Sep 26, 2009

Medicine in Buddhist and Jaina Traditions

By Pankaj Goyal
Lok Vigyan Kendra
Almora 263601 India

It is believed that Lord Buddha showed the path of liberation from disease and death and due to this reason he is also known as the great physician (Mahabhisak). He propounded the four noble truths that are nothing but medical logic. These four noble truths include disease, its cause, treatment and its ways and are collectively known as Aryasatyacatustaya. Diagnosis of disease and charitable distribution of medicines among the sick people were the regular programmes of the Buddhist sanghas. Buddhist monks and nuns also implemented the same in Buddha-viharas. Emperor Asoka who adopted the Buddha religion after the Kalinga war not only established many hospitals and dispensaries for the treatment of the sick but also ordered planting of medicinal plants at different places.

P.V.Sharma, the well known historian of Indian medicinal sciences, summarises the medical practices prevalent among the Buddhists and the Jainas. We give a summary of his essay here.

Medicine in Buddhist Tradition
The oldest source of literature that gives a glimpse of Indian medicine in the Buddhist tradition is the Tripitaka. Tripitaka mentions tikiccha in place of Ayurveda and disease is mentioned as gilana instead of atura as in medical text. This book also gives some references that suggest that tikiccha was one of the most important subjects of learning in Taksasila.

P.V.Sharma says that there are five well-known bhutas, but the Buddhist texts mention only four of them, excepting akasa. Cullavagga has got enough material that gives a good view of daily life of monks and nuns, health and hygiene and the arrangements in the viharas. In the viharas, there were systematic arrangements for the maintenance of privies and bathrooms. Personal cleaning as well as cleaning of the surroundings was strictly observed. A special care was also taken for water. A number of diseases are mentioned in Tripitaka texts while kustha, ganda, kilasa, sosa and apasmara are said to be the five prevalent abadhas.

Mahavagga (MV) gives valuable information regarding diseases and their treatment in the book (vi) on medicaments. This book provides us very useful information particularly on the treatment of diseases. Some of the treatments contained in this book are described here in brief. To treat headache the drug was administered through nose and oil was also applied on the head. In the case of jaundice, Haritaki impregnated with cow’s urine was prescribed. In the case of snakebite, four types of filth - dung, urine, ashes and clay were prescribed. For eye-disease, eye ointments and collyriums were also mentioned. Similarly a lot of other treatments are described in that book.

Drugs have been classified in the beginning of MV (VI). Here fat of animal is first described, and then the vegetable drugs are mentioned in the given groups:

Leaves- patola, tulasi etc.
Fruits- vidanga, pippali etc.
Niryasa- hingu, sarjarasa etc.

At the end an inorganic substance salt is also mentioned. A large number of medicinal plants are also referred but in different contexts.

Mahavagga (viii.1.1-29) contains a detailed account of the renowned scholar Jivaka and his amazing medical and surgical cures. He performed a large number of miraculous cures. He was born of Salavati, a courtesan of Vaisali. He learnt this medicinal science from Atreya at Taksasila. Atreya was himself a renowned scholar of medicine during the Buddhist period. Later, he became a physician in the court of Bimbisara.

Dhammapada – Dhammapada mentions freedom from disease as the highest gain. It advises to avoid two extremes - ayoga and atiyoga and to adopt the middle path. In Dhammapada, the word ‘atura’ has been used for diseased; although in the Buddhist texts word ‘gilana’ is used.

Apadana- Avadana is the other name of Apadana. There are many texts on this topic of which avadanasataka and divyavadana are more popular.

Avadanasataka is an interesting text dated about 100 CE. According to this text, cloth, food, beddings, appliances for diagnosis and treatment of the sick were offered to Lord Buddha. Several types of diseases, their symptoms and methods of their treatment are also described in it. The case of pregnancy in terms of drugs, diet and behaviour is described in a systematic manner. A pregnant woman was advised to avoid all the six tastes and any kind of unpleasant sound. Once, while operating a women’s abdomen to deliver the foetus, Jivaka advised the lady to take five parts of a plant as a drug.

Different types of houses for different seasons (winter, summer and rainy season) are mentioned in Divyavadana. Application of gosirsa candana is suggested in case of fever with burning sensation. Sammohini and sanjivani osadhi are also referred to in this text. The Jyotiskavadana text gives references about Jivaka.

In Sardulakarnavadana, plants are referred to in a classified way and divided in to seven different groups such as phalguvrksa, sthalaja vrksa, ksiravrksa, phalabhaisajya vrska, sthalaja puspavrksa and jalaja puspa. Herbs growing in the villages as well as in the hills are also mentioned. Some diseases like Apasmara, kilasa and kustha are also described. At the end there is also a topic based on dreams. According to this text, constellations (Naksatras) also play a role and it is said that the collection as well as the administration of drugs should be started in Satabhisa.

Kunalavadana contains an interesting anecdote about a disease of King Asoka and its treatment with onion by his wife. Initially, his wife experimentally observed the effects of onion on intestinal worms.

Milindapanha is one of the non-canonical Pali texts. It originated in northwest India by about beginning of the Christian era. It holds some precious knowledge about Buddhist traditions. This text is in the form of dialogues between Nagasena and king Milinda. This text also holds some significant information about the Buddhist tradition. According to this text, medicine was one of the most important subjects of teaching during the Buddhist times. There is also a reference that king Milinda himself learned cikitsa along with other eighteen subjects. Treatment of wounds with paste, application of oil and dressing is preferred for better and early healing of the wounds. In the case of poisoning, a mixture of ghee, butter, oil, honey and jaggery is suggested. A very interesting connection of urine with reproduction is shown in a story where a fakir or ascetic was born by intake of urine of an ascetic or fakir. According to Nagasena the disease is caused by eight factors – vata, pitta, slesma, sannipata, seasonal imbalance, irregular diet, improper treatment and past deeds. Nagasena further narrates the aggravation of vata, pitta and slesma in ten, three and three ways respectively. According to him vata is aggravated by cold, heat, hunger, thirst, overeating, sedentary habit, anxiety, exertion, treatment and past deeds, while pitta and kapha are aggravated by cold, heat and irregular diet.

Saddharmapundarika is a work that belongs to first century CE. It is one of the most sacred Mahayana texts. This text mentions that followers of the Buddhist tradition established many viharas that were well equipped with food, drinks, appliances for diagnosis and treatment of the sick and other comforts. One of the chief characteristics of these viharas was that these were attached with a flower garden and park. According to this text diseases were classified into four types- vatika, paittika, slaismika and sannipatika. Along with the classification of diseases a large number of diseases are also mentioned such as kustha, kilasa etc. Deformity in the various body parts and different types of continuous and intermittent fevers are mentioned too. Plants are classified into four types – trna, gulma, osadhi and vanaspati. The parts of the plant are mentioned as nala, sakha, patra, puspa and phala. Drugs were taken in various forms such as juice, paste, decoction, infusion, after combining with other drugs, by injecting through needle or cauterization or mixing with food.

Mahayana texts contain some valuable information about the Buddhist tradition. Lalitavistara is one of the important texts that deal with the advent of Lord Buddha and his teachings. Lord Buddha is mentioned in this text by several names such as the king of physicians, best among physicians, the great surgeon etc. Several types of diseases are also mentioned here.

According to Suvarnaprabhasasutra, two factors play a vital role in the longevity of life – avoiding exertion and proper nutrition. Here, four dhatus (bhutas) are mentioned out of which two are said as moving upwards and the other two going downwards and thus they neutralize each other. The most interesting and important medical document in Suvarnaprabhsasutra is chapter 17. In this chapter, a great and well-informed man in all the branches of Ayurveda taught Astanga Ayurveda to his son and the discussion between them exposed some very interesting and valuable information about medicine. Four different seasons (rainy season, autumn, winter, and summer) and four different types of disorders (vatika, paittka, sannipatika and kaphaja) are mentioned that occur in these four seasons respectively. The pacification of these disorders is also given in the text.

The poetic works of Asvagohsa (2nd Cent.CE), Buddhacarita and Saundarananda, also contain some valuable information related to Buddhist medicine system.

The following authors representing the Buddhist tradition are significant in the field of Ayurveda:

Vagbhata- Vagabhata composed the Astangasangraha and the Astangahrdaya. These books not only contain the Samhitas of Caraka and Susruta but also include many Vidyas and mantras as well as a large number of medical formulae prevalent in the Buddhist tradition.

Ravigupta- Ravigupta, a Buddhist scholar, composed the Siddhasara that also contained a nighantu at the end. The date of Ravigupta is fixed as 650 CE, viz. after Vagbhata and before Madhava. The Siddhasara contains 31 chapters and the Siddhasara-nighantu as appendix. First four chapters of this book are based on Tantra, dravyagana, annapanavidhi and arista, while chapters 5 to 25 deal with individual diseases. Further chapters are based on Varna, Salakya, Visa, Rasayana- Vajikarana, Kumaratantra, Pancakarma and Kalpa.

Nagarjuna- A large number of works was produced by Nagarjuna in different periods. Yogasataka is such a work by Nagarjuna that represents work of this tradition. Apart from Yogasataka following works of Nagarjuna are incorporated into the Tibetan Tanjur:
(a) Avabhesajakalpa
(b) Arya raja name vatika
(c) Arya mulakosamahausadhavali

Candranandana- The following works of Candranandana are incorporated in the Tibetan Tanjur:
(a) Vaidya-Astangahrdayavrtti
(b) Vaidya-Astangahrdayavrttau bhesajanama-paryayanama
(c) Padarthacandrika…… Astangahrdaya-vivrti

Educational Centres
Medicine was a popular subject of teaching in the curricula of the Viharas and mahaviharas as Buddhists treat it as an important tool for missionary service to humanity and animals. Medicine was an important and compulsory subject in all the universities. The University of Taksasila was famous for this subject where Atreya was a renowned teacher. Jivaka was a famous student of this university, who got proficiency in medicine as well as surgery. The Nalanda University had also medicine as one of the compulsory subjects of teaching. Medicine was also taught in Vikramasila University. Tantras as well as Rasasastra also flourished there in theory and practice.

Royal Patronage
During the periods of Kings Asoka, Kaniska and Sri Harsa, the Buddhist tradition flourished side by side with the Vedic traditions. These kings established many viharas in various parts of the country as well as far off places. As a result of this Buddhism spread to other Asian countries along with which Indian medicine also reached out there. Some valuable accounts given by Chinese travellers like Fahian, Huan Chwang and Itsing give a detailed view of Buddhist tradition in those periods.

Medicine in Jaina Tradition
The Jainas had a well established tradition of medicine that was known as pranavaya. It dealt with mental disciplines, dietetics and drugs and covered all the eight angas of Ayurveda. It was the science of vitality maintaining the health of body and mind. It mainly dealt with mental disciplines, dietectics and drugs and covered all the 8 angas of Ayurveda. The Jaina saints looked after their health and their sickness themselves. In the field of medicine the Jainas were very strict and had forbidden alcohol, honey and meat and as a result the Jaina physicians had to adjust the formulations accordingly. The Jaina physicians used plants and minerals mainly as a source of drugs. These physicians were very practical and believed in curing the diseases with tried and tested medicines rather than going into beliefs and fundamental doctrines.

Medicine in Jaina Tradition
According to Acarangasutra, the nature of plants and animals is similar. Both plants as well as animals are born, grow old, have animation, fall sick, require food, decay and die. It mentions that the animate beings are produced as follows:

From eggs (as birds etc.)
From a foetus (as elephant etc.)
From a foetus with an enveloping membrane (as cow etc.)
From fluids (as worms etc.)
From sweat (as bugs etc.)
By coagulation (as ants etc.)
From sprouts (as butterflies etc.)
By regeneration (as man etc.)

A list including mango, grapes, ginger, mustard stalks, asvattha, kadamba, coconut, kaseru, lotus, sugarcane, bilva and garlic etc. is described. Cleanliness of body, speech and mind was greatly preferred and special care was taken of it. This also gives an idea about the behaviour of the Jainas towards cleanliness. At certain places some methods of treatment are mentioned. Surgical operation with sharp instrument, treatment by charms (pure and impure) and drugs were prevalent. There are sixteen diseases enumerated at one place:

1. Boils
2. Leprosy
3. Consumption
4. Epilepsy
5. Blindness
6. Stiffness
7. Lameness
8. Hump-backedness
9. Abdominal enlargement
10. Dumbness
11. Swelling
12. Anaemia
13. Trembling
14. Crippledness
15. Elephantiasis
16. Diabetes

Uttaradhyayana Sutra accepted sickness as one of the troubles. An account of eye disease and fever is mentioned, but in the form of a story. Different methods of treatment like spells, roots, emetics, purgatives, fumigation, anointing of the eye are mentioned in detail. Plants are classified as vrksa, gaccha, gulma, lata, valli and trna and various plants related to this classification are described. Use of inorganic substances such as metals, except mercury, stones, mica, and sulphur are mentioned. Similarly, animals also held a position in this text along with their classification.

Sustrakrtanga is another text in which certain body parts, substances used in cosmetics and some domestic devices are specified. Seeds are described as of four different types – those generated at the top of a plant, at its root, at its knot, and at its stem. Different parts of plant like bulb, stem, root, branches, twigs, leaves, flowers, fruits and seeds are mentioned.

Kalyanakaraka is the only authoritative text available on the pranavaya tradition of medicine. It was composed by Ugradityacarya who was contemporary of Amoghavarsa I, the Rastrakuta king (815-877 CE) and disciple of Srinandi. He has mentioned the authors in different branches of Ayurveda as follows:
Pujyapada – Salakya
Patraswami – Salya
Siddhasena – Visa and graham (bhuta)
Dasarathaguru – Kayacikitsa
Meghanada – Balaroga
Simhanada – Rasayana – Vajikarana
Samantabhadra – All the eight branches (Astanga)

The text includes 20 chapters. The first three chapters are based on the basic concepts, while the fourth and the fifth deal with food and drink including anupana. The sixth chapter includes the topics related to personal hygiene. The seventh chapter is based on groundwork related to medicines, arrangements in the hospital and patient’s examination. Kayacikitsa begins from the eighth chapter. The eighth, ninth and the tenth chapters cover topics associated with vataroga, pittaroga and kapharoga. The chapter based on pittaroga includes raktapitta, pradara, visarpa, vatarakta, jvara and atisara. Chapters 11th, 12th and 13th deal with great diseases (mahamayas) and the 14th chapter deals with upadamsa, slipada and ksudraroga. Chapter 15th is based on salakya and 16th to 18th are again based on Kayacikitsa. Visaroga is described in the 20th chapter and 21st chapter covers some general things about medicine. Chapter 21st is based on the application of ksara, agni, and jalauka, while chapters 22-23 deal with pancakarma. Mercury and its processing are described in detail in the 24th chapter. The last chapter is based on Kalpas. According to the author, there is no penance greater than cikitsa. He says, “Cikitsa is for destroying sins and promoting virtues”.

Medicine proved as an effectual tool in the expansion of Buddhism. There are certain examples where people adopted Buddhism only for being treated by renowned physicians like Jivaka. In Buddhist Viharas medicine was one of the most important programmes in their daily activities. Indian medicine travelled far and wide and spread to other countries along with Buddhism. A feeling of deep sympathy and sorrow as well as great service towards the sick was a unique feature of Buddhism and because of this reason the sick had a feeling of great respect for Lord Buddha. Like Buddhism, the Jaina tradition contributed a lot in the field of health and medicine. There is a huge amount of Jaina literature from which we can get quite a vast material related to medicine. It was the common belief of the Jainas that diseases resulted from sinful acts. They were passive recipients of medical treatment rather than active promoters of the same like Buddhists. However, the basic foundation of the Jaina tradition is the same as of the Buddhist medicine.

Sharma,P.V. 1992. Medicine in Buddhist and Jaina traditions. In History of Medicine in India. P.V.Sharma (Ed). New Delhi: INSA. Pp. 117-135.

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