous measures of eye treatment are employed, which are medical and surgical. Medical remedies include: collyria, eye drops, and eye bathing; application of medicated paste (around the eyes);adminstration of drugs through the nose; inhalation of medicinal smoke;bloodletting; emesis, purgation, and enema; head-evacuative measures; and so on. Amongst these, collyria assume a dominant role. There are three types of collyrium: scraping (lekhana), healing (ropaṇa), and clearing (prasādana) (Suśruta Saṃhitā Uttarasthāna 18. 52; Aṣṭāṅga Hṛdaya Saṃhitā Sūtrasthāna 23. 1011). Moreover, collyria are mainly made in three forms: pill (guṭika or piṇḍa), thin paste (rasakriyā), and powder (cūrṇa) (Suśruta Saṃhitā Uttarasthāna 18. 58; Aṣṭāṅga Hṛdaya Saṃhitā Sūtrasthāna 23. 14). For making collyria, substances–such as metallic powders, minerals, salts, precious stones, teeth, horns, bones, ashes of hair, fruits, flowers, scented substances, essence collyrium, Sauvīra collyriunm, stream collyrium, conch shell, and so on–are commonly utilised.^[32] Metal rods (e.g. made of copper, iron, gold, silver) and finger are the usual applicator of collyrium (Suśruta Saṃhitā Uttarasthāna 18. 62-63; Aṣṭāṅga Hṛdaya Saṃhitā Sūtrasthāna 23. 12-13). Surgical procedures undertaken for curing eye diseases are puncture, excision, incision, scraping, and cauterisation.^[33]

For the collyria mentioned in the Buddhist sources, their main components are known. These substances are: iron oxide for red chalk (geruka/gairika);zinc oxide for flower collyrium (puṣpāñjana); extract of Berberis aristata for essence collyrium (rasañjana/rasāñjana);lead sulphide or antimony sulphide for stream collyrium (sotañjana/srotoñjana) and Sauvīra collyrium (sauvīrāñjana).^[34]

In modern ophthalmology, there are many congenital and acquired disorders afflicting different parts or functions of the eye. Many disorders can cause painful eye, such as: acute angle-closure glaucoma;scleritis (inflammation of the sclera); anterior uveitis (inflammation of the iris and/or the ciliary body); optic neuritis (inflammatory demyelination of the optic nerve); keratitis (inflammation of the cornea); corneal abrasion;conjunctivitis (inflammation of the conjunctiva); subconjunctival haemaorrhage;bhepharitis (inflammation of eyelid); dacryocystitis (inflammation of the lacrimal sac); endophthalmitis (inflammation within the eyeball); and so on (Dargin and Lowenstein 2008, 199-215; Harris et al. 2012, 1057; Horton 2012, 228-230). Corneal opacity due to scar can result from corneal lesions such as abrasive or perforative trauma to cornea; corneal foreign body; infectious keratitis caused by bacteria, viruses, fungi, or protozoa; non-infectious keratitis due to, for example, ultraviolet light, topical drug toxicity, allergic conditions, chemical injury, and dry eye syndrome; and so on (Dargin and Lowenstein 2008, 207-215; Harris et al. 2012, 1059-1061; Khurana 2008, 121-122). Pterygium is a wing-shaped growth of the conjunctiva that arises on either or both sides of the cornea, and threatens the vision by extending towards the cornea (Khurana 2008, 80). Therapeutic measures for eye disorders generally include: treating underlying causes; removal of any foreign bodies;symptomatic relief of pain or discomfort by means of analgesic, topical anaesthesia, and/or topical lubricant or artificial tears; covering or padding of the eye; various medications such as antimicrobial agents, topical steroids, anti-allergic drugs, and drugs reducing intraocular pressure–be these in preparations as eye drops, eye ointment, oral medication, or parenteral administration; surgical operations; and so forth (Harris et al. 2012, 1057-1065).

Abundant data about eye problems and treatments are found in the above Buddhist sources. In most of these cases the conditions were not specified, except baiyi is named in the Dharmaguptaka Bhaiṣajyaskandhaka. Treatments mostly relied on the use of collyria, but other remedies such as smoke therapy and nose-treatment were also used. In Āyurveda, these cures are also employed. In addition, there are also surgical treatments for eye diseases. According to modern ophthalmology, many disorders can cause painful eyes. There are also various conditions that can affect the cornea, causing visual obscuration. They are treated medically with drugs and/or surgically with operations.

Footnotes and references:

[1]:

It is an extract of Indian barberry (Dash 2008, 222; Dutt 2012, 74).

[2]:

See footnote 130 of Chapter Four.

[3]:

Horner, in The Book of Discipline IV. 276, translated “phalamaya” as “made of crystal”, based on the meaning provided in the Pali-English Dictionary (s.v. “phalamaya”) which claims that the term “stands in all probability for phalikamaya, made of crystal.” But there are fruits which can be used as containers, e.g. bitter bottle gourd and coconut. The author’s translation here is based on the word provided in the source.

[4]:

Theravāda Vinaya Piṭaka I. 203-204: “tena kho pana samayena aññatarassa bhikkhuno cakkhurogābādho hoti.... atha kho bhagavā etasmiṃ nidāne dhammikathaṃ katvā bhikkhū āmantesi: anujānāmi bhikkhave añjanaṃ kāḷañjanaṃ rasañjanaṃ sotañjanaṃ gerukaṃ kapallan ti. añjanūpapisanehi attho hoti–gha–anujānāmi bhikkhave candanaṃ tagaraṃ kāḷānusāriyaṃ tālīsaṃ bhaddamuttakan ti. tena kho pana samayena bhikkhū piṭṭhāni añjanāni thālikesu pi sarāvakesu pi nikkhipanti. tiṇacuṇṇehi pi paṃsukehi pi okiriyanti–gha–anujānāmi bhikkhave añjanin ti. tena kho pana samayena chabbaggiyā bhikkhū uccāvacā añjaniyo dhārenti sovaṇṇamayaṃ rūpiyamayaṃ. manussā ujjhāyanti khīyanti vipācenti: seyyathāpi gihī kāmabhogino’ti. bhagavato etam atthaṃ ārocesuṃ. na bhikkhave uccāvacā añjanī dhāretabbā. yo dhāreyya, āpatti dukkaṭassa. anujānāmi bhikkhave aṭṭhimayaṃ dantamayaṃ visāṇamayaṃ naḷamayaṃ veḷumayaṃ kaṭṭhamayaṃ jatumayaṃ phalamayaṃ lohamayaṃ saṅkhanābhimayan ti. tena kho pana samayena añjanī apārutā honti. tiṇacuṇṇehi pi paṃsukehi pi okiriyanti–la–anujānāmi bhikkhave apidhānan ti. apidhānaṃ nipatati. anujānāmi bhikkhave suttakena bandhitvā añjaniyā bandhitun ti. añjanī nipatati. anujānāmi bhikkhave suttakena sibbetun ti. tena kho pana samayena bhikkhū aṅguliyā añjanti. akkhīni dukkhāni honti–la–anujānāmi bhikkhave añjanisalākan ti. tena kho pana samayena chabbaggiyā bhikkhū uccāvacā añjanisalākāyo dhārenti sovaṇṇamayaṃ rūpiyamayaṃ.... na bhikkhave uccāvacā añjanisalākā dhāretabbā. yo dhāreyya, āpatti dukkaṭassa. anujānāmi bhikkhave aṭṭhimayaṃ–la–saṅkhanābhimayan ti. tena kho pana samayena añjanisalākā bhūmiyaṃ patitā pharusā hoti–la–anujānāmi bhikkhave salākodhāniyan ti. tena kho pana samayena bhikkhū añjanim pi añjanisalākam pi hatthena pariharanti–la–anujānāmi bhikkhave añjanithavikan ti. aṃsabandhako na hoti–la–anujānāmi bhikkhave aṃsabandhakaṃ bandhanasuttakan ti.”

[5]:

陀婆闍那 probably refers to dhūpa-añjana, i.e. smoke-collyrium, as suggested in Shanjian lüpiposha (Virtuous-Seeing: A Commentary of the Discipline) (Taishō Tripiṭaka 1462. 795a26). But no other Vinayas or any Āyurvedic texts mention this kind of collyrium.

[6]:

耆羅闍那 seems to mean gairika-añjana, i.e. red chalk, as suggested in Shanjian lüpiposha (Taishō Tripiṭaka 1462. 795a26-27).

[7]:

According to Kangxi zidian, 瞖 means an eye disease or a barrier to eye (Zhang et al. 2005, 743). Cihai explains that 翳, synonymous with 瞖, is a thin layer arisen on the eye (Shu et al. 2005, 1076). Thus, 白瞖 (or 白翳 in older editions of Chinese Buddhist canon) refers to a white barrier or layer on the eye which may become obstacle to vision. Furthermore, 白翳 can mean corneal scar resulting from a corneal lesion according to traditional Chinese medicine (Chongbian Guoyu cidian xiudingben 重編國語辭典修訂本 (A Redaction of the Re-Edited Chinese Dictionary), s.v.

“白翳” [accessed April 4, 2015, http://dict.revised.moe.edu.tw/cgi-

bin/newDict/dict.sh?idx=dict.idx&cond=%A5%D5%C1k&pieceLen=50&fld=1&cat=&imgFont=1 ]). But it may also refer to another lesion known as pterygium, according to the meaning of 瞖 (or 翳).

[8]:

琉璃 refers to veḷuriya (Pāli) or vaiḍūrya (Sanskrit), which should be beryl (Digital Dictionary of Buddhism, s.v. “琉璃” [accessed April 14, 2015, http://www.buddhism-dict.net/cgi-bin/xpr-ddb.pl?q=%E7%90%89%E7%92%83]; Foguang da cidian (Large Dictionary of the Buddha’s Light), s.v. “琉璃” [accessed April 21, 2015, https://www.fgs.org.tw/fgs_book/fgs_drser.aspx]).

鎞 is sometimes written as 篦, according to the Kangxi zidian. It is a spearhead-like knife, which was used in the past to cure eye diseases or to scrape the thin layer on the eye (Zhang et al. 2005, 1245). See also Chongbian Guoyu cidian xiudingben, s.v. “鎞” [accessed April 4, 2015, http://dict.revised.moe.edu.tw/cgi-

bin/newDict/dict.sh?cond=%F1%5D&pieceLen=50&fld=1&cat=&ukey=-

[9]:

&serial=1&recNo=1&op=f&imgFont=1]). But it may also be used as an applicator for eye medicine.

[10]:

Taishō Tripiṭaka 1428. 867b22-29: “爾時比丘病須眼藥，佛言：「聽用。是中眼藥者，陀婆闍那，耆羅闍那，比丘有病因緣盡形壽應服。」爾時比丘眼有白瞖生，須人血，白佛，佛言：「聽用。」爾時比丘患眼白瞖，須人骨，佛言：「聽用。」爾時比丘患眼白瞖，須細軟髮。「聽燒末著眼中。」爾時畢陵伽婆蹉患眼痛，得琉璃篦，佛言：「聽為治眼病故畜用。」”

[11]:

Taishō Tripiṭaka 1421. 134c5-9: “有諸比丘患眼，醫言：「以人額骨磨著眼中。」諸比丘言：「佛不聽我等捉死人骨，更說餘方。」醫言：「更無餘治。」諸比丘作是念：「若世尊聽病時捉死人骨者，病可得差。」以是白佛，佛言：「聽屏處取骨，如二指大，磨著眼中。」” This account is not within the Mahīśāsaka Bhaiṣajyadharmaka.

[12]:

Taishō Tripiṭaka 1421. 147c15: “有比丘患眼，佛言：「聽作眼藥。」”

[13]:

羅散禪 should refer to rasāñjana.

[14]:

See Nanshan Vinaya Dictionary, s.v. “半鉢”.

[15]:

鍵鎡 should be ghaṭī, which is a water-jar.

[16]:

The Taishō Tripiṭaka (and the CBETA) gives 匕, which means a spoon. Older editions of Chinese

Buddhist canon have it as 籌 (a small piece of wood or a small stick). The author’s translation is based on older editions.

[17]:

Taishō Tripiṭaka 1435. 184c12-23: “佛在舍衛國。是時長老畢陵伽婆蹉目痛，藥師語言：「以羅散禪塗眼。」答言：「佛未聽我等以羅散禪塗眼。」諸比丘以是事白佛，佛言：「聽以羅散禪塗眼。」是長老以羅散禪盛著鉢中半鉢鍵鎡小鍵鎡，絡囊懸象牙杙上。取藥時流污壁及臥具，房舍中臭穢，佛言：「應用函盛。」雖盛不覆，土塵墮中，用時增益眼痛，佛言：「應作蓋。」蓋直動脫，佛言：「子口合作。」是時諸比丘，用鳥翮、雞翮、孔雀尾著眼藥，眼痛更增，佛言：「用匕。」長老優波離問佛：「應用何等物作匕？」佛言：「若鐵、若銅、若貝、若象牙、若角、若木、若瓦。」”

[18]:

青木香藥 should be the root of costus (Jiang and Wang 2009). But why it is prohibited by the Buddha is not clear.

[19]:

Taishō Tripiṭaka 1435. 275c13-21: “佛在舍衛國。爾時長老畢陵伽婆蹉眼痛，時藥師教言：「和藥作丸著火上燒服烟。」優波離問佛：「用何物作藥？」佛言：「但除青木香藥，和合餘一切香，著火中手接取烟而咽。」時以手接烟不得，佛言：「作筒。」時筒太長不得烟，佛言：「莫長作。」又復短作便燒手，佛言：「莫太短。」又時丸藥在一處、筒在一處，取時難得，佛言：「應畜囊盛。」盛時筒破藥丸，佛言：「中應施鬲。」施鬲已不繫頭筒墮地，佛言：

「應繫頭。」” This information is not in the Sarvāstivāda Bhaiṣajyadharmaka, but elsewhere in this Vinaya.

[20]:

Pala is a certain weight or a fluid measure (both Pali-English Dictionary and A Sanskrit-English Dictionary, s.v. “pala”).

[21]:

Taishō Tripiṭaka 1435. 275c28-276a6: “佛在舍衛國。長老畢陵伽婆蹉患眼痛，時藥師教言：「應脂灌鼻。」時比丘以指渧鼻中，或以毳取而渧，渧時不便流入，眼更增痛劇。是事白佛，佛言：「作筒灌。」作筒大，鼻不受；復小作，溢失不中用。是事白佛，佛言：「莫大莫小作，得受

一波羅、若一波羅半，欲唾以手承取。」以手承取故便欲吐，佛言：「聽用弊衲承取。」”

This information is not in the Sarvāstivāda Bhaiṣajyadharmaka.

[22]:

The term puṣpāñjana has no English equivelent. The Chinese version of Mūlasarvāstivāda Bhaiṣajyavastu has rendered it as flower collyrium, based on its literal meaning. The Sanskrit term is thus translated as flower collyrium here. But exactly what substance it is it cannot be ascertained. According to Dash (2008, 222) and Sudarshan (2005, vol. 5, 35), it is zinc oxide. But it is thin flakes of brass according to Srikantha Murthy in his translation of the Aṣṭāṅga Hṛdaya Saṃhitā (vol. III, 514, table 7(3)). A Sanskrit-English Dictionary says it is calx of brass (s.v. “puṣpāñjana”).

[23]:

The Sanskrit term given in the Gilgit Manuscripts is sauvīrakāñjanaṃ, but in Āyurvedic texts it is sauvīrāñjana.

It should refer to a kind of black pebble from the country of Sauvīra (Dutt 2012, 74). See also the translator’s notes to Aṣṭāṅga Hṛdaya Saṃhitā Sūtrasthāna 2. 5.

[24]:

According to A Sanskrit-English Dictionary, nāgadantaka is synonymous with nāgadanta, which means an ivory peg on the wall for hanging things. See also Pali-English Dictionary, s.v. “nāgadanta”.

[25]:

Gilgit Manuscripts III. 1.viii-ix: “śrāvastyāṃ nidānam | tena khalu samayenānyatama)sya bhikṣorakṣirogaḥ prādurbhūtaḥ | sa vaidyasakāśamupasaṃkrāntaḥ | bhadramukha akṣirogo me prādurbhūtaḥ | bhaiṣajyaṃ vyapadiśeti | sa kathayati | ārya añjanaṃ pratisevasva | svāsthyaṃ te bha(viṣyati | bhadramukha kiṃ vayaṃ kāmabhoginaḥ | ārya idaṃ te bhaiṣajyam| na śakyamanyathā svasthe-)na bhavitum | etat prakaraṇaṃ bhikṣavo bhagavata ārocayanti | bhagavānāha | vaidyopadeśenāñjanaṃ sevitavyam | te na jānanti | tairvaidyaḥ pṛṣṭaḥ | sa katha(yati | ārya śāstā te sarvajñaḥ | tameva gatvā pṛccheti | etatprakaraṇaṃ bhikṣavo bhagavata ārocayanti | bhagavānāha) | pañcāñjanāni | puṣpāñjanaṃ rasāñjanaṃ cūrṇāñjanaṃ guṭikāñjanaṃ sauvīrakāñjanam | tena sevitam | svasthībhūtaḥ | tenāvaśiṣṭamañjanaṃ yatra tatra vā (sthāpitaṃ vinaṣṭam |... etatprakaraṇaṃ bhikṣavo bhagavata ārocayanti ) | bhagavānāha | na bhikṣuṇā añjanaṃ yatra vā tatra vā sthāpayitavyam |... añjanadhārakairbhikṣubhirañjanāni evamevaṃ sthāpayitavyāni | puṣpāñjanaṃ pātre ) rasāñjanaṃ samudgake sthāpayitavyam | cūrṇāñjanaṃ

guṭikāñjanaṃ sauvīrakaṃ ca puṭikāṃ baddhvā nāgadantake sthāpa(yitavyam |...”

[26]:

See footnote 162 above.

[27]:

Taishō Tripiṭaka 1448. 2b11-c7: “緣在室羅伐城，時有苾芻患眼，遂往醫人處問曰：「賢首！我今患眼，為我處方。」醫人報曰：「聖者！宜用安膳那藥，即應得差。」苾芻報曰：「我豈是愛欲之人?」醫人報曰：「聖者！此是好治眼藥，除此，餘藥不能療也。」以此因緣，時諸苾芻往白世尊。佛言：「若醫人言：『此是治眼藥，餘不能療。』者，應當用安膳那。」然彼苾芻不知用何安膳那，便問醫人，醫人報曰：「聖者！汝師具一切智，應往問之。」以斯緣故，時諸苾芻往白世尊。佛言：「有五種安膳那：一者花安膳那、二者汁安膳那、三者粖安膳那、四者丸安膳那、五者騷毘羅石安膳那。此之五種，咸能療眼。是故苾芻若患眼者，應用安膳那，方得除差。」病既差已，所有殘安膳那遂便棄却。...以此因緣，往白世尊。佛言：「苾芻！若有殘安膳那，不應輒棄而不收舉。...其安膳那，應置牢固處，花安膳那置於銅器中，汁藥安小合內，粖藥置在竹筒裏。後一一安置袋中，或以物裹，或於牆壁釘橛繫之。...」”

[28]:

空青, according to Cihai, is a substance found in copper ore, which can be used as an eye medicine (Shu et al. 2005, 998). It may be either azurite or malachite. Both of these are copper carbonate minerals. In Āyurveda, blue vitriol, known as tuttha or another variety mayūragrīvaka in Sanskrit, is used as eye medicine. Tuttha or mayūragrīvaka contains copper sulphate. See Dash 2008, 219.

[29]:

Taishō Tripiṭaka 1425. 487c1-28: “眼藥者...佛住舍衛城耆舊童子菴婆羅園，時諸比丘眼痛...佛言：「從今已後聽用眼藥，除空青。若醫言：『尊者！此眼痛，得空青屑塗便差，更無餘方。』若爾者得塗。塗已不得眾中住，應在邊小房中，差已當淨洗得還入眾。」是名眼藥。眼藥筒者，佛住舍衛城，時諸比丘持樹葉盛眼藥。佛知而故問：「比丘！此是何等？」答言：「是眼藥。」佛言：「眼藥是貴物，應用筒盛。」時諸比丘作金銀筒盛，佛言：「金銀及一切寶不聽用。應用銅、鐵、白臘、竹、葦筐、鳥翮，下至皮裹。」是名藥筒。眼藥籌者，佛住舍衛城，時有比丘持竹作眼藥籌，佛知而故問：「比丘！此是何等？」答言：「世尊！是眼藥籌。」佛言：「眼是軟物，應用滑物作籌。」時有比丘便以金銀作，佛言：「不聽金銀及一切寶物作，應用銅、鐵、牙、骨、栴檀、堅木作，揩摩令滑澤，下至用指頭。」是名眼藥籌法。” This piece of information is not within the Chapter on Medicine parallel of the Mahāsāṃghika Vianya.

[30]:

In the Bhesajjakkhandhaka (Theravāda Vinaya Piṭaka I. 203), it talks about a need of powdered collyria (añjanūpapisanehi attho).

[31]:

Samantapāsādikā V. 1090-1091: “añjanan ti sabbasaṅgāhikavacanam etaṃ. kāḷañjanan ti ekā añjanajāti sabbasambhārapakkaṃ vā. rasañjanan ti nānāsambhārehi kataṃ. sotañjanan ti nadīsotādīsu uppajjanakaañjanaṃ. geruko nāma suvaṇṇageruko. kapallan ti dīpasikhato gahitam asi. candanan ti lohitacandanādikaṃ yaṃ kiñci. tagarādīni pākaṭāni. aññāni pi nīluppalādīni vaṭṭanti yeva. añjanupapiṃsanehī’ti añjanena saddhiṃ ekato piṃsitabbehi. na hi kiñci añjanupapiṃsanaṃ na vaṭṭati. aṭṭhimayan ti manussaṭṭhiṃ ṭhapetvā avasesaṃ aṭṭhimayaṃ. dantamayan ti hatthidantādi sabbaṃ dantamayaṃ. visāṇamaye’pi akappiyaṃ nāma n’atthi, naḷamayaādayo ekantakappiyā yeva. salākodhāniyan ti yattha salākaṃ odahanti, taṃ susiradaṇḍakaṃ vā thavikaṃ vā anujānāmī’ti attho. aṃsabaddhako ti añjanatthavikāya aṃsabaddhako.”

[32]:

The various collyria mentioned in the Buddhist sources are found in the medical corpus of Āyurveda.

[33]:

The above concise descriptions of treatments for eye diseases are summarised from the vast information found in Caraka Saṃhitā Cikitsāsthāna 26. 231-262; Suśruta Saṃhitā Uttarasthāna 9-19; Aṣṭāṅga Hṛdaya Saṃhitā Sūtrasthāna 23-24; Uttarasthāna 9, 11, 13, 14, 16.

[34]:

The identification of these collyrium substances is based on the references provided by Dash (2008, 218, 221-222), Dutt (2012, 73-74), A Sanskrit-English Dictionary, Sudarshan (2005), Srikantha Murthy’s translations of the Aṣṭāṅga Hṛdaya Saṃhitā (vol. III, table 7(3)), and the Bhāvaprakāśā (vol. 1, appendix 6). It is not certain whether the chief mineral for stream collyrium and Sauvīra collyrium is antimony sulphide or lead sulphide, for the scholars above furnish different interpretations.