Conclusion: Summary of Present Research

One of the main issues dealt with by most religions is the relief of suffering, which includes sickness. Buddhism is no exception. It includes a lot of teachings pertaining to alleviating or eliminating illnesses. There are instructions for healing physical diseases, as well as doctrines for relieving mental afflictions. Many Buddhist scriptures record diverse medical knowledge on materia medica and remedies for diseases, which represents part of the ancient Indian medical lore. One such Buddhist text is the Chapter on Medicine in the Vinaya Piṭaka which comprises abundant data on medicinal substances and cases of diseases together with their treatments. This text is an important one for studying ancient Indian medicine, especially that of the śramaṇ-ic phase (between the ninth century Before Common Era and the turn of the Common Era). This thesis focuses on the medical facts preserved in the Chapter on Medicine of the extant versions of Vinaya Piṭaka, namely, the Theravāda, Dharmaguptaka, Mahīśāsaka, Sarvāstivāda, Mūlasarvāstivāda, and Mahāsāṃghika Vinayas.

In this, the final chapter of this thesis, we will provide a summary of the present study, which highlights what has been done to answer the raised research questions and to achieve the aims of the study; list the contributions of the research in relation to ancient Indian medicine and Buddhism; reveal its limitations; and propose possible directions for future studies.

This study has concentrated on ancient Indian medical information contained in the Chapter on Medicine. It has been shown in the Literature Review (Section 1. 1) in Chapter One that the Chapter on Medicine, though rich in medical facts, has not been extensively examined. In most of the scholarly works on this text, the Pāli source has been predominantly studied, whereas the Sanskrit, Chinese, and Tibetan versions have seldom been looked into. Moreover, often only certain aspects of the medical data (e.g. medicinal plants, gum-resins) have been researched in these works, while many of the materia medica and diseases have not been explored. Therefore, a comprehensive study of the Chapter on Medicine encompassing all extant versions of the text was needed. Furthermore, since medical data in the text are often brief and lack details, readers may find such material difficult to apprehend. These reasons have given rise to a thorough examination and interpretation of the medical particulars in the Chapter on Medicine, and formed the chief purpose of the present study. Research questions raised in this thesis were thus: (i) what are the medicinal substances, as well as the illnesses and their remedies mentioned in the Chapters on Medicine? (ii) with which method can we understand such medical facts? (iii) can we understand the medical data in terms of modern scientific/medical knowledge and, if so, how can we interpret them? These were the main research questions for this thesis. Moreover, certain aims were expected to be achieved such as: (i) to learn more about śramaṇ-ic medical knowledge in the history of ancient Indian medicine by collecting medical details in the Chapters on Medicine; (ii) to interpret such facts and hence reach a better understanding of Indian medical lore; (iii) to translate the primary sources into English so that readers who are not familiar with the languages of Pāli, Sanskrit, and classical Chinese can access such information; and (iv) to devise a method which can be applied to study and elaborate the medical data in the Chapter on Medicine, as well as those in other Buddhist texts.^[1] The present study has been conducted in order to answer these questions and to attain such aims.

With regards to the question on the method with which we can comprehend the medical data in the Chapter on Medicine, a special means has been devised. The one employed in the present study entailed an examination of such information in the extant versions of the Chapter on Medicine comprising: the Theravāda Bhesajjakkhandhaka, the Dharmaguptaka Bhaiṣajyaskandhaka, the Mahīśāsaka Bhaiṣajyadharmaka, the Sarvāstivāda Bhaiṣajyadharmaka, the Mūlasarvāstivāda Bhaiṣajyavastu, and the relevant section in the Mahāsāṃghika Vinaya as there is not a distinct Chapter on Medicine in this Vinaya. This threefold interpretative method aims at making ancient Indian medical accounts understandable: firstly, it provides narrations of the classified drugs or diseases with their treatments, by grouping from the Chapters on Medicine relevant records of such drugs and diseases; secondly, it supplies explanations of these data based on Buddhist commentarial information and Āyurvedic doctrines; and, thirdly, it furnishes “translations” (interpretations) of these drugs and diseases in terms of modern scientific/medical knowledge. With this three-fold approach to the study of the medical facts, we can obtain a more detailed description of each group of drugs or illnesses in the Chapters on Medicine and come to a better understanding of each of them by means of Āyurvedic and modern medical/scientific knowledge. Moreover, the method has been justified against certain challenges as shown in Section 1. 3. 2 on Method: it is valid as it is a combination of interpretative methods already utilised by scholars; the interpretations through this method are reliable since they are based on the available data in the Chapters on Medicine, as well as the doctrines of Āyurveda and modern medicine; and it takes into consideration the difficulties of retrospective diagnosis and has measures to overcome them.^[2]

The findings and discussions of medicinal substances and diseases with their cures, presented in Chapter Four and Chapter Five respectively, concern the first and third research questions–namely, identifying drugs and diseases and ascertaining whether the medical data can be interpreted in light of modern knowledge of science or medicine. Before elaborating on these medical details, relevant background information has been provided to facilitate a more informed understanding.

In Chapter Two the history of ancient Indian medicine up to the time of the Buddha has been overviewed for showing the context of the medical knowledge recorded in early Buddhist scriptures. This part of the history has been divided into: the pre-Vedic phase (about 3000 to 1500 Before Common Era), which relates to the Harappā Culture, though there is no definite medical knowledge left to us; the Vedic phase (about 1500 to 800 Before Common Era), which was chiefly magico-religious healing; and the śramaṇ-ic phase (about 800 Before Common Era to around the turn of the Common Era), a period of an empirical and rational approach to curing, which was followed by that of Āyurveda (from the early centuries of the Common Era up to now). Moreover, it is agreed by most scholars that the early Buddhist texts, including the Chapter on Medicine, are significant sources in preserving the lore of the śramaṇ-ic medicine, which should have developed into classical Āyurveda. Then, the main source materials–viz., the Vinaya Piṭaka, the Skandhaka section of the Vinaya Piṭaka, and the Chapter on Medicine in the Skandhaka–have also been introduced regarding their probable formations, functions, and contents. The Chapter on Medicine, which is likely an early compiled section in the Skandhaka of the Vinaya Piṭaka, is known to contain vast information on medicines, remedies for diseases, foods and drinks, and so on. Since the present study involves interpretation of the medical data in the Chapter on Medicine by means of Āyurveda and modern biomedicine, these two medical systems are presented. A brief account of the history and the basic tenets of Āyurveda is also furnished. Āyurveda, believed to have arisen in the early centuries of the Common Era by incorporating the śramaṇ-ic medicine into the Brāhmaṇistic tradition, is characterised by its systematised and empirical lore and practice as well as the production of numerous medical texts throughout its history, including the significant classical treatises such as the Caraka Saṃhitā, the Suśruta Saṃhitā, the Aṣṭāṅga Hṛdaya Saṃhitā, and many others. A discussion of the basic tenets is also provided, comprising the meaning and purpose of Āyurveda; the eight branches; anatomical knowledge; physiological principles such as pañca-mahābhūtas, doṣas, dhātus, and malas; diagnostic skills;the materia medica; various treatment modes such as empirical remedies (e.g. pañcakarma and surgery); and abundant advice and measures for health maintenance. Finally, the history and the basic principles of modern medicine have been concisely elucidated. Modern medicine commenced in the periods of the Renaissance and Enlightenment due to, respectively, an increased interest in human anatomy and physiology, and the scientific revolution; but its empirical approach can be traced back to Greek medicine before the Common Era. There have also been uncountable discoveries and advances in biomedical knowledge and practice in the last few hundred years. Modern biomedicine is characterised by its reliance on natural sciences, utilisation of advanced technology, division into various specialties and subspecialties, systematic modes of diagnosis and treatment, and evidencebased practice.

Chapter Three introduces general concepts about health and disease as well as medical principles prescribed in early Buddhist literature (including the Nikāyas, Āgamas, and Vinayas) as a prelude to the discussion of specific knowledge in śramaṇ-ic medicine recorded in the Chapter on Medicine. General discussions of concepts of health and illness included different facets. The Buddha, the “Unsurpassed Physician and Surgeon” or the “Great Physician King” (as honoured in the Itivuttaka and the Saṃyukta Āgama), possessed four healing skills (viz. the disease, the causation of disease, the treatment, and the non-recurrence of disease) which resembles the Four Noble Truths. The arising of illness, which is a form of suffering, was particularly due to ignorance, craving, and the six sense-bases;cessation of which required disciplining bodily and verbal conduct and the cultivation of mind, as taught in the Noble Eightfold Path. Sickness was known to be unavoidable. It was undesirable and regarded as a loss, and could be an obstruction to spiritual development; whereas health was desirable and considered as an attainment, even as “the highest gain”. But health could become an infatuation leading to misconduct and hence miserable rebirth. Sickness, on the other hand, could be an opportunity for certain spiritual practices, such as the four establishments of mindfulness, the seven enlightenment factors, the ten perceptions, and so on. Mind-body relationship has been succinctly discussed. Based on the doctrines of the five aggregates and nāma-rūpa, body and mind have been explained to be inseparable and dependent on each other. Thus, physical health and mental health are mutually dependent and closely related. Medical principles mentioned in the early Buddhist texts have been found to embrace multiple tenets on anatomy (the numerous body parts);physiology (the four great elements and the three humours); aetiology (the eight causes of illness: wind humour, bile humour, phlegm humour, all humours in combination, seasonal change, wrong personal behaviour, assault, and the results of one’s deeds); disease nomenclature (the enumeration of different diseases);various therapies (e.g. the use of drugs, emesis, purgation, sweating therapy, bloodletting, surgery, and so on); and health maintenance (e.g. diet, physical exercise, dental care, sanitation, and so forth).

Abundant medicinal substances are covered in the Chapters on Medicine, especially those which were named for treating certain diseases (i.e. the seven-day medicines and those which were allowed for use throughout the duration of one’s life). These drugs are grouped and discussed in Chapter Four. These substances included lipids and sweets such as ghee, butter, honey, molasses, rock sugar, and oil, as well as different forms of tallow; parts or derivatives of plants such as roots, stems, leaves, flowers, fruits, gum-resins, decoctions, and alkaline ashes; various types of salt; and others such as scented substances, putrid medicines and so on. These various drugs have been examined by the three-fold interpretative method: records of related drugs have been narrated together, explained by exegetical and Āyurvedic information, and rendered into modern scientific names and significance.

Cases of diseases with their treatments recorded in the Chapters on Medicine are classified and elaborated in Chapter Five. These diseases have been put into categories according to the medical specialties in which they are usually managed. The diseases and specialties are: autumnal illness, wind diseases, humoral problems, fever, gastrointestinal disorders, headache, and jaundice in the discipline of internal medicine; snakebite and poisoning in toxicology;painful eyes and baiyi in ophthalmology; itching, carbuncles, wounds, and other skin diseases in dermatology; perineal lesions and foot problems in surgery; and insanity (or non-human-causing disease) in psychiatry. Relevant passages in the Chapters on Medicine narrating these illnesses and their remedies are grouped for each of the aforementioned diseases, and then explicated with commentarial annotations, references to Āyurvedic doctrines, and modern medical facts.

Footnotes and references:

[1]:

The research questions and the aims of the research are set out in detail in Sections 1. 2. 1 and 1. 2. 2 in Chapter One respectively.

[2]:

For the details of the arguments, see p. 20-22 in Chapter One.