Chapter Summary

This chapter has explored the general concepts of health and disease as well as the medical principles, based on the tenets found in the early Buddhist literature of the Nikāya-s/Āgamas and the Vinayas. Buddhism honours its founder as “the Unsurpassed Physician and Surgeon” or “the Great Physician King,” who has the knowledge of the four skills of healing–the disease, the causation of disease, the treatment, and the non-recurrence of disease–which resemble the Four Noble Truths. Illness, being a form of suffering, has arisen dependent on ignorance, craving, and the six sense-bases, according to the Four Noble Truths and the doctrine of dependent arising. The allayment of illness, therefore, depends on the cessation of these factors. This requires living in consistence with the Noble Eightfold Path, which means disciplining bodily and verbal conduct, as well as cultivating the mind.

There are various viewpoints on disease and health in accordance with Buddhism. Sickness is unavoidable. It certainly occurs in life and no one can escape from it. It is considered as a kind of loss in life, while health is an attainment. Illness is viewed as undesirable and health as desirable. For Buddhist practitioners, disease is unwanted while health is favourable, for the former is obstructive to spiritual practice and the latter is conducive. Furthermore, health is greatly praised as the highest gain, and it is even comparable to nirvāṇa, the highest bliss.

But health is not always positive. Health can become a kind of intoxication (infatuation), and healthy people may commit misconduct in body, speech and mind, resulting in a miserable rebirth in a future life. Such a state of intoxication has to be overcome by frequent contemplation of the unavoidability of sickness. Similarly, illness is not always negative. It can be the time for certain practices, such as the four establishments of mindfulness, the seven enlightenment factors, the ten perceptions, and so on.

Apart from these perspectives on disease and health, the two phenomena can be classified into two aspects, namely, disease/health of body and that of mind. However, Buddhism does not advocate the idea of mind-body dualism. In Buddhist philosophy, a living being is composed of five aggregates which form the psychophysical complex of mind and body. Since the five aggregates are dependent on each other, the physical principle of body (the material aggregate) and the psychological principle of mind (the four immaterial aggregates) are not separable. They coexist and operate together. Another important concept in Buddhism–nāmarūpa (mentality-materiality)–also sheds light on the non-duality of mind and body. Nāma refers to the four psychological aggregates, and rūpa to the material aggregate of the four great elements and dependent materials. Owing to the fact that nāma and rūpa are interdependent and exist together, the mind and body of a being cannot be separated. This implies that the physical condition can affect the mental state, and vice versa. Hence, physical health and mental health are interrelated with each other, and one cannot be achieved without the other.

With regard to medical principles, there is a lot of information in the early Buddhist scriptures. Knowledge of anatomy, physiology, aetiology, disease nomenclature, therapeutic, and health protection can be found. Anatomical parts, such as hairs, nails, skin, muscles, tendons, bones, internal organs, bodily fluids or secretions, and so on, are named in the discourses. Physiological concepts of the three bodily humours (wind, bile, and phlegm), as well as the internal and external aspects of the four great elements (earth, water, fire, and wind), are mentioned in the Buddhist texts. Specific causative factors of disease which are listed include bile, wind, phlegm, the combination of these humours, seasonal changes, wrong behaviour, assaults, and previous unwholesome deeds. Various diseases are designated, such as diseases of body parts, respiratory diseases, bowel problems, skin lesions, and many others. Numerous remedies are recorded in the discourses and the Vinaya texts, such as emesis, purgation, ear-oil, eye-wash, nose-treatment, medicinal powders, collyrium, eye-surgery, use of medicaments, and so forth. Advice on health maintenance is also found. Measures such as moderation of diet, beneficial food, walking exercise, use of tooth-wood, public hygiene by means of the use of the lavatory etc. are there in the early Buddhist literature.

With the general information in this chapter serving as a foundation, the vast specific medical data in the different versions of the Chapter on Medicine will be discussed in detail in the following two chapters. In the next chapter (Chapter Four), medicinal drugs will be grouped and illuminated; in Chapter Five, the various diseases and their treatments will be analysed and interpreted.