The Therapeutic Use of Water in the Bencao gangmu, Part One: Introduction to the Text

 

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This post is written in preparation for a lecture I will be giving while soaking in the hot springs at Ojo Caliente in New Mexico, in the framework of a retreat on Chinese herbs and the Chinese medicine classics taught by Z’ev Rosenberg and myself in Taos on August 19-23, 2018. For more information on that retreat, see here. My interest in water is obviously also inspired by my current life on the Puget Sound on Whidbey Island where I go wade, swim, and play in the blue stuff almost every day.

 Thanks to my daughter for modeling as a mermaid.

Thanks to my daughter for modeling as a mermaid.

While late Imperial China is not my specific area of expertise, I have always been intrigued by Li Shizhen 李時珍 and his grand masterpiece, the Bencao gangmu 本草綱目 “Classified Materia Medica,” and consult it frequently in my research in medical history. Anybody interested in the natural sciences in Chinese history needs to read Carla Nappi’s wonderful book on the subject, titled The Monkey and the Inkpot: Natural History and Its Transformations in Early Modern China! If you haven’t, the following information is meant to give you a little taster.

To provide a bit of historical background, this text was composed in the late Ming 明 dynasty and was perhaps influenced by three developments relevant to natural history in China:

1.     The Ming dynasty (1368-1644) was a return to indigenous Chinese rule that followed after the Yuan 元 dynasty (1279-1368) when China was under Mongol control. While undoubtedly traumatic and associated with a horrendous loss of Chinese lives and cultural treasures, China’s incorporation into the Mongol empire also resulted in the creation of a multicultural, multiethnic society with a vibrant exchange of knowledge, substances, languages, religions, artefacts, and peoples all over central Asia, connecting Europe to India to China. As part of this diverse culture, medicine in China became more exposed than ever to the theories, clinical techniques, and medicinal substances of Greek, Arabic, Tibetan, Mongolian, and Indian medicine. In addition, the Mongols eventually succeeded in reunifying the north of China with a much more developed south.

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2.     The cultural openness, confidence, and dynamism of the early Ming dynasty, exemplified by the famous seven voyages of Admiral Zheng He in his fleet of “treasure boats” between 1405 and 1433 was abruptly replaced with xenophobia and isolationism, especially after a humiliating defeat of the imperial army at the hands of the Mongols in 1449. Rather than collecting tributes in the Indian Ocean and bringing home giraffes from Africa, the Ming rulers turned their focus to defending against Northern invaders by fortifying what would become known as the Great Wall.

3.     The cultural and economic development of the Jiangnan region south of the Yangzi from the Song period on introduced different diseases into mainstream Chinese medicine. Consequently, both medical theory and clinical therapy expanded, as exemplified by the School of Warm Diseases 溫病 and an emphasis on supplementation of weak deficient Southern bodies. From the Ming dynasty forward, famous literati physicians tended to come from medical lineages in the Jiangnan area.

Against this backdrop, Li Shizhen 李時珍 lived and worked in the late Ming dynasty (1511-1593). Descended from a medical family, he ended up becoming a doctor like his father after he failed the highest level of the civil service examination. Besides being an accomplished physician and compiling one of the greatest books of Chinese natural history and eleven other medical texts, he was a voracious reader, skillful poet, and dedicated scientist and naturalist who spent decades traveling throughout China for his textual, oral, and clinical research. In his relentless pursuit of knowledge, he interviewed countless local sources and interacted with people from all backgrounds. He is reported to have poisoned himself repeatedly by experimenting on his own body and investigating the objects of his research directly by dissection, close observation, and even smelling and tasting. The reader should be warned that Li’s passion for research in his subject matter may be contagious and that it is easy to get lost in the plethora of mind-bending stories in his book.

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The Bencao gangmu is undoubtedly one of the greatest books ever written in Chinese history, published posthumously by Li’s sons in 1603. Based on 27 years of research, it summarizes 40 bencao (materia medica) texts and 361 other medical sources, consulting a total of 932 texts, as listed in the bibliography! In the spirit of the Neo-Confucian “investigation of things” 格物, Li Shizhen embraced direct empirical research in combination with thorough studies of all relevant literature, to examine all sorts of natural phenomena and their effect on humans. In 53 volumes, almost 2 million characters, and 1892 main entries or categories (綱 gāng), which are further subdivided into specific entries (目 ), it classifies 1892 substances (plants, animals, “stones,” and objects employed, derived from, or otherwise related to humans) and offers 11,000 formulas for their medical use. The entries include clearly marked subsections identified as

·      “Elucidation of names” 釋名: Including sometimes lengthy lists of alternate names and discussion thereof, this philological preoccupation with naming can be traced back to the Confucian emphasis on “rectifying names” 正名 as an important aspect of scholarly activity.

·      “Collected explanations” 集解: A collection of quotations from a wide range of literature and contemporaneous local informants, with a critical discussion by Li Shizhen himself, on the object and its natural history, lifecycle, varieties and distinguishing features, myths and stories, and other general information. This is a goldmine of facts and fiction for any natural historian;

·      Separate entries on the specific parts used and their preparation and processing as a medicinal substance 修治;

·      Qi (i.e., thermodynamic quality) and flavor 氣味, including information on toxicity and substances to avoid while taking it, also faithfully quoting disagreements in the literature;

·      Indications 主治: The clinical uses of the substances, as traced through the bencao literature up to Li Shizhen’s time;

·      Elaboration 發明: Perhaps the most useful part for clinically inclined readers, this section elaborates on the reasons why the substances has the effect on the body described in the “Indications” section.

·      “Attached formulas”: This section not only cites earlier sources, written and oral, but also includes Li’s personal experience, thereby providing great insight into the actual clinical use of the substance in the late Ming period.

 

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Probably the most innovative feature of the Bencao gangmu is the classification of substances: In the earliest edition of the earliest transmitted bencao text, the Shennong bencao jing 神農本草經 (“Divine Farmer’s Classic of Materia Medica,” translated and published by yours truly here), contains 365 substances categorized into three levels associated with Heaven, Humanity, and Earth in that order, based on their effect on the body and with generally increasing levels of toxicity. This text does employ the system of the Five Dynamic Agents 五行 to classify the substances according to flavor, but not as an organizing principle for the text itself. In his later edition from 492 CE, Tao Hongjing uses the distinction between minerals, plants, and animals, in that order as his main organizing principle, and then subdivides each of these categories into the three classes of Heaven, Humanity, and Earth. Subsequent materia medica text followed this general organization but changed the order to start with plants, followed by minerals, then animals, and ending with human substances.

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In sharp contrast to his predecessors, Li Shizhen used the Five Dynamic Agents wuxing 五行 as the overarching paradigm for organizing all substances that affect the human body and therefore created the following major “parts” 部: Waters, Fires, Earths, Metals and Stones, Herbs, Grains, Vegetables, Fruits, Trees, Clothes and Utensils, Bugs, Scaly Creatures, Shelled Creatures, Birds, Quadrupeds, and Humans. Of these major parts, the first three (waters, fires, and earths) are a radical departure from previous bencao literature! The order of the wuxing here does not follow either the cycle of creation or the cycle of control, but instead is subordinated to what Carla Nappi describes as progressing “from the most fundamental to the most exalted.” These large “Parts” 部 are then subdivided further and further into “Categories” 類 and individual Entries 種. For example, we go from “bugs” to “egg-born bugs” to “bees,” or from “herbs” to “mountain herbs” to “gancao.” Besides this emphasis on correct classification and rectification of names, the organization of substances in this text also reflects the Confucian preoccupation with hierarchical ordering of the natural world, especially in the progression from plants to animals (and therein from bugs to scaly to shelled creatures to birds and then quadrupeds) and lastly to humans.

Among the main parts, the section on Fires is the shortest, with no separate “Categories” and only twelve Entries. The first of these is titled “Yin Fire and Yang Fire” and offers an introduction to the topic of fires. Here, Li states that Fire can be categorized into three “Guiding Principles” 綱 , namely Heaven Fire, Earth Fire, and Human Fire, and 12 “Entries” 目, perhaps because it “has Qi but no substance.” Part Two of this blog on the therapeutic uses of water in the Bencao gangmu will discuss the section on Waters in this text in greater detail. Stay tuned….. because right now the tide is high and it’s time for a swim…

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Curing Illness with Meditation in Sixth Century China

This is a syndicated post that first appeared on BuddhistDoor
By C. Pierce Salguero

Buddhistdoor Global | 2018-06-29 |

 

Though he lived in the sixth century, Zhiyi (538–597) has a lot to teach the modern practitioner of meditation, whether Buddhist or secular. He is best known as the founding patriarch of the Tiantai school of Buddhism, widely considered to be the first native East Asian school, and thus a precursor to Chan and other later developments. Among the foundational writings of Tiantai are several treatises on meditation composed by Zhiyi.

Although it is popular to think of meditation as a solution for all kinds of illness, Zhiyi knew it was more complicated. In his Shorter Treatise on Samatha and Vipasyana (in Chinese, Xiao zhiguan), Zhiyi suggests not only that not all illnesses can or should be treated with meditation, but that meditation itself can be a cause of illness: one might be unskillful in harmonizing the mind, body, and breath, and thus fall ill. But he does advise eight different healing meditation practices.

These eight practices are divided into two categories. First are the calming meditations, or, as he calls them, employing the Chinese translation of the Sanskrit samatha, “stopping” meditations:

1. Settle the mind on the location of the illness.
2. Settle the mind on the dantian,* one inch below the navel.
3. Settle the mind on the soles of the feet.
4. Abiding calmly, remain aware that all phenomena (including the illness) are empty.

Next, Zhiyi introduces what he calls “seeing” meditations. Here he uses the Chinese translation of the Sanskrit vipashyana, although most are quite different from what contemporary meditators mean by the term vipassana. There are four practices in this category:

1. The Six Breaths, a Chinese exercise in which the practitioner makes the sounds “chui,” “hu,” “xi,” “he,” “xu,” or “si,” while exhaling in order to regulate internal processes.
2. The Twelve Respirations, which are different types of Indian breathing exercises (pranayamas) intended to regulate various symptoms of illness.
3. Visualization techniques in which one concentrates on one type of qi in order to counteract ailments caused by others. (He gives the example of concentrating on fire-like qi to cure cold in the body.)
4. Finally, Zhiyi mentions using both samatha and vipasyana together to “analyze the non-existent nature” of physical and mental illnesses, resulting in their spontaneous healing.

painting of Sramana Zhiyi, founder of the Tiantai school of Buddhism. From wikipedia.org
Painting of Master Zhiyi, founder of the Tiantai school
of Buddhism. From wikipedia.org

Lamentably, Zhiyi does not give us much detail on specifically how to practice the techniques mentioned in this particular chapter. (Zhiyi did write instructions on samatha and vipasyanameditation, much of which has been translated into English. [Chih-i 1997; Zhiyi 2009]) The most detailed descriptions he gives concern the specific medical applications of the Six Breaths and for the Twelve Resiprations.

For example, each of the Six Breaths should be used as follows:

Imagine each of the Six Breaths revolving around inside your mouth and between your lips, and then make [the sounds]. If you are in meditation, use chui when you are cold and hu when you are hot. In the treatment of illnesses, chui is for eliminating cold, hu is for eliminating heat, xi is for eliminating pain and treating wind, he is for eliminating mental troubles and also flatulence, xu is for breaking up phlegm and relieving congestion, and si is for replenishing exhaustion. If you are treating the Five Viscera, the two breaths of hu and chui can treat the heart, xu is for treating the liver, he is for treating the lungs, xi is for treating the spleen, and siis for treating the kidneys.

For the Twelve Respirations, he instructs:

Now, to explain how the Twelve Respirations relate to the treatment of symptoms: the upward respiration cures weight gain, the downward respiration cures feeling spent, the falling respiration cures emaciation, the scorching respiration cures bloating, the increasing respiration cures depletion [of the Four Elements], the dissipating respiration cures [their] excess, the warming respiration cures cold, the cooling respiration cures heat, the forceful respiration cures blockages, the retained respiration cures trembling, the harmonizing respiration completely cures disharmony of the Four Elements, and the nourishing respiration nourishes the Four Elements. One who is good at using these respirations can cure any and all afflictions—but, as you can infer from this, doing them wrong can cause even more afflictions to arise.

In closing the chapter, Zhiyi offers general reflections on the practice of healing using meditation. Advising the practitioner to become skilled in all of the eight techniques, he notes that he has only provided an overview, and that we should seek out more complete instruction. Above all, Zhiyi is emphatic that healing meditations help us cultivate various good qualities. He explicitly states that if one follows 10 “dharmas,” then one’s “treatments are guaranteed to be effective and will not be in vain:”

1. Faith in the effectiveness of the methods outlined in the text.
2. Regular practice.
3. Sustained effort.
4. Staying entirely focused on the object of the meditation one chooses.
5. Clearly discriminating the causes of illness (presumably in order to apply the correct meditation).
6. Using skill in choosing the right practice for the ailment in question.
7. Maintaining a long-term perspective and not giving up when results come slowly.
8. Knowing when to continue with a beneficial practice and when to abandon a non-beneficial one.
9. Avoiding mental distractions and moral transgressions.
10. Avoiding hindrances to practice such as pride and frustration.

Zhiyi lived in a very different religious and medical culture than we do today. Throughout the essay, we see that his notion of illness revolves around traditional Asian medical concepts, such as qi and the “five viscera” from Chinese medicine and the “four elements” from Indian classical medicine. However, it is quite possible that Zhiyi’s essay is describing contemplative techniques that can be proven to be efficacious in the modern context. At the very least, he is pointing out avenues beyond the current fixation on mindfulness meditation that merit further medical research and exploration.

* Qi or energy center.

C. Pierce Salguero is an interdisciplinary humanities scholar interested in the role of Buddhism in the cross-cultural exchange of medical ideas. He has a PhD in the history of medicine from the Johns Hopkins School of Medicine, and teaches Asian history, religion, and culture at Penn State University’s Abington College. He is the author of numerous books and articles on Buddhism and medicine, including Buddhism and Medicine: An Anthology of Premodern Sources.

References

Chih-i. 1997. Stopping and Seeing: A Comprehensive Course in Buddhist Meditation. Translated by Thomas Cleary. Boulder, CO: Shambhala Publications.

Zhiyi, Shramana. 2009. The Essentials of Buddhist Meditation. Translated by Bhikshu Dharmamitra. Seattle: Kalavinka Press.

Salguero, C. Pierce, ed. 2017. Buddhism and Medicine: An Anthology of Premodern Sources. New York City: Columbia University Press.

See more

Pierce Salguero

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The Seminal Suwen Chapters: A Blueprint for Human and Ecological Health

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Given the fact that I am really busy right now finishing up my forthcoming book Humming with Elephants: The Great Treatise on the Resonant Manifestations of Yīn and Yáng (a discussion of the Yellow Emperor’s Inner Classic, Plain Questions 5 黃帝內經素問:陰陽應象大論) and getting ready for a busy spring lecturing season, my esteemed colleague Z’ev Rosenberg, professor emeritus and former chair of the Department of Herbal Medicine at the Pacific College of Oriental Medicine in San Diego, has kindly offered to help out. Incidentally, Z’ev and I will be teaching a “medical classics study and herb expedition summer retreat” in Taos, New Mexico, in August of this year, which will incorporate material from both of our books. For more information on that, see here. To read more about Z’ev and his ongoing projects, visit his website here. In the guest blog below, he is providing a brief excerpt from his long awaited brand-new book Returning to the Source: Han Dynasty Medical Classics in Modern Clinical Practice, which has just been released by Singing Dragon and promises to be a real gem. Here is a little taste:

The essential first three chapters of the Huang di nei jing Su wen set the stage for the core principles of Chinese medicine. These opening chapters contain the compass of life and medicine; the text reveals the equations that allow us to see how far we’ve deviated from the principles of life. As Wang Bing explains in his commentary of Chapter 3 in the Su wen:

“If one’s desires cannot fatigue one’s eyes, if the evil of lewdness cannot confuse one’s heart, if no recklessness causes fatigue, this is ‘clarity and purity.’ Because of one’s clarity and purity, the flesh and interstice [structures] are closed and the skin is sealed tightly. The true and proper qi guards the interior and no depletion evil intrudes… Those that are ‘clear and pure’ follow the order/sequence of the four seasons, …they do not cause fatigue through reckless behavior, and rising and resting follow certain rules. As a result, their generative qi is never exhausted and they are able to preserve their strength forever.”

Many modern practitioners of Chinese medicine criticize the seminal first three chapters of the Su wen as ‘fantasy’, about a world that no longer exists, of sages living in perfect harmony with the way (dào 道). The Su wen describes it as an ideal, as a way of living that even at the time of the Huang Di nei jing was long past. In Chapter 1 of the Su wen Huang Di asked Qi Bo:

“The people of high antiquity, in [the sequence of] spring and autumn, all exceeded one hundred years. But it their movements and activities there was no weakening. As for the people of today, after one half of a hundred years, the movements and activities of all of them weaken. Is this because the times are different? Or that the people have lost this [ability]?”

Qi Bo responded:

“The people of high antiquity, those who knew the Way, they modeled [their behavior] on yin and yang…. [Their] eating and drinking was moderate. [Their] risings and resting had regularity. They did not tax [themselves]) with meaningless work. Hence, they were able to keep physical appearance and spirit together, and to exhaust the years [allotted by] heaven. Their life span exceeded one hundred years before they departed.”

What many people don’t glean from the passage is that the Su wen presents the principles for the practice of ecological medicine, based on living in harmony with natural law and its influences on the intricacies of human health. This has been known since ancient times, first mentioned in the Mawangdui manuscripts, as nourishing life (yǎng shēng 養生). The ideal way of life attributed to the sages is based on the intrinsic harmony of heaven (sky) and earth, and the human being as an intermediary between these poles of existence. So right at the beginning of Chinese history, we are seeing that the human being has a profound influence on the world around us.

In modern times, the predominating dogma(s) in modern science, on the one hand, are that nature is unconscious, working according to Darwinian mechanisms that push survival and adaption forward. On the other hand, are the religious fundamentalists who believe that such phenomena as climate change are a hoax, and free-market evangelists who believe that energy companies should be deregulated and be allowed to despoil the environment in the name of economic need and job growth? Nowhere is this problem more acute than in mainland China, as we discussed above. The closest modern theory I could find from a scientist is James Lovelock and Lynn Margulis’ “Gaia Principle,” which states that the Earth is a living being that responds to our activities. One of the great sea changes of the scientific revolution in the West was the complete repudiation of what is called the vitalist principle, the concept of a life force in creation that animates all living and sentient beings, replaced by a more mechanistic view of life. In my opinion, this is the biggest rift between Western and Chinese medicine. And to the degree that Chinese medicine abandons so-called vitalism, it moves far from its Han dynasty sources.

According to the evidence, of course doctors should recommend acupuncture for pain

Last week, the BMJ published an invited head to head debate as to whether doctors should recommend acupuncture for the treatment of pain. Below is my rapid response:

What’s most interesting about this discussion of whether or not doctors should recommend acupuncture for pain is a total lack of discussion of the other available treatment options that doctors and patients decide amongst and how acupuncture compares in terms of efficacy, effectiveness, safety and cost-effectiveness. Surely this is the only reasonable starting point for any intelligent discussion about how healthcare resources should be utilized to best help this patient population.

If we continue for a moment to look at acupuncture in an artificial vacuum, as Ernst and Hrobjartsson have done here, there are a few things to note. First, the small effect size that they note of acupuncture over sham needling for pain, which given that the review in question discarded the most positive studies constitutes an underestimation,1 both demonstrates specific effects of acupuncture and at the same time, is a completely irrelevant comparison to determine ‘clinical effects.’2 Doctors and patients are not choosing between acupuncture and sham acupuncture needling control; they are choosing between acupuncture, paracetomol, NSAIDs, opioids, surgery, off-label, poorly tolerated, experimental medication in the case of migraines and fibromyalgia, and physiotherapy, all of which are limited in their ability to effectively treat pain whilst introducing considerable and measurable harm. Sham controlled acupuncture trials merely assess two different types of acupuncture needling. Both are often superior to conventional care in terms of pain reduction and improved quality of life, with the highest-quality evidence demonstrating a statistically significant benefit of acupuncture over sham needling, with an effect size greater than that of paracetomol compared to placebo for many types of pain.3

If we look at sham controlled studies of orthopedic surgery, we find not a small difference between surgery and the sham procedure but no difference at all.4 Clearly surgery and acupuncture have similar methodological challenges to being studied using the double-blind RCT study design held as the gold-standard for pharmaceuticals. If lack of practitioner blinding is such a powerful force as the authors suggest, surely this should have a much stronger effect in the case of surgery, which is more invasive and more expensive (factors that we’re told influence acupuncture outcomes), and yet there’s no difference between fake surgery and the real thing when it comes to reducing patients’ pain. It seems odd to argue against something with at least small specific effects and large non-specific effects (in other words, large proven clinical effects in helping patients reduce their pain) rather than something that’s ineffective, invasive and expensive to boot.

It’s also helpful to note that studies of placebo, including Hrobjartsson’s own research, repeatedly and consistently demonstrate that placebos are ineffective and while they can bring short-term benefits for subjective outcome measures such as pain, they don’t work in the long-term at all.56 This is diametrically opposed to what we see in acupuncture research. Acupuncture brings meaningful reduction in pain symptoms that persists at 12 months,7 as Dr Cummings has pointed out. No placebo has been demonstrated to do this so I’m curious if the authors are arguing that acupuncture is a particularly special placebo unlike any other that has ever been studied before. Of course, this would be special pleading, which is an argument firmly rooted in the authors’ own bias rather than faithfully interpreting the evidence in a consistent and objective way in order to best help patients.

If the authors’ reading of the acupuncture mechanism literature stops at the gate control theory as they have stated, I’m confused as to why they feel qualified to comment as subject experts. Specific mechanisms for acupuncture in pain control are numerous and well-documented, involving but not limited to peripheral effects mediated by purinergic signalling and nitric oxide release, spinal reflexes, modulation of endogenous analgesic biochemicals (including endorphins i.e. endogenous morphine, very effective for pain relief!), improved functional connectivity in the brain, modulation of parasympathetic activity and modulation of inflammatory signaling.8

Of course, the ability to articulate how a treatment works has zero relevance for clinical effectiveness, which is what we’re actually discussing. On the other hand, a recent review in this journal that found that paracetamol is even more harmful than generally appreciated, notes that the ‘mechanism of paracetamol’s analgesic action remains largely unknown.’9

This comes after another recent review of paracetamol for spinal pain and osteoarthritis, also published in this journal, that finds that “paracetamol is ineffective in the treatment of low back pain and provides minimal short term benefit for people with osteoarthritis” 10. In short, paracetamol is widely used and prescribed, increases the risk heart attack, stroke, kidney damage, GI bleeding and death, and we don’t know how it works which is moot because it doesn’t work anyways. In that light, doesn’t it seem a bit silly to debate whether or not to recommend a treatment that is repeatedly demonstrated to be efficacious, effective, cost-effective, and safe, where the only question is exactly how much of its sizable clinical effect is down to the specific effects through analgesia induced through mechano-transduction and how much is due to the ambiance of the acupuncture clinic or the caring disposition of the clinician?

Another mainstay of pain treatment in the NHS are NSAIDs. This class of drugs suffers from a paucity of long-term clinical data but are frequently prescribed indefinitely, despite serious risks. A recent review looking at over 400,000 patients, also published in this journal, found that “All NSAIDs, including naproxen, were found to be associated with an increased risk of acute myocardial infarction” (which is fancy medical speak for ‘heart attack’) when taken for any time period, including as little as one week.11 A now out-dated and absurdly conservative estimate shows that the adverse effects of NSAIDs costs the NHS a median estimate of £251 million pounds a year.12 This figure is only based on the cost of treating GI perforation and doesn’t take into account any of the heart attacks and strokes caused by NSAIDs when taken as directed.

Of course, the harms caused by NSAID and paracetamol consumption pale in comparison to those of opioids, which are extremely addictive, frequently debilitating and often lethal (in the UK, deaths related to prescription opioids doubled between 2005 and 200913), which is why until a successful albeit illegal marketing campaign by their manufacturer in the 1990’s, oral opioids were only available as part of end-of life pain management for terminal cancer patients. In this light, it’s interesting to note that the first and only study ever performed on long-term effectiveness of opioids for pain-relief found that those taking opioids were actually in more pain than their non-opioid popping counter-parts.14 Talk about a poor benefit to harm ratio! While NICE guidelines for various pain conditions urge doctors to use these drugs sparingly and as a last resort, recommending against using acupuncture as a treatment for pain directly increases the usage of these drugs, which is clearly in no one’s best interest and makes the recommendations seem disingenuous.

As acupuncture has been repeatedly demonstrated to reduce the consumption of pain medication, including opioids and NSAIDs, surely a discussion of the cost of acupuncture should take this into account, given how much treating the harms of these drugs costs the NHS each year. Indeed, if we look at the cost-benefit ratio of what’s typically offered for pain, it would be more germane to discuss the cost to the NHS and harms to patients of not recommending acupuncture.

Compared to physiotherapy, acupuncture has a much stronger evidence base. As one point of reference, there are over 10,000 trials on Cochrane’s Central Register for acupuncture compared to under 7,000 for physio (ironically, this latter number includes studies of physios doing acupuncture). With this in mind, it’s interesting to note that physios frequently add acupuncture to their practice (the UK’s Acupuncture Association of Chartered Physios boasts over 6,000 members), often after very minimal training, contrary to World Health Organisation safety recommendations. It’s difficult to reconcile why physios would increasingly start using acupuncture if it didn’t work and their own tools that they learned in their training yielded satisfactory results in practice. Are you suggesting that physiotherapy techniques are so ineffective at treating pain that thousands of physios are offering a placebo to their patients instead?

Any discussion about which treatments should be recommended for pain that center on patients’ wellbeing and the allocation of precious healthcare resources should be based on a comparison of the benefits versus the harms of available treatments. This is self-evident. Such an approach, no matter how you slice the evidence-base, leaves acupuncture amongst first-line treatment options for pain, if not a clear winner. If Hrobjartsson and Ernst insist on banging the disproven placebo drum despite repeated demonstration of specific effects, clinical superiority over treatments that themselves are shown to be superior to placebo and despite the scientific community’s clear understanding of specific mechanisms of how acupuncture is able to achieve these results, then the discussion we should be having is not about the ethics of recommending placebos. Rather the discussion would need to be about the ethics of recommending treatments that fail to outperform or in some cases are inferior to a treatment that you claim is s placebo, all while exposing patients to considerable and avoidable harm. That’s the only logically consistent reading of your suggested interpretation. So let’s have a discussion about the ethics of that.

In the interest of patients and the responsible provision of healthcare resources, I sincerely invite the authors to explain: if not acupuncture for pain, then what do they recommend instead and based on what evidence? If they are unable to provide evidence of a more effective treatment, one with stronger evidence of positive effect, one that does not unacceptably harm patients, then perhaps a reconsideration of providing such a respectable platform for such outdated and un-evidenced opinions is appropriate, as it directly puts patients at risk while impeding access to a proven and effective treatment for a poorly treated affliction.

The post According to the evidence, of course doctors should recommend acupuncture for pain appeared first on A Better Way To Health.

Healing Experiences of Vipassanā Practitioners in Contemporary China, Case study 5

This is a case study that is part of a series of linked posts:
Introduction, case 1 | 2 | 3 | 4 | 5

Case 5: Candasaro

Before ordaining as a monk in Thailand, Candasaro had worked at a private factory as a production manager in Sichuan for over 30 years. In 2008 he started exploring Theravāda meditation by learning observing the breath[i] with Pa-Auk Sayadaw’s method at Jiju Mountain for about two months in Yunnan. He later gave up this practice as he could not see any sign[ii] emerged in his sitting. “My personality is quite fast-paced. It’s difficult to cultivate calmness.”[iii] In May 2011, he firstly learnt about the practice of dynamic movement at a ten-day retreat led by Luangpor Khamkhian Suvanno, from Thailand, in Hongzhou.[iv] During the retreat, he tasted a sense of joy[v], a positive outcome of meditation.

Candasaro found that dynamic movement suited him perfectly. He explained about the practice: “In the beginning [you] observe the movement of the body. Later [you can] observe the mind. All practices are similar. They firstly cultivate calmness by bringing awareness to one point. That is developing an ability of concentrating the mind. Without calmness, it is impossible to practice vipassanā. When you open the six sense doors, you hold one of them, like a monkey holding the main pillar. In dynamic movement, the main practice is moving the arms. In Mahāsi’s method, it is about the rising and falling of the abdomen. … I like observing the movement.”

He also practiced the dynamic movement at workplace. “While I was working at the control room, I managed the office work and communicated with my colleagues [when it was necessary]. The workload was not so heavy. There was only about one working our every day. It was relaxing.” Then in October 2011 Candasaro joined an organized trip to stay at WatPa Sukato[vi] for two months in South Thailand. This was the first time he travelled to Thailand. Located at Chaiyaphum Province, the temple covering an area of 185 acres, including a river and Phu Kong Mountain that was 470 meters above sea level. Sukato means ‘good’. Luang Phor Kham Khian Suwanno, the first abbot, shared his intention of building the temple, “Sukato is a place where people come and go for wellness, also for the beneficial impact of the environment, human being, river, forest and air. This is the wellness in coming, going and being. This wellness is born from earth, water, air and fire, not from one person alone. …There are shelter, food and friends who will teach, demonstrate, and give advice. Should one wish to stay here, his or her intention to practice dharma shall be fulfilled.”[vii]

In this huge forest temple, there were around 30 monks and 30 lay people only. As there were plenty established huts, every resident could stay in one hut.[viii] Every morning, all residents woke up at 3 o’clock in the early morning to prepare for the chanting and dhamma talk at 4 o’clock. Around 6 am, Candasaro and other monks, dressed in yellow monastic robe, formally visited villages nearby carrying their alms bowls for their daily alms round. (See Fig. 3 and Fig. 4) In Chinese Buddhist communities in China, alms round practices have been faded out for many centuries. With bare feet, the monks lined up tidily first and started walking towards one of the target villages. After entering the village, they stopped in front of a household where donors were waiting with cooked rice and food. Whenever people from households offered food to monks one by one, they would line up before the householders and chant blessing words in Pāli. All the monks went back to the monastery with the received alms. At around 7.30 am, volunteers in the monastery kitchen finished preparing the foods so that the monks and all residents could have their first meal. For monks, this was also the only meal according to their precepts.

In August 2012, he stayed there again for a month. In 2013, he decided to quit his job and receive early retired pension. He decided to ordain as a bhikkhu and settled at WatPa Sukato. He enjoyed his monastic life very much, “I don’t need to spend any money by living at a monastery. I have been working in government and business sectors for many years. I am very tired of them. And my wife agreed to that [the separation] ….  After you practice diligently, awareness lead you to have a strong sense of renunciation from the mundane world. Firstly, [it’s] renunciation; secondly, you do not attach or crave something.” (See Fig. 5)

Although Candasaro could not speak English, he had learnt some basic Thai words to communicate with Thai people for his daily basic needs. Over the past four years, he went back to China a few times to attend retreats and also invited some friends to travel to WatPa Sukato. In 2017, he returned to China and settled in Fujian Province. He started teaching dynamic meditation and led alms round in the village.

[i] Ch. guanhuxi; P. ānāpānasati.

[ii] Ch. chanxiang; P. nimitta.

[iii] Ch. ding; P. samādhi.

[iv] Luangpor Khamkhian Suvanno was a disciple of Luangpor Teean.

[v] Ch. xi; P. piti.

[vi] See “Wa-Pa-Sukato,” Tourism Authority of Thailand, https://www.tourismthailand.org/Attraction/Wat-Pa-Sukato–3354

[vii] Ibid.

[viii] Ch. gudi; P. kuṭi

Healing Experiences of Vipassanā Practitioners in Contemporary China, Case study 4

This is a case study that is part of a series of linked posts:
Introduction, case 1 | 2 | 3 | 4 | 5

Case 4: Jiang Hailong

Since May in 2006, Jiang Hailong, a forty-six-year-old civil servant from Fujian Province, had started practicing vipassanā with Goenka’s method for ten years. He attended four ten-day retreats and five eight-day satipaṭṭhāna retreats. Jiang said: “Learning vipassanā can purify the mind and cultivate wisdom. After a car accident in October 2005, I started suffering from headaches all the time. They could not be cured, although I had tried various kinds of treatment in clinics by spending a lot of money.”

Finally, he started practicing vipassanā to help relieve his physical pain in his daily life. He shared with me in a grateful tone: “I practice mindfulness every moment. From my experience, I feel pain in my head if I don’t practice. Yet with moment-to-moment awareness, the headache can be released. I can see clearly the change in the mind and the body. The whole body is composed of waves and particles. They emerge and disappear. I can see the phenomenon clearly during sitting and in my daily life. There is no concept of my arms, legs and head. They are waves only, with the vibration of particles. They arise and fall like bubbles… many bubbles …arise and fall… very quickly.”

Jiang highly recommend the teaching of Goenka. He believes that the teaching can lead to liberation of life and death. “Without awareness, I feel so painful. It is suffering. With awareness, the pain is relieved. Previously I had hatred towards the pain. Progressively the pain and hatred have faded away. A pleasant feeling even sometimes arises. Yet [I remind myself] not to attach to it.”

Jiang highlighted meditators should report to meditation teachers, who would give instructions during interview. Jiang thought that he did not practice well. He said shyly and humbly, “I have never dared to share with anyone about my practice–the experience of impermanence and not-self. But when I report to teacher, he confirmed that he could see it [in a similar way].”

Healing Experiences of Vipassanā Practitioners in Contemporary China, Case study 3

This is a case study that is part of a series of linked posts:
Introduction, case 1 | 2 | 3 | 4 | 5

Case 3: Xie Mingda

Xie Mingda, in his 40s, was born in Shamen of Fujian Province. With the influence of his parents and relatives, he has had chances of learning Buddhism since he was a child. “I attended some classes of Buddhism, and learned some Chinese Buddhist scriptures, such as The Diamond Sutra. I have a few good friends who have ordained as monks in Chinese Buddhist tradition, and also some in Theravāda tradition. I have been interested in learning scriptures in Theravāda tradition and Pāli language.”

Since 2008 he has attended ten-day vipassanā retreats of Goenka’s method for ten times, twenty-day for once and thirty-day for twice.[i] He has also served ten-day vipassanā retreats ten times as a volunteer helper.[ii] Nowadays he practices meditation for two hours every day. He found that his physical health has improved. His mind has become more balanced and more compassionate.

“I had suffered from Ankylosing Spondylitis, a disease related to immune system. It took me a few minutes to get up from sitting meditation posture. After I insisted to practice regular meditation, my body has been improved a lot. I feel that the body is full of energy after meditation.” However, he emphasized that a right attitude of meditation practice is important. In the beginning of his practice, he hurt his leg as he tried to strive for good results.

Overall, Xie Mingda showed a great sense of gratitude to meditation practice. “[Through practicing meditation, I have experience the sense of impermanence[iii] and not-self.[iv] Comparing with a few years ago, I feel that the sense of self has been reduced.” The benefits of meditation have influenced his mental state. “I work in Futures trading [which renders me a lot of stress.] After practicing vipassanā, the anxiety emotion has been reduced. The mind has become more balanced. I think that my frequent donation also helps.”

[i] See Vipassana Meditation website for details https://www.dhamma.org/

[ii] It is usually called as Dhamma worker (Ch. fagong).

[iii] Ch. wuchang; P. anicca.

[iv] Ch. wuwo; P. anattā.

Healing Experiences of Vipassanā Practitioners in Contemporary China, Case study 2

This is a case study that is part of a series of linked posts:
Introduction, case 1 | 2 | 3 | 4 | 5

Case 2: Wu Jianhong

After the experience of curing sub-arachnoid hemorrhage, a life-threatening condition in 2013, Wu Jianhong, a 50-year-old civil servant, has changed his lifestyle rigorously. He was still impressed about the shocking moment: “I visited a medical doctor after having a long-term serious headache. After the assessment, I was shocked that when he asked me: ‘Do you have any religious belief? You’d better have one as you cannot do much either office or labour work in future.’ I said I didn’t know that as I have never explored any religions. The doctor said he became a Christian after studying abroad in France and the United States. I said that I was not interested in Christianity. I think that I may be interested in Buddhism.”

Wu then reflected on his previous lifestyle: “I remember that I used to experience mental stress from my office work. And I was quite frustrated about my unsatisfied achievement, such as my financial situation and social status. Then I was pessimistic about many things in my life. And I started some unhealthy habits. For example, I addicted to gambling and drinking. [However,] when I was sick, I thought it was time to understand my life again. I started thinking: why do human beings live with suffering?”

“What are the origins of suffering? … I had never thought about that. I spent most of my time on work, entertainment and drinking. From the book, I remember a quote. ‘The source of suffering is an attachment to self.’ ……When we compare with others [about our achievement], we experience mental stress and suffering…… I finally understand that the cause of suffering is ‘the self’.” Wu Jianhong received a few books about Buddhism before the operation. After returning home from the hospital, he read Heart Sutra and Human Wisdom, a book written by Venerable Jiqun, the abbot of the Xiyuan Monastery in Suzhou. As he knew the great variety in Buddhist practices, he had an idea of exploring a way of practice. From reading The Diamond Sutra[i] and the Platform Sutra of the Sixth Patriarch, he found that meditation was suitable for him. When his body was recovering, Lu visited Xiyuan Monastery to attend his first one day meditation retreat with Mahasī’s vipassanā method. “I remember that when I registered for the activity, I kept a very pious mind. It was so fortunate that I was selected to join the meditation retreat. ……Since then, I have learned to practice mindfulness at the present moment.”

As Jianxi Province is more close to his home, Wu then visited Yunshan Monastery in Jianxi for about three times every year to join seven-day or ten-day vipassanā meditation retreats.(See Fig. 1 and Fig. 2) For example, he first attended seven-day retreat led by Sayadaw U Indaka, a Burmese vipassanā teacher who practices with Chanmyay Sayadaw’s method.[ii] He also explored some books on vipassanā meditation. ‘Venerable Juexing gave me two books: Don’t Look Down on the Defilements and Dhamma Everywhere.[iii] After reading them, I felt that [the practice] is the same as that of Platform Sutra. I have already found my way of practice. I do not need to explore anywhere. I can understand my life.” To him, the practices of the Northern School and the Southern School are the same. “I am willing to learn whatever is beneficial to me…….I will check that whether the practice is about the Fourth Noble Truth, the Eightfold Path and the Twelve Links of Dependent Origination.” He does include the practice of reciting the Buddha’s name of the Pure Land tradition. When he is agitated, he practice meditation. “I calm down myself, and practice observing the breath. There are many ways of practices, for example, bringing awareness to some parts of the body.”

Wu Jianhong has cut off all his habits of gambling, smoking and drinking. Instead of spending time on entertainment, he enjoys practicing Buddhism and meditation. “In daily life I think, if Buddhist practice cannot be brought into daily life, it is difficult for us to survive in this society.” However, most of his family members, including his father, siblings and his wife, misunderstand his big change. “They even slander [me]. Yet I continuously insist [my practice]. Why? It has been greatly beneficial to me, including my body recovery. It support the recovery of my body and mind. I can see the changes. I used to have bad temper. Now I rarely lose my temper.” Despite the existing misunderstanding of Buddhism in the society, Wu does not intend to argue with those people. “I try to do my best about what I need to do. I think it shows how I have changed with Buddhist practice.”

[i] Ch. Jingangjing; Skt. Vajracchedikā-prajñāpāramitā-sūtra

[ii] Sayadaw U Indaka is the disciple of Chanmyay Sayadaw following the lineage of Mahāsi Sayadaw.

[iii] See U Tejaniya 2014.

Healing Experiences of Vipassanā Practitioners in Contemporary China, Case study 1

This is a case study that is part of a series of linked posts:
Introduction, case 1 | 2 | 3 | 4 | 5

Case 1: Lu Hongji

Lu Hongji, a Chinese medical doctor from Shanxi in his 40s, is who has received benefits from vipassanā meditation of Mahāsi’s method. He started exploring various Buddhist practices, including canhuatou in Chan practice, since 1996. When Pa-Auk Sayadaw visited Guangdong Province in 1999, he became interested in the meditation practices of Theravāda traditions. With the encouragement from a friend who visited Myanmar, he traveled to Myanmar two times. He recalled: “In the first visit I had stayed at the meditation center of Chanmyay Sayadaw for over four months. In 2014 I had spent nearly four months at the meditation center of U Paṇḍita Sayadaw, who is famous for the strict rules for meditation practices. In the beginning I misunderstood that vipassanā was the same as qigong. Only after I have committed to the practice that I can fully understand the method. Now I understand that it is a unique practice. But it is connected with the practice of observing the mind from Chan tradition. I practice walking meditation to reduce the sense of sleepiness before sitting meditation. Each time after serious practice, my body is soften. I can feel the warmth in the abdomen area. The mind has become gradually awake and serene. With right mindfulness, insight developed from vipassanā meditation arise to deal with all kinds of thoughts in the mind. Practicing vipassanā has brought me an experience of great change in my life. For instance, I stop pursuing those materialistic goals which tire me. I am contented with the inner peace at the present moment.”

Lu Hongji emphasized that it is important to learn meditation from an experienced teacher with skillful instruction skills. He said, “A good teacher can guide students to overcome any difficulties during meditation. Meditation can improve physical health. Once I gave meditation instructions to a few young people. The body of a student was weak. While he was practicing sitting or walking meditation, his body moved obviously. Strong reaction during meditation reflects that the body is weak.” He explained that, “[From the perspective of Buddhism], physical movement is a reaction of the wind element. That is also an imbalance of the four elements (the earth element, the water element, the fire element and the wind element). From the perspective of Chinese medicine, practicing meditation gives rise to positive energy (Ch. yangqi). The physical reaction is due to the interaction of the energy and the blocking area in the body.” Although meditation can heal the body, Lu reminded that one cannot strive in meditation practice. Meditators should prepare their body with a balance of four elements before the development of the mind.

Healing Experiences of Vipassanā Practitioners in Contemporary China

This is part of a series of linked posts:
Introduction, case 1 | 2 | 3 | 4 | 5

 

Meditation (chan), recognized as one of the key practices in Chinese Buddhism, has in mainland China historically been restricted mainly to monks at Buddhist monasteries. However, there has recently been an increasing number of laypeople learning various satipaṭṭhāna meditation practices from the Theravāda traditions, especially vipassanā derived from Burmese and Thai teachings. Hundreds of people have attended seven-day or ten-day vipassanā retreats in different parts of China. Drawing on interview transcripts from recent fieldwork in mainland China, this chapter focuses on the healing experiences of Han Chinese vipassanā practitioners.

Vipassanā, as it is known today, is largely a product of the modern era. With the influence of colonization and Buddhist modernism in the late nineteenth century in Southeast Asia, various Buddhist meditation practices were modernized. Scholars have identified Ledi Sayadaw (1846-1923) as a key player in the modernization of vipassanā.[i] As a Buddhist scholar and meditation teacher in Burma, Ledi Sayadaw simplified the theoretical underpinnings of meditation (the abhidhamma), and emphasized the cultivation of insight through vipassanā rather than the intensively ascetic mental absorptions known as jhāna. These innovations evoked a massive increase in lay people learning meditation in Burma.

After the independence of Burma in the 1950s, the vipassanā meditation teachings of Mahāsi Sayadaw (1904-1982), and their adaptations by lay teacher Satya Narayan Goenka (1924-2013) have become popular, and have spread to other Asian countries such as Sri Lanka and Thailand.[ii] Since the 1960s, some westerners travelled to Myanmar and Thailand to learn meditation as monastics or lay practitioners. Vipassanā meditation has been spread to Europe and North America by these Western meditators, as well as by Asian monks who have established meditation centers in the West and published meditation manuals in English.

Since the turn of the century, various meditation practices from Theravāda traditions have also been spread to Malaysia, Singapore, Taiwan, Hong Kong, and then mainland China through published books, websites, and travellers.[iii] Some Buddhist monastics and lay people from China have travelled to Southeast Asia to stay at meditation centers for a few months, or even a few years, to learn meditation. After returning to mainland China, some Chinese practitioners have organized retreats, inviting teachers from Myanmar and Thailand to teach vipassanā meditation in China.

In the mainland Chinese context, vipassanā meditation is translated as neiguan chan (lit. “internal contemplation meditation”), which emphasizes the observation of the mind and the body. Among those vipassanā meditation practices transmitted into contemporary Chinese societies, popular teachings include that of Mahāsi Sayadaw and Goenka from Burmese lineages, and the dynamic movement practice of the Thai monk Luang Por Teean. There are currently six vipassanā meditation centers set up offering Goenka’s meditation program across the country,[iv] and one meditation center offering Luang Por Teean’s teachings in Sichuan.[v] Although there is thus far no center dedicated to Mahāsi Sayadaw’s system established in China, a few famous disciples of his, including U Paṇḍita Sayadaw (1921-2016) and Chanmyay Sayadaw (b. 1928) have led retreats in China.

The three systems of meditation have their differences. Mahāsi Sayadaw has highlighted the role of vipassanā in helping the practitioner to overcome suffering by understanding the true nature of body (rūpa) and mind (nāma) as being composed of the Five Aggregates, according to the classic Buddhist doctrine. Unlike Mahāsi Sayādaw, Goenka uses the terminology of modern science. He explains that the mind and body are “nothing, but subtle wavelets of subatomic particles,”[vi] and he highlights vipassanā’s adaptation for modern life as a “secular, universal and scientific technique.”[vii] Unlike both Mahāsi Sayādaw’s and Goenka’s methods, which teach meditators to sit still with closed eyes to attain calmness, Luang Por Teean’s meditators practice rhythmic movements continuously. Keeping their eyes open, they believe that this practice can train the mind to become active, clear, and pure and to realize a state of freedom.

Overall, the transcripts from interviews that are excerpted and translated below will demonstrate that a number of Han Chinese practitioners of vipassanā have claimed to experience significant therapeutic benefits from their meditations. Many experienced practitioners shared that the main cause of suffering is attachment to self and material things in Buddhism. Vipassanā meditation has facilitated them to understand impermanence and not-self through mind-body experiences, so that they can deal with physical pain from their physical illness. The strong moment-to-moment awareness from the meditation practice in daily life can help meditators to reduce the sense of self and attachment to material world. With the right attitude of practice, the mind can cultivate calmness and joy with a balanced mental state. Hence long-term meditators can easily contented with their balanced mental state in daily life. Without a striving mind in the mundane world, one can reduce suffering and unhappiness gradually.

[i] Braun 2013. Burma is used in this chapter to refer to Myanmar before the end of colonization.

[ii] About the influence of the teaching of Mahāsi Sayadaw in Myanmar and Thailand, see Jordt 2007 and Cook 2010 respectively; about the influence of the teaching of Goenka in Burma and Asian countries, see Bond 2003.

[iii] About the development of vipassanā meditation in Taiwan, see Chen 2012; about the development of vipassanā meditation in Hong Kong, see Lau, Ngar-sze. 2014. “Changing Buddhism in Contemporary Chinese Societies, with special reference to meditation and secular mindfulness practices in Hong Kong and Taiwan.” MPhil diss., University of Oxford.

[iv] See the website of Vipassana Meditation centres in mainland China, http://vipassana.sutta.org/

[v] Mahasati Dynamic Meditation Centre, http://www.zndzc.org/

[vi] Hart 1987: 115.

[vii] Goldberg 2014: 79.

FURTHER READING

Bond, George D. 2003.The Contemporary Lay Meditation Movement and Lay Gurus in Sri Lanka.” Religion 33: 23-55.

Braun, Erik. 2013. The birth of insight: meditation, modern Buddhism, and the Burmese monk Ledi Sayadaw. Chicago; London: The University of Chicago Press.

Chen, Chialuen. 2012. “Nanchuan fojiao zaitaiwan difazhan yuyingxiang.” Taiwanese Sociology 24: 155-206.

Cook, Joanna. 2010. Meditation in Modern Buddhism: Renunciation and Change in Thai Monastic Life. Cambridge: Cambridge University Press.

Goldberg, Kory. 2014. “Chapter 3 For the Benefit of Many: S.N. Goenka’s Vipassana Meditation Movement in Canada.” In Flowers on the Rock: Global and Local Buddhisms in Canada, ed. John S. Harding, Victor Sogen Hori, and Alexander Soucy, Montreal & Kingston: McGill-Queen’s University Press.

Hart, William. 1987. The Art of Living: Vipassana Meditation as Taught by S. N. Goenka. Onalaska: Harper & Row.

Jordt, Ingrid. Burma’s mass lay meditation movement: Buddhism and the cultural construction of power. Athens: Ohio University Press, 2007.

Mahasī, Sayādaw. Dhamma Therapy Revisited: Cases of Healing through Vipassanā Meditation. (Aggacitta Bhikkhu Trans.). Taiping: Sāsanārakkha Buddhist Sanctuary, 2009. (Original work published 1976)

Pagis, Michal. 2009. “Embodied Self-Reflexivity.” Social Psychology Quarterly 72, (3): 265-283.

Schedneck, Brooke. 2015. Thailand’s International Meditation Centers: Tourism and the global commodification of religious practices. Abingdon: Routledge.

U Tejaniya, Sayadaw [Dejianiya Chanshi]. 2014. Bie qingshi fannao [Don’t Look down on the Defilements: They Will Laugh at You]. Translated by Li Mingqiang. Jianxi: Jianxi Buddhist Academy.

———. 2014. Yiqie doushi fa [Dhamma Everywhere]. Translated by Li Mingqiang. Jianxi Buddhist Academy.

GLOSSARY

Abhidhamma     ‘higher teaching’; refers to the collection of commentaries on Buddhist canon

Chan                            (Ch. meditation)

Jhāna                           mental absorption or trance

neiguan chan               (Ch. internal contemplation meditation)

satipaṭṭhāna                 foundations of mindfulness

rūpa                             body; physical component

nāma                            mind; mental components

 

See also: Case Study 1 | 2 | 3 | 4 | 5