Thai & SE Asian Medicines

From secret knowledge to science: creating modern practitioners

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By Assunta Hunter

“My initial interest in traditional healing in Thailand began with a trip to Thailand that was billed as a study tour of Northern Thailand Healers. It was advertised in a professional journal. I travelled with a pair of old friends (one of whom had previously lived in Thailand for 3 years and spoke some Northern Thai). We drove from Chiang Mai into the hill-tribe villages north west of Chiang Mai in what is called the upper north of Chiang Mai Province. It was late March and early April, the hottest driest time of year in that part of Thailand. The heat was intense, and the terrain mountainous and jungle-covered. There was a lot of dust and smoke. At that time of year smoke from the burning off associated with forestry and swidden agriculture obstructed our vision, gave us all chronic coughs and didn’t let us appreciate the full beauty of these mountain landscapes. We visited a variety of different hill-tribe practitioners (Hmong, Lisu, Black Lahu, Red Lahu and Karen) and some local Northern Thai practitioners who worked in Chiang Mai Province. It was a tourist package but had been advertised in a professional journal as a study tour and most of the small group of eight people were naturopaths or had a broader interest in traditional healing practices.

My memories of the trip are of my intense frustration at not being able to talk to the healers we visited and at the speed of the tour (it was a whistle-stop travel experience). There was a sense too, of peering briefly at a range of practitioners and practices that I realized even then I wanted to know much more about. I disliked the sensation of being a tourist in relation to traditional medicine and in many ways felt myself to be interacting with healers who practiced in a different cultural tradition, but with whom I felt an affinity. For many people these traditional healers may have been exotic but as a herbalist and naturopath I recognized in these traditional medical practices, similar kinds of understandings of the body, health and treatment to those found in ‘traditional herbal medicine’. Ideas about health and well-being were couched in terms of balance. Descriptions of patients and plants as hot and cold, and foods as medicines, were familiar to me from my own herbal tradition. Health in Thailand is considered a fragile, daily balance in which the environment, family and social relationships, emotions, spirits, karma and magic all feature. Patients speak of being dry and hot, of their medicines as cooling and refreshing and describe foods as strengthening. Folk healers talked about illness in terms of blood (lueat เลือด), poison (phit พิษ) and karma (kam กรรม). There were also features of the medical tradition that were quite unfamiliar to me like the use incantations (khaa thaa คาถา) to potentize medicines and to secure beneficial outcomes.

The other main memory I have from this trip was of managing somehow to have a fruitful conversation with the mo tam yae (หมอตำแย midwife) at a Lisu village where my herbal colleague and I shared birthing lore. Needless to say they were far more experienced in this area than we were. We spoke through the village headman, a youngish Thai man who spoke English, had a university education and had returned to his Lisu village home, which was unusual. We talked about everything from the use of roses for skin treatment to the use of ice-cubes for moving mal-positioned foetuses. Even now (14 years later) I wonder about whether this information has been used by the midwives. Did these bits of knowledge slip into practice in this Lisu village? Have these fragments of information and practice entered into Lisu traditions, in the way that the adoption of Hopi ear candles has permeated Australian naturopathic practice? ” (Hunter, 2014 (unpublished thesis): p.39-41)

This is a fragment from the thesis I subsequently wrote about the modernization and professionalization of traditional medicine in Thailand. I went on to spend a year in Thailand (in 2009 and 2010) doing ethnographic fieldwork as part of a PhD in medical anthropology at the University of Melbourne. I lived with, talked to and befriended many traditional medicine practitioners in Chiang Mai. I immersed myself in their world of students, classes, rituals and in the conferences which took place during my time there. I did my research not as a total outsider (despite my obvious whiteness and very basic command of Thai) but as a herbalist and teacher from another tradition. What I wrote about in my thesis was the way in which traditional medicine practitioners were now able to choose between learning from a teacher (khruu ครู) or going to university. As you can imagine the difference between becoming an apprentice and becoming a university student is considerable.

What I explored in my thesis was the changing landscape of traditional medicine education in Thailand. Folk healers established their knowledge through a sense of vocation by apprenticing themselves to a teacher, a process which linked them to a lineage of knowledge and teachers extending to Shivaka Kormarpaj, the Buddha’s physician and the Father of Healing in the Thai tradition. This method of learning was  an oral tradition. Students learnt by watching and working with their teacher; learning how to recognise plants, how to make medicines and observing how their teacher treated patients and gradually absorbing the healing traditions which had been passed down over centuries. The healing practices were taught in the context of the Buddhist culture they were drawn from. Healing rituals, use of magic and incantation were all part of healing practices. Rituals, beliefs and practices were local and the healing traditions of Thailand vary considerably from region to region.

By contrast modern university training has been established through a process of drawing together material in a formal educational curriculum. It draws on written sources and because it is taught in a modern educational institution it has been grafted onto a scientific base. Students acquire a formal education which emphasizes the scientific rationale for using plants and massage. They learn about plant medicines using pharmacology and chemistry as the lens through which they understand their properties and uses. They are trained to work in a modern health system and to work with nurses, doctors and pharmacists. In short they are trained to be modern health professionals.

I’ll write more about what these changes in the education of Thai traditional medicine practitioners mean in my next piece.

Chinese & East Asian Medicines, Religion & Medicine

An Excerpt from Fascicle Twenty-Nine of Huilin’s Yiqie jing yinyi 一切經音義, Pronunciations and Meanings for All [Buddhist] Scriptures

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An Excerpt from Fascicle Twenty-Nine of Huilin’s Yiqie jing yinyi 一切經音義, Pronunciations and Meanings for All [Buddhist] Scriptures[1]

Translated and introduced by Robban Toleno

The following lexical entries come from the Yiqie jing yinyi, a hundred-fascicle guide to the language of Buddhist scriptures that was compiled in 807 by the Buddhist monk Huilin 慧琳 (737-820). Huilin’s philological work builds upon the earlier efforts of the monk Xuanying 玄應 (d.u.). The organization of this reading aid follows the chapters of whatever scripture is under scrutiny. In the excerpt below, Huilin has listed words from the ninth fascicle of the Jin’guangming zuishengwang jing 金光明最勝王經, Sutra of the Most Excellent King of Golden Light[2], which was translated to Chinese in 703 by Yijing (635-713). Much of Huilin’s notation concerns the proper forms and pronunciations of characters. Because the meanings of Chinese words often depended on pronunciation rather than inherent semantic values of characters[3], and because Chinese Buddhists often chanted their scriptures, guidance on the pronunciation of obscure vocabulary had a practical significance. Philological study helped keep chanting in unison, reduced scribal errors in the copying of sutras, and aided readers in interpreting scriptures. Huilin relies on a number of lexical works that predate the arrival of Buddhist writings, effectively grounding the philological study of Buddhist scriptures in a classical vein of Chinese knowledge production stretching back to ancient writings. These lexical notes contain a wealth of information for linguists working to reconstruct the pronunciations of Middle Chinese, which differed considerably from those of modern Mandarin.[4] They also demonstrate that Chinese Buddhist scholar-monks such as Huilin were well versed in practical forms of knowledge including natural history and medicine.

 

Ninth Fascicle of the Jinguangming zuishengwang jing, Sutra of the Most Excellent King of Golden Light

金光明最勝王經卷第九

 

匱乏[5] The first [character’s pronunciation] combines gwijH 逵 and hwijH 位. The Shuowen [jiezi says that] 匱 [means] a box. Derived from 匚, the pronunciation of which is pjang 方, and kjw+jH 貴 for the tone. The latter [character’s pronunciation] combines bjom 凡 and pjop 法. The Shuowen cites the Chunqiu zhuan, saying that [匱乏] is properly interpreted [to mean] lacking (乏). Fa 乏 means paucity.

匱乏(上逵位反。說文匱匣也。從匚，匚音方，貴聲。下凡法反。說文引春秋傳曰:反正為乏。乏少也)。

 

金翅[6] [The second character] combines the sounds syij 尸 and tsyijH 至. Also known as “kae-lju-la” (transliteration of Skt. garuḍa) or ‘dragon-window’, this is the Gold-Winged King of Birds[7], the eater of dragons. Ancient writings render [the character 翅] as 翄 or [羽+氏].

金翅(尸至反，一名加婁羅，一名龍䆫，即金翅鳥王也，食龍者。古文作翄亦作[羽*氏]也)。

 

滋繁[8] The first [character’s] pronunciation is tsij 諮 and its proper form comes from 水 and 並, with two 玄. When today it is rendered 茲, this is a vernacular form of the character. The latter [character] is pronounced byon 煩, with the tone of khawX 考; [its form] derives from 敏, with hejH 系 for the tone.[9]

滋繁(上音諮，正體從水並二玄，今作茲時俗字也。下音煩，考聲也，從敏，系聲也)。

 

老耄[10] The latter [character’s pronunciation] combines maw 毛 and pawH 報. The Liji annotated by Zheng reads, “Mao [means] senile and forgetful.” In ancient writings it derives from 蒿 and is rendered [蒿 over 老]. The Gujin zhengzi derives it from 老 with maw 毛 for the tone. The Zishu‘s having it [老 over 鬼] is a vernacular form of the character.[11]

老耄(下毛報反，鄭注禮記云:耄惛忘也。古文從蒿作[蒿/老] ，古今正字從老，毛聲，字書有作[老/鬼]俗字也)。

 

痰癊[12] The first [character’s] pronunciation is dam 談; the second is a combination of ‘im 陰 and kimH 禁. Note that the characters for 痰癊 do not have a definitive form. An illness of the breath located in the diaphragm. Bodily fluid that congeals and does not disperse due to a shortness of breath, and which like tendon glue (a collagen/gelatin product) does not sever when stretched. Its name is dam ‘imH 痰癊 and among the root [causes] of the four [types of] illness, this one can cause a hundred illnesses, all of which are ailments of the diaphragm.

痰癊(上音談，下陰禁反。案痰癊字無定體。[凶/月]鬲中氣病也。津液因氣疑結不散，如筋膠引挽不斷。名為痰癊，四病根本之中此一能生百病，皆上焦之疾也)。

 

鹹醋[13] The first [character’s] pronunciation is heam 咸. The “Hongfan” [chapter of the Shangshu] says of water that it trickles downward and becomes salty (鹹). The Erya says saltiness is bitter. Annotation [of the Erya] by Guo says bitter is great saltiness. The Shuowen [says] 鹹 [is pronounced] haem 銜 and is the flavor of the northern regions. [The character] derives from 鹵 with heam 咸 for the tone and luX 鹵 for the sound. The Lujing‘s use of 酉 to make 醎 is erroneous, as this is not a proper form [of the character]. The latter [character in the headword] combines tshang 倉 and kuH 固, [having the same] tone as khawX 考, and refers to vinegar. The Jixun [gives] swan 酸 [for 鹹酸, salty and sour].[14] This character (酸) is not proper, and according to the customary meanings and pronunciations [given] in scriptures, the character tshuH 醋 [associated with] fermented bean sauces is [to be] used. The wordbooks of the various philologists of recent generations are in agreement on the above pronunciation.[15] The Shuowen and [other] ancient wordbooks have since former times held that the construction 醋 is pronounced the same as dzak 昨. Where the [Jixun] says, “A guest pours (tsyak 酌) wine with the host,” this corresponds with the [second] character in dzyuw tsak 酬酢 (to toast with wine), the pronunciation of which combines dzang 藏 and lak 洛 and means to toast reciprocally with wine. If we rely on [information in] the Shuowen, the seven wordbooks Yupian, Gujin zhengzi, Wenzi dianshuo, Guangya, Qieyun, Zitong, and Zilin have both tsjangH 醬 (fermented bean sauces) and 醋 as derived from dzraeH 乍 to form tsak 酢 (the return toast of a guest to a host). Orthodox physicians [have] the character 酢 deriving from 乍. The Shuowen says it is verified. The Cangjiepian [has] 酸. The custom today is to revert to using the pronunciation dzak 昨. [I] still do not know which of the two forms is right, in the past or today, so for now I am writing both [solutions] together here.

鹹醋(上音咸。洪範云水曰:潤下潤下作鹹。尒雅云鹹苦也。郭注云苦即大鹹也。說文鹹銜也北方味也。從鹵，咸聲,鹵音。魯經從酉作醎誤也，非正體。下倉固反，考聲，云醋䤈也。集訓酸也。此字非正，且依經義音之俗用醬醋字也。近代切韻諸家字書並同上音。說文及古字書從昔作醋者並音為昨。訓云客酌主人酒也，是相酬酢字也，音藏洛反，獻酬也。若依說文，玉篇、古今正字、文字典說、廣雅、切韻、字統、字林七本字書醬醋字並從乍作酢。音倉固反。正醫酢字從乍也。說文云驗也。蒼頡篇酸也。今俗用却音為昨。未知二體今古孰是，今並書之也)。

 

甛膩[16] The first [character’s pronunciation] is a combination of drip[17] 䐑 (M. zhé) and yem 閻. The Guangya [says it means] sweet. The Shuowen [says it means] tasty 美, deriving from a sweet (甘) tongue (舌), which if formed into 甜 also means the same. The latter [character] is a combination of nrij 尼 and trjeH 智. The Chuci annotated by Wang Yi says that 膩 means oily. The Shuowen [gives] [月+㔾] (perhaps a variant of chì [月+匕], meaning an oily/slick appearance), [saying] it is derived from 肉 (meat) with nyijH 貳 for the tone, and is not derived from 月 (moon).

甛膩(上䐑閻反，廣雅甛甘也。說文美也，從甘舌，或作甜亦通。下尼智反，王逸注楚辭云膩滑也。說文[夗-夕+月]也，從肉，貳聲，從月非也)。

 

鍼刺[18] The first [character’s pronunciation] combines tsyip 執 and nyimH 任. The Guangya [says] 鍼 also [means] to prick (刺). The Liji says married women wear on the right side of the waist a needle tube and silk thread. The Shuowen accordingly [refers to] sewing. The Yupian [gives] the patching of clothes. Vernacular usage makes 針 based on 十, which not only accords with the times but is moreover in [common] use. The proper [form] derives from 金 (metal) and 箴 (needle), with simplification of the phonetic [element of the character, i.e., 箴 becoming 咸]. Pronunciation of the latter [character] 刺 [in the headword] is a combination of tsheng 青 and yek 亦, and also of tshjeX 此 and sijH 四. The two pronunciations are both acceptable for the proper form of the character. The Shuowen [says that 刺 means] to meet with injury. Gu Yewang[19] writes that [it means] needle-sharp and piercing into human flesh,[20] and says that the Gujin zhengzi [has it] derived from 刀 with tshjeH 朿 for the tone, 朿 being pronounced tshijH 次.[21] Deriving it from 朿 is not correct. Where scriptures have it derived from 夹 to make 刾, this is a vernacular character form.

鍼刺(上執任反。廣雅鍼亦刺也。禮記婦右佩鍼管線纊，說文所以縫也。玉篇綴衣也。俗用從十作針，亦順時，且用也。正從金從箴，省聲。下刺音青亦反，又此四反，二音並通正體字也。說文直傷也。顧野王云銳鑱人(=入)人肉中曰古今正字從刀，朿聲，朿音次，從朿者非也。經從夹作刾俗字也)。

 

鼻梁㩻[22] The last [character’s] pronunciation is khi 欺. Gu Yewang writes that 㩻 [means] slanted and not straight. The Shuowen [says it means] 陋 (provincial, inferior),[23] and that it derives from ngjwe 危, with tsye 支 for the tone. Others have it derived from 山 to make 崎; still others have it derived from 器 to make [器+支]. These are all ancient characters. Where scriptural writings derives it from 奇 to make 攲, this is not right. Sun Qingzi (the philosopher Xunzi) wrote that the ancestral shrine of Duke Huan had in it a ’tilting vessel’ (㩻器), which slanted when empty, overturned when full, and [remained] level when filled to the middle, in conformity with [the way] people [are].

鼻梁㩻(下音欺顧野王云㩻傾側不正也。說文陋也，從危，支聲。或從山作崎，或從器作[器+支] ，皆古字也。經文從奇作攲非也。孫卿子曰桓公廟有㩻器焉，虛則㩻，滿則覆，中則平，以誡於人也)。

 

餌藥[24] Combining nyi 而 and tsyiH 志, [餌] is a falling-tone character (去聲字).[25] The Cangjiepian says that 餌 is food. Gu Yewang says that in general everything that is eaten is called 餌. The Gujin zhengzi [says it refers to] cakes. The Shuowen derives it from [弓+畐+弓] to make [耳 over 弓+畐+弓], [defining it as] pastries.[26] Deriving it from [弓+畐+弓] with nyiX 耳 for the tone is an ancient character. Today it is derived from 食 to make 餌. The Zhouli annotated by Zheng Xuan (127-200) writes that what is steamed together is called pjengX 餅 (cakes and other products made from flour). The Zishu says it is 餻 (cakes or pastry).[27] The Shuowen derives it from 食 (food) with nyiX 耳 for the tone.

餌藥(而志反，去聲字也。蒼頡篇云餌食也。顧野王云凡所食皆曰餌。古今正字餅也。說文從[弼-百+(幅-巾)]作[耳/(弼-百+(幅-巾))]粉餅也，從[弼-百+(幅-巾)]耳聲古字也。今從食作餌。鄭玄注周禮云合蒸曰餅。字書云糕也。說文從食耳聲也)。

 

豺狼[28] The first [character] is pronounced dzrea 柴 [and] is the name of a rural animal. The Kuodi zhi says that the shape of dholes is like that of dogs but smaller, that they like to move in groups, and that they are a social animal. There is a [status] difference between the high and the low. Slave (i.e., low status) dholes will often move on ahead [of the group] and hunt down a bird or deer, and, not daring to start eating first, will keep guard, waiting for the leading dhole. The leading dhole arrives later but eats first, and only when it is satiated and abandons the remaining meat will the slave dholes commence eating together. The “Yueling” chapter of the Liji says that in the moon of the autumn season (the ninth month of the lunar calendar), dholes make sacrificial offerings of animals. The latter [character of the headword] is pronounced lang 郎. It is a wild animal. The deserts of the northern lands abound with this animal. They often live in dens [near] rivers and marshes. The Shuowen says wolves resemble dogs, with a pointed head and white forehead that is protruding in the front and wide in the back, the ears rising up vertically, the mouth square, the tail usually hanging downward, [and the fur] a bluish yellow or white color. They are exceedingly strong––donkeys, horses, people, and domestic animals all suffer harm. The Erya says of wolves that the males are called xwan 貛 (“badgers”), the females[29] lang 狼, and their young 獥 (M. jiào[30]), and that they are incomparably strong and fast. [狼] is a phono-semantic character (i.e., with one part providing a sound and another indicating something about the meaning). The pronunciation of 貛 is xwan 歡.

豺狼(上音柴。山獸名也。括地志云豺形似狗而小，好羣行，義獸也。有良賤之異。豺奴常先行獵得禽鹿等物，不敢前食，守待豺郎。豺郎後至先食，飽棄餘肉，豺奴方始共食。禮記月令云季秋之月豺乃祭獸。下音郎。野獸也。北地沙漠多饒此獸。常居川澤穴處。說文狼似犬，銳頭白額高前廣後，耳聳竪，口方，尾常垂下，青黃色或白色。甚有力，驢馬人皆遭害。爾雅曰狼，牡貛，牡狼，其子獥，絕有力迅。形聲字。 貛音歡也)。

 

狐玃[31] The first [character’s] pronunciation is hu 胡. Above, I already explained 野狐 (wild foxes). The latter [character’s pronunciation] is a combination of kju 俱 and ngjak[32] 籰 (M. yuè). The Erya annotated by Guo says that the jue 玃 is like the macaque only larger, bluish-black in color, and that it is able to seize and carry off humans, from which it gets its name.[33] Looking back [over the written record], this type of category is exceedingly common. Each has a different name. The Shuowen says it is a female monkey. Another name [for it] is naw 獶, a character with the form (a semantic indicator) on the left and the sound on the right. The pronunciation of 獶 is a combination of nu 奴 and taw 刀.

狐玃(上音胡。前已釋野狐也。下俱籰反。郭注爾雅云玃似獼猴而大，倉黑色，能[玃-(目*目)+賏]持人，故以為名。好顧眄此等種類甚多。各別異名。說文母猴也。一名獶，左形右聲字也。獶音奴刀反)。

 

鵰鷲[34] The first [character’s] pronunciation is tew 彫. The latter [character’s pronunciation] is dzjuwH 就. Because the third fascicle of the [Yiqie] yinyi on the Da bore jing (Skt. Mahāprajñāpāramitā-sūtra) already has an explanation [on this], I will not reiterate.[35]

鵰鷲(上音彫也。下音就。前大般若經音義第三卷已具釋文，繁不述)。

 

宛轉[36] The first [character’s pronunciation] is a combination of ‘jwon 冤 and hjwonX 遠. The Shuowen says 宛轉 [means] wo 臥 (resting, reposed). [The first character] deriving from xi 夕 (evening), [it means] resting (臥), temperate (有節). It derives from 夕 and 卪(= jié 節). Scriptures also have it derived from 女 (woman) to make ‘jwonX 婉 (gentle), [but that] is not this usage.

宛轉(上冤遠反。說文宛轉臥也。從夕，臥，有節也。從夕從卪。經又從女作婉，非此用也)。

 

欲涸[37] A combination of ha 何 and kak 各 [constitutes the second character’s pronunciation]. The Guangya says that 涸 [means] to be exhausted. The Guoyu annotated by Jia says that 涸 [means] to be used up. The Shuowen says that water dries up (涸). It derives from water 水, with kuH 固 for the tone.

欲涸(何各反。廣雅涸盡也。賈注國語云涸竭也。說文水涸也。從水固聲也)。

 

象廄[38] The first is the proper form of the character 象. The latter [character’s pronunciation] is a combination of kjuw 鳩 and hjuwH 又. The Shuowen [says these are] lodgings for elephants and horses. The Zhouli says 214 horses make up one jiu 厩 (stable).[39] Derived from 广 and 段. The pronunciation of 广 is ngjaemX 儼. The pronunciation of kjwieX 𣪘 is the same as [what was given] above.

象廄(上正體象字也。下鳩又反。說文象馬舍也。周禮曰馬二百一十四匹為一厩。從广段，广音儼。𣪘音同上也)。

 

皮囊[40] [The second character is] a combination of nak 諾 and lang 郎. Explanatory notes in the [Qieyun[41]] say that it is a bag with a base. It derives from [襄-〦], which derives from hwonH 㯻 (to tie up), simplified to [襄-〦] and pronounced nreang[42] 儜 (M. níng). 㯻 is pronounced hwonH 溷.

皮囊(諾郎反。韻詮云有底袋也。從[襄-〦]從㯻省[襄-〦] ，音儜。㯻音溷)。

 

循岸[43] The pronunciation of 循 is zwin 巡. Zwin 循 (“to follow the course of”) developed from 行 (walking).

循岸(循音巡，循由行也)。

 

睡寤[44] The first [character’s pronunciation] combines dzywe 垂 and lwijH 淚 and means sleep. The latter [character’s] pronunciation is mjuH 悟 and means to fall asleep. [It] derives from mjuwngH 㝱, economizing by deriving from [only] 爿.

睡寤(上垂淚反，眠也。下音悟，睡覺也。從㝱省從爿也)。

 

References

Baxter, William H. and Laurent Sagart. Old Chinese: A New Reconstruction. New York: Oxford, 2014.

Dictionary of Chinese Character Variants => Taiwan Ministry of Education. Yitizi zidian 異體字字典, http://dict2.variants.moe.edu.tw/variants/rbt/home.do; accessed November 2016.

Kroll, Paul W. A Student’s Dictionary of Classical and Medieval Chinese. Leiden / Boston: Brill, 2015.

Kwan, Tze-wan. “Abstract Concept Formation in Archaic Chinese Script Forms: Some Humboldtian Perspectives.” Philosophy East and West 61, no. 3 (2011): 409–52.

McDonald, Edward. “Getting Over the Walls of Discourse: “Character Fetishization” in Chinese Studies.” The Journal of Asian Studies 68, no. 4 (2009): 1189–213.

Muller, A. Charles, ed. Digital Dictionary of Buddhism. http://buddhism–dict.net/ddb. Edition of 2016-08-28.

SAT => SAT Daizōkyō Text Database 大正新脩藏經テキストデータベース , http://21dzk.l.u-tokyo.ac.jp/SAT/satdb2015.php; accessed November 2016.

T. => Taishō shinshū daizōkyō 大正新脩大藏經, Taishō-Era Newly Revised Tripitaka, the digitized text of which can be accessed through CBETA or SAT.

Notes

[1]           T. 2128, v.54, 502c07-503a16.

[2]           Skt. Suvarṇa-prabhāsôttama-sūtra. Yijing’s translation is T. 665, v.16, beginning on 403a04. For detailed notes regarding this sutra and its various editions, see Michael Radich, “Jinguangming jing 金光明經,” in Muller, Digital Dictionary of Buddhism, http://www.buddhism-dict.net.ezproxy.cul.columbia.edu/cgi-bin/xpr-ddb.pl?91.xml+id(‘b91d1-5149-660e-7d93’).

[3]           The compound qīqū is a good example of a word that can be represented with different character sets (崎嶇, 陭䧢, and 㩻䧢) and still mean the same thing. On the ideograph/logograph debate over what constitutes a word in premodern Chinese, see McDonald, “Getting over the Walls of Discourse” and Kwan, “Abstract Concept Formation in Archaic Chinese Script Forms.”

[4]           For an example of how Huilin’s work has been useful to linguists, see Baxter and Sagart, Old Chinese, 114.

[5]           MC gwijH bjop / M. guìfá; Skt. vaikalya; poverty. Huilin’s lexical notes include pronunciation glosses based on Middle Chinese (MC), which differs from modern Mandarin Chinese (M.) pronunciations. Where pronunciation is mentioned, I provide first Middle Chinese and then Mandarin readings, giving the Mandarin tone only for the headword and for instances where the body text discusses tonal values. The Middle Chinese readings are from Kroll, A Student’s Dictionary of Classical and Medieval Chinese, 53, which are based on Baxter and Sagart’s reconstructions. In some cases I have inferred Middle Chinese readings from the fanqie 反切 explanations provided by Huilin, if I cannot otherwise find a reconstruction. Because the logic of some of his explanations does not work there is a good likelihood of errors, whether entering from Huilin’s judgment or dialect, from problems with our modern-day reconstructions, or from my own carelessness. The traditional tonal system of Middle Chinese is indicated as follows: an unmarked (no X, H, or k) final position indicates a píng 平 tone; -X in the final position indicates a shǎng 上 tone, -H a qù 去 tone, and -p, -t, or -k in the final position a rù 入 tone. I find this notation cumbersome, but follow it because it is in use. See Baxter and Sagart, Old Chinese, 14.

[6]           MC kim syeH / M. jīnchì; Skt. garuḍa; a kind of mythical super bird like a roc.

[7]           An alternative reading has 王 as 正. The statement would then read that, of the different names for this bird type, jinchiniao 金翅鳥, or Gold Winged Birds, is the proper one.

[8]           MC tsi bjon / M. zīfán; proliferate.

[9]           Even after comparing Middle Chinese reconstructions, the logic of this statement is not clear.

[10]         MC khawX mawH / M. lǎomào; an elderly person; senile.

[11]         This text is probably the Ganlu zishu 干祿字書, by Yan Yuansun 顔元孫 (jinshi ca. 685-688).

[12]         MC dam ‘imH / M. tányìn; phlegm.

[13]         MC hen tshuH / M. xiáncù; salty and sour.

[14]         The identity of this work is not clear, as “jixun,” which appears to mean an anthology for training purposes, is likely an abbreviation of a longer title.

[15]         Wordbooks 字書 are semantically organized word lists, such as the Erya.

[16]         MC dem nrijH / M. tiánnì; sweet, sweet and fatty. A character variant is used which cannot be represented digitally: 肉*(武-止+(二/貝)). Having confirmed this variant (see A03366) in the Dictionary of Chinese Character Variants (異體字字典) maintained by the Taiwan Ministry of Education (http://dict2.variants.moe.edu.tw/variants/rbt/home.do), I use the standard form.

[17]         Inferring the reconstruction from 直葉切, as given in the Shuowen jiezi, accessed through the Dictionary of Chinese Character Variants.

[18]         MC tsyim tshjeH / M. zhēncì; pricking with needles; acupuncture.

[19]         Author of the Yupian and other works. He lived 518-581 CE.

[20]         Reading the first 人 as 入, since this appears to be a transcription error.

[21]         Discrepancies like this show the tentative nature of our knowledge of Middle Chinese reconstructions.

[22]         MC bjij ljang khje / M. bíliáng qī; “the bridge of the nose is slanting.”

[23]         Although this is the character appearing in the print and digital editions of the Taishō Buddhist canon, it appears to be an error, whether by Huilin or by a later scribe. The Shuowen gives khju / qū 䧢, meaning slanted. This character occurs in the compound qīqū, meaning steep (as in a road or hillside), and variously represented as 崎嶇, 陭䧢, and 㩻䧢.

[24]         MC nyiX yak / M. ěryào; to take medicine. Despite Huilin’s discussion here about cakes and pastries, historical sources use this compound as verb+object, meaning to eat medicine.

[25]         Huilin would have it pronounced nyiH.

[26]         “Powder cakes.” These are a type of small pastry made from powdered ingredients lightly bound together.

[27]         Following the Taishō print edition. The digitized canon shows 糕.

[28]         MC dzreaj lang / M. cháiláng; dholes (Asian wild dog) and wolves.

[29]         The Taishō print edition and corresponding digital text is in error here. The second 牡 should read pin 牝, a female animal.

[30]         The Middle Chinese is not clear for this character, which seems to have had multiple phonetic readings through its history.

[31]         MC hu kyak / M. hújué; foxes and apes.

[32]         Inferring the reconstruction from 玉縛切, as given in the Shuowen jiezi.

[33]         Reading 倉黑 as 蒼黑 and [玃-(目*目)+賏] as kjak / jue 攫, which appears to be the implied meaning.

[34]         MC tew dzjuwH / M. diāojiù; eagles and vultures.

[35]         Huilin provides explanations in several places, e.g. T54 n2128, 334b20-21.

[36]         MC ‘jwonX trjwenX / M. wǎnzhuǎn; resting, reposed; in some contexts it has the nuance of being supple, accommodating.

[37]         MC yowk hak / M. yùhé; desires dry up.

[38]         MC zjangX kjuwH / M. xiàngjiù; elephant stables.

[39]         Three characters have entered modern usage as acceptable variants for the word kjuwH / jiù, “stable”: 廄, 厩, and 廐.

[40]         MC bje nang / M. pínáng; leather bag.

[41]         Or perhaps this refers to another rime dictionary.

[42]         Inferring from 女耕切, as given in the Yupian and Guangyun.

[43]         MC zwin nganH / M. xún’àn; to follow the course of a riverbank.

[44]         MC dzyweH nguH / M. shuìwù; to sleep and wake.

Chinese & East Asian Medicines

Nestorian Christianity in the Tang Dynasty

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This is a syndicated post that first appeared at: http://huayanzang.blogspot.com/2016/10/nestorian-christianity-in-tang-dynasty.html

Nestorian Christianity in the Tang Dynasty

As of late I’ve been reading about the Nestorian Christian (Jingjiao 景教) community that thrived in China from the early seventh to mid-ninth century. Their church was, it seems, largely responsible for transmitting Hellenistic astrology and even some Near Eastern occult practices into China, hence my present interest. Their active influence in Chinese religious history during this period is not always recognized, especially in Buddhist Studies. There are several documents from their movement preserved in Chinese, in addition to two steles that were unearthed in Chang’an and Luoyang, thus we know a fair amount about their church.

Nestorianism as a Christian movement initially developed in the fifth century starting from Nestorios (c.381–c.451), who was bishop of Constantinople between 428–431. The primary doctrine of Nestorianism is that Christ was comprised of two separate persons, one human and one divine. This was rejected as heretical by their opponents. The Nestorian bishops were condemned at the Council of Ephesus in 431. The result was an eastward spread of the Nestorian movement. It eventually spread all across the Near East and Central Asia before reaching China in the year 635 when a mission led by Aluoben 阿羅夲 (also rendered as 阿羅本) arrived in the capital Chang’an 長安. His name in Chinese might have been a transliteration of ‘Abraham’. This mission occurred towards the final years of the Sassanian dynasty (224–650), and was shortly after the first Arab invasions of Iran starting in 633.1 This leads me to wonder if these early Christians in China might have been refugees.

By the late eighth century the Nestorian Christian community was thriving in China. We know this from a famous stele that was erected in the year 781, often called the ‘Nestorian Stele’ 大秦景教流行中國碑. The stele inscription describes the first Christian mission to China, some basic Christian doctrines and the names of clergymen in Chinese with parallel Syriac and Persian names written in Syriac script. It interestingly also provides dates according to the Chinese, Greek and Persian calendars. The text is composed in very elegant literary Chinese and was clearly written with elites in mind judging from its grammar and use of refined vocabulary.

The inscription on the stele was composed by a certain cleric named Adam 景淨 from Daqin-si 大秦寺. In one Buddhist source, to which we will return shortly, Adam is also identified as a ‘Persian monk’ 波斯僧.2 ‘Daqin-si’ referred to a Nestorian Christian church, but in this case refers to the one in Chang’an. Normally, Buddhist monasteries are indicated by the suffix –si 寺 (temple), but throughout the Tang dynasty (618–907), Nestorian churches were also designated with this suffix. There were such churches in both capitals (Chang’an and Luoyang). They were originally called ‘Persian temples’ 波斯寺 due to the original missionaries in 635 having come from Persia, though in 745 an imperial edict had them renamed to Daqin-si. The following edict records this.

天寶四載九月詔曰：波斯經教，出自大秦，傳習而來，久行中國。爰初建寺，因以為名，將欲示人。必修其本。其兩京波斯寺，宜改為大秦寺。天下諸府郡置者，亦準此。

In lunar month nine of year four [745] in reign era Tianbao the following edict was issued. The scriptural teachings of Persia came from Daqin, and long have they been transmitted in China. They were named [as Persian temples] when they were first built so as to show people [their origin]. It is necessary to revise their origin. The Persian temples in the two capitals should be renamed to ‘Daqin temples’. All prefectures and counties in which [such temples] are present will also follow suit.3

The ‘Daqin’ 大秦 (‘Great Qin’) in the name of the church is interesting as this term originally referred to the Roman empire in the early centuries CE, or more specifically its eastern territories, in particular Alexandria. In the eighth century, however, it does not appear to refer to the Byzantine empire, but rather to the Levant in general. The evidence to support this assertion is actually found in the stele from 781 as it provides the following hint:

神天宣慶，室女誕聖於大秦；㬌宿告祥，波斯覩耀以来貢。

The angel [Gabriel] proclaimed good tidings. The Virgin gave birth to the Sage in Daqin. The luminous asterism indicated a portent. The Persians witnessed the brilliance and came to pay tribute.

This of course is referring to the birth of Jesus Christ in Bethlehem. In light of this and the otherwise nebulous understanding of Daqin as being “west of the Western sea ​(i.e., the Caspian Sea),” I am convinced that ‘Daqin’ refers to the general geographic region of the Levant. It seems that Nestorians arriving in China all identified as either from Persia or Daqin, which is instructive since these territories were under the rule of the caliphates. They did not, so far as I know, identify as coming from Arabia. The word for Arabia in Chinese in this period was Dashi 大食, its Middle Chinese pronunciation reconstructed as dâiᶜ dźjək(Schuessler IPA). This is most certainly derived from Middle Persian word tāzīk / tāzīg, ‘Arab’.4 One might imagine Nestorian Christians in China identifying their ethnicity as Syrian, Persian or Sogdian, but never Arab even when they had been born under a caliphate.

Incidentally, later on ‘Daqin’ was changed to ‘Fulin’ 拂菻. In Middle Chinese this is reconstructed as pʰjuət *ljəmᴮ (Schuessler IPA). This appears to be a transliteration of an Iranian pronunciation of ‘Rome’, such Sogdian frwn and brwn, or Middle Persian hrōm. How do we know that this refers to Byzantium specifically? The New History of the Tang 新唐書, the revised history of the Tang dynasty compiled in 1060, states the following.

拂菻，古大秦也，居西海上，一曰海西國。去京師四萬里，在苫西，北直突厥可薩部，西瀕海，有遲散城，東南接波斯。

Fulin in former times was Daqin. It is located on the western sea. One [account] calls it the ‘Country on the Western Sea’. It is forty-thousand li from the capital [of Chang’an]. It is west of *Shan. To the north it meets the Turkish Khanate. To the west it approaches the sea, where there is *Alexandria.5 To the southeast it meets Persia.

The name Shan 苫 here most likely refers to Damascus. Its Middle-Chinese pronunciation is reconstructed as syem (Baxter-Sagart 2011). This seems to correspond to al-Shām, the Arabic name for Syria. A Chinese writer named Du Huan 杜環 travelled to the Abbasid Caliphate and returned to China in 762. His travelogue, the Jingxing ji 經行記, states that “the country of *Shan is on the western frontier of the Arab [state]” (苫國在大食西界).

The Byzantine Empire c. 867

This change in name from Daqin to Fulin appears to reflect the ongoing loss of territory of the Byzantium empire. The Levant in the ninth century was no longer under the control of Byzantium state. Chinese scholars only possessed an approximate conception of the Near East’s political and physical geography, which helps to explain why Alexandria is erroneously placed at its western side. Nevertheless, it is quite clear that Fulin is a transliteration of an Iranian pronunciation of ‘Rome’. Nestorians initially identified themselves as having come from Persia. Later they identified as hailing from ‘Daqin’, a general term for the Levant, likely as a result of the demise of the Sassanian state by the mid-seventh century. Finally, at some point in the ninth century it seems that ‘Daqin’ was understood to be the former territories of ‘Rome’ occupied by the Arabs.

Returning back to Nestorianism in China, I want to discuss its interaction with Buddhism. There is an account of the aforementioned clergyman Adam translating a Buddhist text with the Buddhist monk Prajñā 般若.

請譯佛經。乃與大秦寺波斯僧景淨，依胡本六波羅蜜經譯成七卷。時為般若不閑胡語，復未解唐言，景淨不識梵文，復未明釋教。雖稱傳譯未獲半珠。… 察其所譯理昧詞疎。且夫，釋氏伽藍，大秦僧寺，居止既別，行法全乖。景淨應傳彌尸訶教，沙門釋子弘闡佛經，欲使教法區分，人無濫涉。

They requested he [Prajñā] translate Buddhist scriptures. Together with the Persian monk Adam of Daqin-si, he translated the *[Mahāyāna-naya-]ṣaṭ-pāramitā-sūtra in seven fascicles based on a Sogdian edition. At the time Prajñā did not understand Sogdian or Chinese, while Adam understood neither Sanskrit nor Buddhism. Although they were said to have translated it, they had yet to obtain the half-pearls [i.e., ascertain the meaning]. … Upon investigating what had been translated, the reasoning was found to be unclear and the vocabulary off. The Buddhist monastery and Daqin church were to keep their residences separate and their practices entirely apart. Adam should transmit the teachings of the Messiah, while Buddhists shall propagate Buddhist scriptures, so as to keep the doctrines separate, and the peoples from excessive intermingling.6

This accounts suggests to me that while the state authorities respected both religions, they desired to keep them separate. In light of the elegant Chinese that Adam composed for the stele of 781, we can infer that he was quite learned in the Chinese classics, and therefore likely mingled with aristocrats in the capital. In such circles eminent Buddhist monks and Daoist priests were also active, thus there were many opportunities for elite religious thinkers to interact.

Another interesting fact about Nestorianism in China is that their clerics are on record as having practiced medicine in China. As to the type of medicine they practiced, I have reason to believe that it was actually Greek. Returning to the travelogue by Du Huan, he gives the following interesting account.

其大秦善醫眼及痢，或未病先見，或開腦出蟲。

The Daqin are adept in treating eyes and dysentery. Some can foresee illness before symptoms emerge. Some can perform trephinations and remove parasites.

The New History of the Tang also mentions such medical practices in Byzantium.

有善醫能開腦出蟲以愈目眚。

There are skilled physicians capable of performing trephinations and removing parasites to heal eye diseases.

Cranial surgery of this type was well known in ancient Greek medicine. As Arani and others note, “Cranial trepanation was first recorded by Hippocrates (460–355 BC).”7 This surgery was apparently performed in China as early as the late years of Emperor Gaozong 高宗 (r. 649 – 27 December 683). There is a story recorded in the Old Book of Tang 舊唐書, compiled in 945, and elsewhere that a cranial operation was performed on Gaozong.

上苦頭重不可忍，侍醫秦鳴鶴曰：「刺頭微出血，可愈。」天后帷中言曰：「此可斬，欲刺血於人主首耶！」上曰：「吾苦頭重，出血未必不佳。」即刺百會，上曰：「吾眼明矣。」

The Emperor was suffering intolerable headaches. His retainer physician Qin Minghe said, “It could be healed by piercing the head and drawing a bit of blood.” The Empress [Wu Zetian] behind a screen said, “He should be beheaded, wanting to draw blood from the leader of men!” The Emperor said, “My headaches are severe. Drawing blood is not necessarily bad.” The crown of the skull was pierced. The Emperor said, “My eyes has cleared up!”

The name Qin Minghe 秦鳴鶴 here possibly indicates a foreigner. The surname Qin could be derived from Daqin and in light of the surgery he performed he was likely from abroad. Huang (2002) and others attempt to identify him as an immigrant Nestorian clergyman.8 Although this is not certain, there are still other accounts that confirms the presence of Nestorian physicians in Tang China. In year 28 of reign era Kaiyuan 開元 (740), the clergyman Chongyi 僧崇一healed the younger brother of Emperor Xuanzong 玄宗 (r. 712–756).9 A report by Li Deyu 李德裕 (787–849) states that a certain Daqin cleric proficient in optometry (醫眼大秦僧一人) was present in Chengdu 成都 at one point.10

It is therefore clear that Nestorian clergyman did in fact practice medicine in China during the Tang dynasty, and moreover they most likely brought with them Greek medical techniques. They also introduced other foreign sciences and arts, such as astronomy and astrology. In 1980 in Xi’an the tombstone of a court astronomer was discovered. His name was Li Su 李素 (743–817) and he is identified as a Persian. It seems that he was a Christian clergyman from the community of Persians resident in Guangzhou. Sometime between 766–779 he was summoned to the court to work in the bureau of astronomy. Later his ‘courtesy name’ 字 of Wen Zhen 文貞 alongside the corresponding name ‘Luka’ in Syriac appears on the list of Christian clergymen on the stele of 781.11 Although not immediately clear from his biographical information, he likely practiced Hellenistic astronomy in light of his ethnic and religious backgrounds. Earlier ‘foreign’ court astronomers, such as Gautama Siddhārtha, employed and even translated Indian astronomy. Li Su as a replacement for Gautama Siddhārtha was likely functioning as a ‘second opinion’ at court in matters related to astronomy and calendrical science, providing a perspective based on foreign methods.

Nestorian clergymen clearly played important roles throughout the Tang dynasty. They were eliminated in China as an institution and religion in 845 when Emperor Wuzong 武宗 (840–846), a Daoist zealot, initiated a purge of foreign religions. Buddhism, Manichaeism and Christianity were, at least in the capital region, rapidly dismantled and their assets liquidated. Buddhist sangha members were defrocked, while Manichean priests were put to death.12 Christianity was to a large part eliminated as a major religion in China until several centuries later under the Mongols.

2《大唐貞元續開元釋教錄》卷1：「大秦寺波斯僧景淨」(CBETA, T55, no. 2156, p. 756, a20-21)

3 This is reported in fasc. 49 of the Tang huiyao 唐會要.
4 There were many ethnically Iranian persons in Tang China, including those identifying themselves as Persians, but also Sogdians and Bukharans.
5 Chisan 遲散 here refers to Alexandria. This is geographically problematic, but the Chinese understanding of the Near East was pieced together from multiple, often chronologically disparate, sources. See Yu Taishan, “China and the Ancient Mediterranean World: A Survey of Ancient Chinese Sources,” Sino-Platonic Papers 242 (2013): 34. http://sino-platonic.org/complete/spp242_china_mediterranean.pdf
6《貞元新定釋教目錄》卷17 . CBETA, T55, no. 2157, p. 892, a7-15.
8 Huang Lanlan 黃蘭蘭, “Tangdai Qin Minghe wei jingyi kao” 唐代秦鳴鶴為景醫考, Zhongshan Daxue xuebao 中山大學學報 42, no. 5 (2002): 61–67.
9 Jiu Tang shu 舊唐書 (fasc. 95).
10 See fasc. 703 of the Quan Tang wen 全唐文.
11 Rong Xinjiang 榮新江, “Yi ge shi Tangchao de Bosi Jingjiao jiazu” 一個仕唐朝的波斯景教家族, in Zhonggu Zhongguo yu wailai wenming 中古中國與外來文明 (Beijing: Sanlian Shudian, 2001), 255–257.
12 This is recorded in the journal of Japanese monk Ennin 圓仁 (794-864):【四月】中旬 敕下，令殺天下摩尼師。剃髮，令着袈裟，作沙門形而殺之。摩尼師即迴鶻所崇重也。
Chinese & East Asian Medicines, Research & Teaching

New Digital Tools for the History of Medicine and Religion in China

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This is a syndicated post that first appeared at www.cpianalysis.org.

When we do textual research on China, we rely on canons that were made with paper. The gold standard for a digital corpus is that it is paired with images of a citeable physical text produced in known historical conditions: at a specific time and place, by a known author or community, or as close to that as possible. Even more, the basic organisation of our wonderful modern databases is structured according to the catalogue and chapter headings of the original collections, which are essentially finding tools for paper archives. While these categories organised the literature and made it easier to find, they also profoundly influence how we, in turn, organise our own research, and how we write history.

The problem is that the categories of researchers change with time. As we analyse our sources in new ways, we give priority to certain texts or features over others, effectively re-indexing them to suit our purposes. Usually, textual scholars will privilege a few texts as case-studies for close study, because we lack the tools for large-scale analysis of textual corpuses to make summative statements about a field of knowledge, or to track changing patterns of a field over time. We can perform thorough and extensive searches for single or a few terms across wide sets of literature, but the long lists of results that are returned are unreadable by humans.

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Figure 1: Search result for a single term, gancao 甘草 (liquorice) in a major text collection

We have a problem of too much information, and too few ways of making sense of it.

In my digital work in the combined histories of Chinese medicine and of Chinese religions, I wish to make a critical intersection into how we theoretically interpret, and digitally analyse our sources. The history of Chinese religions has recently taken on some new directions in the theory of practice. In order to better understand the ways in which historical actors creatively combine aspects of “different” religions, such as Buddhism and Daoism, some scholars have started modelling religions as “repertoires of practice.”  This has a very productive overlap with actor-network theory in Science and Technology Studies (STS), which also sees knowledge as produced by “clots” or “assemblages” of people and things, practices, thoughts and institutions and many more.  Furthermore, the concept of “situated knowing” that came out of STS argues that different actors organise knowledge differently; there is no single, authoritative perspective on a particular field of knowledge.

This theoretical conjunction raises an important methodological question: How can we identify, sort through and organise a history of “repertoires of practice,” as they are enacted by historical actors of different stripes? Especially when these practices are disparate and escape the cataloguer’s eye?  How can we tell when and which practices are being combined and deployed, in concert or separately, and whether concentrations of practices remain constant across different sectarian affiliations, or whether they change in significant ways?  Can we identify patterns of change or stability?

In the Drugs Across Asia project, Chen Shih-pei and I are developing a pilot platform to test how to do exactly this. With generous support from Department III of the Max Planck Institute for the History of Science (MPIWG), in collaboration with the Research Center for Digital Humanities at National Taiwan University (NTU), and with Dharma Drum Institute of Liberal Arts (DILA), we are undertaking a pilot study to analyse all Daoist and Buddhist Canon and most medical sources up through the Six Dynasties (to 589 CE) for the presence of drug terms.

In stage one, I use a statistical tool developed by NTU to analyse the texts to identify where drug knowledge is located among the set of sources. NTU have uploaded all the texts for analysis as separate juan in the form of *.txt files. I have selected a combination of open source texts from various sources, primarily drawing from Kanripo. I then upload a large list of known drug terms (11,000!), which the tool uses to analyse which drugs appear in which juanaccording to frequency, and produces a list like this one.

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Figure 2: Chapters from Buddhist and Daoist Canons, according to Drug Term Frequency

From this list, I select the juan for further analysis. It is somewhat self-selecting, as I sort according to how many terms appear per juan. After this, I analyse whether or not the found terms are homonyms for other things, such as relics, deities, or other terms. In this method, more hits is a good thing, because a high concentration of terms per juan is an indicator that drugs are an important topic in that text.

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Figure 3: Drug terms in Buddhist monastic codes

From this data set, I can already begin to compare drug repertoires of different communities. For example, the graph above shows clusters of drug terms from five different Buddhist monastic codes. The terms that appear between the clusters are shared between two or more texts. When compared to an early Chinese materia medica, as in the graph below, it is visibly clear how different the drug lore from China and from India was.  There are only a very few common terms between the Chinese text and the five Indian texts. These terms need to be more thoroughly analysed to explain these differences and correlations, but the foundations of a research paper are already here.

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Figure 4: Buddhist Codes compared to Chinese Materia Medica

In the second stage, we mark up individual juan. It is exciting how easy MARKUS makes it to do this work. Using Keyword Search, I can paste my entire list of drug terms into MARKUS, and with one click identify which of those 11,000 terms appears in the text and where. This lets me quickly and easily see where the “action” is, where the drug knowledge is concentrated, without having to read through the entire juan first.  I can then go and review how drug knowledge is framed and organised in that text in particular.

This way of organising reveals the “ontology” of the drug knowledge in the juan. Does it mention other important data like disease terms, drug properties, anatomical terms, or material practices like decocting, chopping, or roasting? Geographic terms? Famous people or locations? These are all important for how drug knowledge is figured. I scan through the text to pick out a representative section, and use Manual markup to highlight these salient features. Having been captured by MARKUS, they can be produced as a data table. Through this process of reading and marking up terms, MARKUS enables the ontology of each text to emerge as a data structure directly from the organisation of the text itself.

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Figure 5: Ontology marked up in MARKUS

I then work closely with DILA to mark up the texts. DILA are responsible for producing CBETA, one of the foremost digital humanities projects in East Asia, and thus have extensive experience with marking Buddhist texts. I forward them the file, and they clean up the automatic marking, and use the sample ontology I’ve provided to continue to manually identify corresponding features throughout the rest of the text.  I check over the results, and forward the marked file to NTU to upload into the analysis platform.

NTU are currently developing a platform called DocuSky , based on the engine behind the Taiwan History Digital Library. This platform will enable detailed analysis of the resulting markups.  It will incorporate detailed meta-data for each text – telling when and by whom a text was compiled or written, in what literary genre, with what sectarian identity, and if available, in which geographic location. By analysing this detailed meta-data along with the markups, I will be able to analyse through which communities what drug knowledge travelled, and, given enough meta-data, at which times and places. The platform will also be capable of visualising the data on a GIS map and dynamic timeline, as in the existing MPIWG platform, PLATIN.

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Figure 6: PLATIN Place and Time Navigator

With this tool, I should be able to quickly identify identical and similar drug recipes at scale, as well as when, where and with whom they travelled, and how they were interpreted. This will provide a much broader and more complex picture of who knew what about which drugs than can currently be known from studying materia medica (bencao 本草) literature. I should be able to track changes in properties of drugs and recipes as they circulated through historical communities, and to do so at scale. It is a mainstay of medical history to compare different community interpretations of a single drug or recipe, but no one has compared large-scale patterns of change and transfer before. By identifying which communities possessed and transmitted which drug knowledge, this platform will facilitate a large-scale picture of one important feature of the relationship between medicine and religion in the Six Dynasties.

While this model is custom-tailored to do research on drugs, it is highly adaptable. In the future, researchers should be able to change their categories and term sets to search for any “repertoire” or “assemblage” of terms. This could include medical data such as anatomical locations or disease names.  But it could also be used to capture divinatory arts, health cultivation exercises, pantheons of gods, philosophical terms – anything you can develop a good term list for. I hope this set of tools will enable the fields of religious studies and medical history to come to much more nuanced descriptions of the histories of material (and immaterial) practice.

 

Religion & Medicine

Workshop Report: Sacred Cures – Situating Medicine and Religion Across Asia

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This announcement first appeared in the IASTAM newsletter: http://iastam.org/wp-content/uploads/2013/12/IASTAM-newsletter-Summer-2016.pdf

Workshop Report
Sacred Cures – Situating Medicine and Religion Across Asia
(Max Planck Institute for the History of Knowledge, May 2-4)

This workshop, co-organised by council members Michael Stanley-Baker and Pierce Salgeuro, brought together specialists in the intersection of religion and medicine in the Himalayas and East, South, and Southeast Asia. All together, they examined what work has been done by the terms medicine/religion, or related binaries such as medicine/healing or classical/vernacular. What is clarified or distorted when these categories are mapped onto other languages, periods and regions? They explored commonalities across regions and across time, working from the classical to the contemporary. How do scholars and cultural actors alike produce “medicine” and “religion” as fields and as methods? Taking stock of recent gains in the field, they discussed remaining areas for study, and compared and refined the tools and terms that might be used in that endeavour.

Papers were pre-circulated, and no presentations were made in the workshop. Participants were invited to address the following areas:

  1. Historiography: How has the religion/medicine question been framed by different academic communities?
  2. Materials: What primary sources or archives are available for the given historical periods and/or cultural contexts, and how these afford different kinds of analysis of the question?
  3. Means: What moments, encounters, processes, practices, and relationships produce or reveal significant (re)structurings of medicine and religion?

Many of the panellists are long-standing IASTAM members, and the forthcoming edited volume will be published with IASTAM members in mind.

Speakers

  • Pre-Modern/Classical-Medieval: Donald Harper, Vivienne Lo, Katja Triplett, Michael Slouber, Tu Aming & Joey Hung,
  • Early Modern: Projit Mukharji, Katharina Saberning, Leslie DeVries, Angelika Messner
  • Modern/Contemporary: Helen Lambert, Celine Coderey, Elisabeth Hsu, Geoffrey Samuels, Mona Schrempf
  • Closing remarks: Judith Farquhar & Kenneth Zysk
Sowa Rigpa & Himalayan Medicines

Mongolian traditional medicine

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Syndicated Post By Nomin Galsandorj. This post first appeared at http://theubpost.mn/2016/08/03/mongolian-traditional-medicine/

Traditional systems of medicine in countries such as Nepal, Sri Lanka, Bangladesh, Pakistan, Tibet, and Mongolia appear to be derived from Ayurveda. In Indian, Tibetan, and Mongolian traditional medicine, the mind, emotions, and body are not seen as separate but as a continuum. A person’s emotional and mental states are seen as having a significant impact on the body and vice versa. Mongolian, Tibetan, and Indian traditional medicine use a number of modalities or therapies for both prevention and treatment of disease. Many medicinal herbs are usually used in combination.

Mongolia has a severe climate with four seasons, throughout which nomadic Mongolians move from place to place tending to their domesticated animals. Their way of life and medical treatments are very peculiar. The methods of medical treatment are derived from their simple lives. Medicinal herbs, the limbs of animals, and minerals are used as natural forms of medical treatment. They are sometimes used individually and sometimes used together for
medicinal purposes. Mongolians combine medicine with psychological therapy and use sayings, such as mantras, shamanic charms, and prophecy. There are certain influences of Buddhism in Mongolian medical treatment, such as the use of spells and the stating of one’s requests and mantra expressions.

In the 4th and 5th centuries, monks of Tibet, Nepal, and China were studying Buddhism in India, and it provided the opportunity for Buddhism to spread in Tibet. Medical books from India were translated from Sanskrit into Tibetan. When Mongolia tried to make Buddhism the official religion in the 13th century, Indian and Tibetan medical books came to Mongolia as well.

The book “Four Tantras” (Jud Shi) was written in the 11th century, a classic creation of Indian and Tibetan medicine. “Jud Shi” was the main textbook of Mongolian doctors when it arrived in the 14th century. In Mongolia, it was read in Tibetan and was also translated into Mongolian. The Mongolian version has been published many times. German scholar Walther Heissig wrote that Choiji Odser translated “Jud Shi” in the 14th century, and during Ligden Khan’s time (1604-1634), “Jud Shi” was revised and re-translated.

The five elements theory of Indian philosophy started to hold an important position in the basic principles of Mongolian traditional medicine and this is related to the popularity of “Jud Shi” in the 16th century and its translation into Mongolian. “Jud Shi” is the amalgamation of Tibetan and Mongolian medicine and the Indian sutra.

“Jud Shi” has four volumes, identified by tantra:

1. Basic Tantra- The Basic Tantra has four parts and is the basis of the other three tantra volumes. It contains all the general meanings of the Four Tantras and is a basic overview of the theories of Indian and Tibetan medicine.

2. Explanatory Tantra – This tantra has 31 parts. The root of Indian and Tibetan medicinal
theory is defined briefly here.

3. Oral Instruction Tantra – This tantra has 92 parts and is the largest part of the book. It
describes how diseases and disorders of the body and organ systems are generally understood in Indian and Tibetan medicine.

4. Subsequent Tantra – This tantra has 27 parts and draws conclusions on the therapies in
the other 3 volumes.

Medicine Buddha by G.Zanabazar
Medicine Buddha by G.Zanabazar

In the 18th century, Mongolian scholar Gombojav was the primary translator of “Dankhaivjunai”, a large Tibetan-Mongolian dictionary, and participated in the Mongolian translation of “Danjuur”. The book “Medicinal Formulas”, which was written by Gombojav, was block printed in Mongolian. In the book, he included some formulas from Indian, Tibetan, and Khoton medicine.

Jambaldorj was one of the greatest doctors in Mongolia during the 19th century. He wrote a 174-page sutra called “Zetsermigjan”. During this time, there were errors and mistakes in identifying medicinal ingredients. He researched the work of the best ancient doctors of India, Tibet, and Mongolia, and defined the shape, form, features, and potency of the medicinal ingredients used. He also wrote a book about ingredients in Sanskrit, Tibetan, Chinese, Manj, and Mongolian, complete with 576 images. This book has attracted the attention of national and foreign scholars and has been published in foreign countries.

Luvsanchultem was a Mongolian doctor of the 19th century. He wrote about the Indian “five elements” theory used in Indian and Tibetan medicine. Mongolians enriched the ancient books on medicine that were passed on from India to Tibet. In Mongolian traditional medicine, anatomy, diseases, and the effects of medicine are explained on the basis of the five elements theory.

Five elements theory and three types of combinations

The five elements theory and the three types of combinations of these elements are the main parts of Indian, Tibetan, and Mongolian traditional medicine. Everything in the universe, including human beings, is composed of five basic elements. The five elements are earth, water, fire, air, and space. These five elements form the metabolism of the body.

– Earth controls the physical structure of the body: bones and flesh. All life forces become
inert and inactive in this element and more energy is used to keep a body active.

– Water controls the kidneys, male and female reproductive organs, and produces antibodies. Water keeps the body and life flowing.

– Fire controls the spleen, liver, pancreas, and keeps all the organs active. It creates fire in the body. It heats water. It regulates sight, provides strength to the body by digesting food, induces hunger and thirst, maintains the suppleness of muscles, and a beautiful complexion.

– Air controls the chest, lungs, and heart and forms the purity of the mind and heart. Air is life itself. It is strength and guides every part of our body. It moves bile and phlegm, which cannot move in the body by itself.

– Space controls the entire body, thyroid, parathyroid, tonsils, saliva, cerebral and spinal fluid, the nervous system, and eliminates poison from the body. In order for air to circulate in the body and maintain a proper balance, there has to be space. If such circulation is blocked, it creates pain, even leading to heart attacks and loss of consciousness.

All these elements should be maintained in proper proportions. Any disturbance (and excess or deficiency) of one element leads to disturbances in other elements, and is considered the root cause of disease. If these five elements are maintained in proper proportions in the body, a proper metabolism is ensured and the body remains healthy. However, due to heredity, as well as eating and living habits, we can disturb one or two of these elements and upset the metabolism. When there is an illness present there is a predominance of one or more of three types of combinations of the five elements. In Indian, Tibetan, and Mongolian traditional medicine, people are diagnosed as being one of these three types of elemental combinations.

1. Kapha (Bad-kan) – the combination of excessive earth and water These elements occupy the largest areas of our body. Kapha people have a regular appetite with relatively slow digestion, and prefer warm drinks and like pungent, astringent, and bitter foods.

2. Pitta (Tri-pa) – the combination of excessive fire and air Pitta people have a strong metabolism, and a good appetite and digestion. They like large quantities of food and water, and like bitter, sweet, and astringent foods and cooling drinks.

3. Vata (Lhung) – excessive air Vata people have a variable appetite and crave salty, sweet, and sour foods, and prefer warm or hot drinks. Their hands and feet are usually cold and dry with cracked skin.

In Indian, Tibetan, and Mongolian traditional medicine, all foods are divided into six tastes: bitter, astringent, pungent, sweet, sour, and salty.

Mongolian diet therapy

Mongolians eat the following five kinds of food:

White – dairy products
Red – meat products
Green – plants and vegetables
Yellow – butter and oil
Black – water and distilled milk vodka

The five kinds of food of the Mongols include milk and milk products, such as curds, fermented mare’s milk, clotted cream, butter, sea buckthorn oil, cedar nut oil, apricot oil, and sheep tail fat.

The oil from sheep tail fat contains calcium, magnesium, iodine, and fluorine. It is also rich in vitamins D, C, A, K, E, B, and is good for fatigue, allergies, poisoning, and the eyes. Sheep tail fat has many medicinal qualities and is very nutritious, and has been considered beneficial “food” for infants and elders since ancient times. It enhances the metabolism and digestion, provides energy, prevents weakness and fatigue, and is thought to speed up the growth of infants. It moisturizes, softens, regenerates, and rejuvenates the skin. Sheep tail fat contains nutrients that cannot be found in any other food. The tip of the sheep tail, which is called uurag suul, is the best nourishment for the liver and supports the brain.

In Mongolian traditional medicine sutras, it’s written, “Fresh white butter is of cool quality and cures lung diseases and coughing, and treats fever. Old butter cures mental disorders, hangovers, and diseases of the eyes, brain, and womb.” In ancient sutras, it’s written “Yellow butter kept for years is good at treating diseases when applied to the skin. It has many diverse curative qualities if mixed with other ingredients. Yellow butter enhances intellectual capability, relaxes the mind, and refreshes one’s sight. It makes elders younger and makes voices melodious. It also improves fertility and cures diseases of the ears, lungs, and mind, and burns, frozen wounds, or cold weapon injuries.” The sutras also say, “Cow’s milk butter is very nutritious and good at healing any illness. The butter of goat’s milk is of cool quality and treats fevers. Yak or sheep milk is of hot quality and produces energy.”

In Indian, Tibetan, and Mongolian medicine, it is said, “Unsuitable food is poison to one’s body. Perfect food nourishes and keeps the body fit, healthy, and energetic. If the food is too little, the body weakens, beauty fades, and illness appears. If the food is too much, the body gets tired from over-consumption and is invaded by sickness. Thus, two quarters of the stomach should be full of food, one quarter of drink, and one quarter left empty.”

Nomadic Mongolians had a healthy lifestyle. During the winter time, meat products were mainly eaten, and during the summer time, dairy products, vegetables, and fruits were mainly eaten. The four conditions of climate, evil spirits, diet, and lifestyle act together to affect disorders. The four remedial measures for disorders are diet, lifestyle, medicine, and external therapies.

The following disorders are treated in Indian, Tibetan, and Mongolian traditional medicine: hot and cold disorders, pediatric disorders, gynecological disorders, wounds, geriatric disorders, infertility, indigestion, tumors, edema, fever, smallpox, and the common cold. They also treat disorders of the head, the eyes, the ears, the nose, the mouth, the goiter, and genital disorders; disorders of vital vessels and organs, such as the heart, lungs, liver, spleen, kidneys, stomach, intestines, and colon. Miscellaneous disorders, such as laryngitis, anorexia, hiccups, asthma, vomiting, diarrhea, constipation, diabetes, gout, arthritis, skin diseases, nervous disorders, and minor injuries are also addressed.

For centuries, Indian, Tibetan, and Mongolian medicinal practices were used not only to diagnose diseases but also to prescribe medicine based on individual conditions, using a unique system of evaluating the pulse, eyes, tongue, skin, and smell. The botanical formulas used thousands of years ago continue to be in use today. The Indian, Tibetan, and Mongolian traditional medicine systems are fond of using formulas involving multiple herbs.
The treatments include decoctions, powders, pills, paste, medicinal butter, calcinated powder, gems, herbal compounds, oil therapy, purgation, emesis, nasal drops, enemas, channel cleansing, venesection, moxibustion, cauterization, compression, medicinal baths, natural spring baths, massage, and surgical therapy.

The diagnostic techniques are visual study, pulse taking, and interrogation. The visual study involves the examination of the tongue and urine. Touching with the fingers is like receiving information transmitted by the patient’s pulse. Interrogation involves the patient’s medical history, looking at the signs and symptoms of illness, as well as dietary factors.

For centuries, Mongolians have utilized traditional methods for surviving the harsh winter season. During the winter months, Mongolians eat “hot” foods that are rich in vitamins and minerals, and abstain from eating “cold” foods. Eating hot foods has the positive effect of increasing blood flow, energy level, improving the functions of the main organs of the body (including the digestive system), and has been scientifically proven to prolong life expectancy to an average of 70 years. However, in recent years, the life expectancy of the population has been decreasing, due to improper dress during the winter season and spending too much time in cold places, therefore not being able to maintain internal body heat. The long-term effect of this is a decrease in the immune system’s functions, cold sweats, and lower blood levels. Daily consumption of cold starters and salads, coffee, soft drinks, juices, beers, and other drinks that are below room temperature and straight from the refrigerator can lead to “cold” digestive ailments.

Cold water, drinks, and ice cream reduce body heat and increase the burden placed on the digestive system. In Indian Ayurvedic medicine, it is said that heat is life, while cold is death. Due to these practices in recent years, and particularly among young people, intestinal inflammation, stomachaches, stomach ulcers, the feeling of fullness or bloating, constipation,
and the removal of gall bladders have been much more common.

P5170431
Yellow Pasqueflower, commonly used in traditional medicine

Mongolia is home to hundreds of rare medicinal plants, most of which are found in the Khangai Mountain Range and the steppes. Prior to making any traditional medicine, plants must be collected at the appropriate time or season. For instance, the yellow snowdrop (aneta) blooms in early spring. Therefore, the exact time of its full bloom must not be missed and the collected plants should be dried out.

There are cases where toxic vegetation is used to make medicines. Those toxic plants need special care, and there are specific methodologies for drying and removing the plant’s poison. A branch of a toxin-containing tree must be cut in half before drying. If the plant has a poisonous surface, the outer layer must be scraped away. To release the toxins in spar, it needs to be placed in a covered dish and set on fire.

Indian, Tibetan, and Mongolian traditional medicine is based on a philosophy that guides the practitioner to serve his patient according to special needs at a special time, and under special circumstances. They are extremely individualized, personal, and flexible, dependent on a person-to-person and expert-to-client relationship. Treatments and prescriptions are tailor-made for the patient, and take into account the individual’s constitution, age, gender, syndrome, primary complaints, accompanying signs and symptoms, the season, and the geographic location.

Nomin Galsandorj is a freelance writer and translator, translating texts from English to Mongolian, including the Dalai Lama’s official website. She can be contacted at nomin1994@yahoo.co.uk.

Religion & Medicine, Thai & SE Asian Medicines

Translation of Chinese Jivaka Story

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By Phillip Behrns

Translated from the French version in Chavannes, Edouard. 1962. Cinq Cents Contes et Apologues: Extraits du Tripitaka Chinois et Traduits en Français. Paris: Libraire d’Amerique et d’Orient, #499.

Sutra pronounced by the Buddha about the Avadana on Daughter of Mango Tree (Amrapali) and Kiyu (Jivaka).

Here is what I heard: one day, the Buddha was in the Kingdom of Loyueche (Rajagrha) and was explaining the law in the middle of the meeting of twelve hundred and fifty disciples, bodhisattvas, mahasattvas, devas, nagas and the eight categories of the great Assembly. Among the people of this time, many were donors, yet, one of them, who was a poor man, only had a handkerchief in rags. He wished to give it as a gift, but remained undecided because he was scared of causing disgust. Then, in the audience, a bhiksuni named Daughter of Mango Tree stood up, arranged her cloth, paid tribute, kneeled on both her knees, joined her hands, and said to the Buddha: “O honoured of the world, I can remember that in a previous life, I was born in the kingdom of Polonai (Varanasi) as a poor girl. At the time there was a Buddha named Kia Ye (Kacyapa), who was explaining the law in the middle of a large assembly. I sat down to hear about the holy books and I was happy; I gave the intention to make a donation, but considering I did not have anything and thinking about my poverty, I became sad; then I went to someone else’s garden and begged for fruit; I was given a mango, it was big and its fragrance excellent; I held a bowl of water in my hand at the same time as this unique mango and gave it as a gift to Buddha Kia Ye ( Kacyapa) and the assembly. The Buddha knew the excellence of my intention, he accepted my gift and made a wish, then he shared and gave out the water and the mango, making sure everybody received some. Thanks to this good fortune, when my life ended, I was born a devi and I became a devi queen; then, when  I was born down here, in this world, I did  not come from a foetus, but was born in a mango flower for ninety one kalpas; I was fresh and beautiful and always knew my previous lives. Now I met the Honoured of the world who opened for me the eye of wisdom. Daughter of Mango Tree recited those stanzas:

The loving beneficence of the Three Venerable is universal, – its intelligence saves men and women without distinction; – the great reward I received for giving a little bit of water and fruit was that I could be freed from all sorrow.
In this world, I was born in a flower; – above I was queen of the Devis; – since I found shelter in the Blessed Saint (Bhagavat); – my field of happiness is deep and fertile.

After she finished paying tribute, the Bhiksuni, Daughter of Mango Tree went back to her seat.

When the Buddha was in this world, in a royal garden of King Weiyeli (Vaicali), a mango tree grew spontaneously; it had numerous branches and leaves, its fruit were a lot bigger than those of other trees, they were shiny , and smelled and tasted wonderful. The king liked this tree a lot and no one was allowed to eat the fruits, except the most honoured women of the harem. Yet in this kingdom, there was a Brahman grhapati whose riches were uncountable and no one in the kingdom could be is equal; moreover, he was intelligent, discerning and more talented and wise than the crowd of the men; the King liked him very much and had made him one of his ministers. One day, the King invited this Brahman for diner, when the meal was finished he gave him a fruit from the mango tree; realising that this mango had a particular fragrance and taste,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                the Brahman asked the king, if there was, under this mango tree, any small offshoot he could ask to be given as a gift. The king answered: “there was a large number of those offshoots, however, because I was afraid they could be detrimental to the big tree, I removed them one after the other; I will give you one if it is your wish.”

So was done, and the Brahman brought this offshoot home and planted it; he was watering it morning and night. The tree was growing day after day, its branches were plentiful and strong; after three years, it grew fruits that were worth the king’s mango tree’s for their beauty and their size. The Brahman thought happily : “ My riches are uncountable and do not compare unfavourably to the King’s; I was only his inferior because I did not have this mango tree, but now that I have it, I am just as good as the King. “ He took one of the fruits and tasted it, but it was very acrid and he could not eat it. The Brahman became very sad; having withdrawn himself, he thought that the reason for that should be that the soil had not been fertilized well enough. So he took the milk of a hundred cows and gave it to drink to one cow, then he collected the milk of that cow and cooked it to make a kind of butter, which he sprinkled on the roots of the mango tree. He did that daily, and the next year the fruits were sweet and delicious, just like the King’s mangos.

However, on the side of the tree, grew an excrescence, which was growing more and more. The Brahman thought the sudden apparition of this excrescence could be detrimental to the fruits, but when he wanted to cut it off, I got afraid to hurt the tree. He meditated for several days perplexed and undecided, until suddenly, from the middle of the excrescence, a branch grew, straight to the sky, strong, straight, flexible and beautiful, it outgrew the top of the tree. When it was seventy feet high, the top divided into several branches, which spread on the sides in a circle to form something like and upside down canopy. The flowers and leaves it was covered with won out over the main tree’s ones. The Brahman was amazed and, because he could not figure out what was at the top, he built a wooden scaffolding and climbed to have a look; he saw that at the top of the branch and at the centre of the upside down canopy, there was a pond of fresh and fragrant water, also there were many flowers with fresh and bright colours, he looked under one of the flowers and found a little girl who was in one of them, the Brahman took her in his arms and brought her home, he fed and raised her. Her name was Daughter of Mango Tree.
When this child reached her fifteenth year, she was so beautiful that nobody in the world could compare, her reputation spread to far away kingdoms. Seven kings arrived at the same time and went to the Brahman to ask to become engaged to Daughter of Mango Tree and make her their wife. The Brahman was very scared, and did not know to which one he should give her; he built a high tower in the middle of a garden and put Daughter of Mango Tree at the top, then he went out and told the kings: “This girl was not conceived by me, she was created spontaneously at the top of a mango tree, I really don’t know if she is the daughter of a deva, a naga, a demon or a djinn. Now, here you are, seven kings coming to ask for this strange person, if I give her to one of you, the six other kings will be annoyed. However I am not going to refuse her to you. .Now, this young lady is in a tower in the garden. Discuss and when you have decided which one of you should have her, this one may just take her. I am not going to decide”.

Then the seven kings started to discuss the matter between them and the night came before the debate was finished; then, one of them, who was king Ping-cha (Bimbisara) entered the tower, found the girl and slept with her. The next day, when he was about to leave, Daughter of Mango Tree told him: “ Dear King, you bothered to lower your highness to come to me, but now, you want to leave, if I have a child, they will have royal blood, who should I entrust with them?” The King answered: “If it is a son, you will give him to me, if it is a girl, I give her to you. “ Then the King took a golden ring with a seal of his finger and gave it to Daughter of Mango Tree to use as an attestation. Then the King went out and told his ministers: “I managed to take Daughter of Mango Tree and I spent the night with her, she has nothing extraordinary and she is just like any woman, thus I am not going to marry her.” All the soldiers of King Ping Cha (Bimbisara) cheered and said:” our King was able to take Daughter of Mango Tree.” Hearing this, the six other kings left.

After King Ping Cha (Bimbisara) left, Daughter of Mango tree became pregnant; then she ordered the doorman to say she was sick if someone asked to see her. When the term came, she gave birth to a boy with a fine face, who was holding a bag of acupuncture needles in his hand. The Brahman declared:” This child is the son of a king, and he is holding a medical instrument; he will certainly be a king doctor.” Then Daughter of Mango Tree wrapped the child in a white cloth and ordered a maid to go and leave him in the street. As per this order, the maid took the baby and abandoned him. At this time Prince Wou Wei was in his chariot, planning to visit the great King and had sent people to clear the road. But the prince noticed from afar a white item on the path , he made the chariot stop and asked his escort:” What is this white object?” He was answered that it was a little boy. “Is he dead or alive? “ He asked. “Alive”, he was replied. The prince ordered his people to take him, and then looked for a wet nurse to feed him; because he was alive, a Brahman took the little boy and gave him back to Daughter of Mango Tree. He was named Ki Yu (Jivaka).

When he reached the age of eight, because of his intelligence, his strong talents and his knowledge of all sorts of books, he was very different from the average children. When he was playing with the neighbourhood boys, he was despising them because he thought they were not his equal. One day, those little boys insulted him together and told him: “Fatherless son, born to a depraved girl, how dare you despise us?” Taken aback, Ki Yu (Jivaka) remained silent and did not answer. He went to his mother and asked her:” I can see that the other little boys are not my equal , however they are insulting me by calling me fatherless son. Where is my father now?”His mother answered:” your father is none other than King Ping Cha (Bimbisara)
– King Ping Cha (Bimbisara), said Ki Yu (Jivaka), can be found in the kingdom of Loyueche (Rajagrha), which is five hundred lis away. How did he conceive me? And if you are telling the truth, O mother, how will I prove it?” His mother showed him the ring with a seal and told him:” This is your father’s ring. Ki Yu (Jivaka) examined the ring and saw that it had the following inscription “Seal of King Ping Cha”. He took the ring and went to the kingdom of Loyueche (Rajagrha) and went straight through the palace door, there was no one at the door to tell him off. I reached to the king, paid tribute, kneeled and said:” O King, I am your son; I was born to Daughter of Mango Tree. Now that I have reached my eighth year, I learned that I am your offspring and this is why I am bringing you proof in the form of the seal ring, and I am coming from far away to become part of your family.” The King saw the inscription on the seal, he remembered the promise he made in the past and admitted he was really his son. Filled with compassion for him, he named him crown prince.

Two years later, he who was to become King A Cho Che (Ajatacatru) was born; Ki yu (Jivaka) said to the King: “When I was born, I was holding a bag of acupuncture needles, it was a sign that I had to become a doctor, even though you named me crown prince, I am not happy. Because you had a son with your first wife, he should succeed to you in your function. As for me, I wish to practice the art of medicine.” The King consented, and told him:” Because you are not the crown prince anymore, you cannot enjoy free emoluments from the King anymore. You need to study the medical science.” The King ordered all the best doctors of his kingdom to teach him all the recipes of their art, but Ki Yu (jivaka) was only playing and did not receive their teachings, all his masters told him:”The art of medicine is not very high: to tell the truth it is not a subject for the honourable prince heir. However, we cannot go against the great king’s injunction, we received orders several months ago, and, O Prince, you didn’t even memorise half a sentence of our formulas. If the King asks, what would we answer?” Ki Yu (Jivaka) told them:”When I was born, I was holding a sign that I would be a doctor, this is why I told the great King: “I renounce the glorious titles and I am asking to study the art of medicine” How can I be so neglectful as to make you reprimand me? My behaviour can be explained by the fact that your science is inadequate to instruct me”. Then he took all the books about plants, medical recipes, acupuncture and pulse, and asked embarrassing questions to his masters, who did not know how to answer. All of them bended in front of Ki Yu (Jivaka ) and paid tribute to him. Kneeling and with joined hands, they told him:”This day we have to admit, O prince, that we cannot reach your divine holiness. All the questions you asked have been subject to controversy for our masters for generations, and we cannot understand them. We are wishing, O Prince, that you explained them to use completely, and that you solved the mysteries that have been tormenting us since we were born.” Then Ki Yu (Jivaka) explained the solution to those problems to them, all the doctors got up full of joy and paid tribute to him by bowing down, saying that they were receiving his teaching with gratitude.

Ki Yu (Jivaka) had the following thought:” Among all the doctors the King gave orders to; none was able to teach me. Who will teach me medicine?” Meanwhile, he found out that, in the kingdom of Tochachelo (Taksacila), there was a doctor named Atili (Atri) nicknamed Pinkialo (Pingala), who had great knowledge about medicine, he could certainly teach him. And so, young Ki Yu (Jivaka) went to this kingdom and upon arriving to Pinkialo (Pingala) he told him:” Great Master, I am asking you to agree to teach me.” After studying under his direction for seven years, he thought: “Now I am trained in the art of medicine, when will I finish?” Therefore he went to his master and told him:” Now I am trained in the art of medicine, when will I finish?”His master gave him a basket and tools needed to collect plants, and told him:”On the length of one yojana, in the kingdom of Tochachelo (Taksacila), look for all the plants and bring me those that do not have a medicinal use. ” Following his master’s orders, Ki Yu (Jivaka) looked for all the plants without a medicinal use in the kingdom of Tochachelo (Taksacila), but in the end he could not find any. As a matter of fact, he could identify all the plants and all the trees he could see, and he knew when they could be used, and all of them could be used in medicine. He came back empty handed and told his master those words:”o Master, now you need to know this: In the kingdom of Tochachelo (Taksacila), I searched for plants that did not have any medicinal use on a surface of one yojana, but I could not find any such plant. For all the plants and tress I saw I could perfectly identify their use”. The master answered to Ki Yu (Jivaka):” You can go now; you know the science of medicine to perfection. I am the first for this art in the Jambudvipa, but after I die, you can succeed to me. “

Then Ki Yu (Jivaka) left and started healing illnesses; all of those he was treating healed at once. His reputation was known all across the kingdom.

Later, Ki Yu (Jivaka) wanted to enter the royal palace. In front of the door, he met a little boy who was carrying a bunch of fire wood. As soon as he saw him from afar, Ki Yu could see this child’s five viscera, including his gut and stomach, and was able to distinguish them neatly. Ki Yu (Jivaka) had the following thought:” In the book of plants, it is told about the king doctor tree (bhaisajyarajà) which illuminates the inside from the outside and allows seeing the viscera inside a person’s stomach. Could it be that there is a piece of king doctor tree in the wood this child is carrying?” He went to the child and asked him what price he wanted for his wood. The child having answered that he wanted ten coins, he paid this price to acquire the wood. The child put the wood down and we could not see the inside of his stomach anymore. Ki Yu (Jivaka) realised that he did not know where in the faggots was the king doctor wood. He untied two faggots and took the sticks one by one and brought them close to the child’s stomach. As he could not see anything appear, he kept trying with all the sticks. The last twig was slightly longer than a foot, he tried to use it to make some light and he saw everything in the stomach. Ki Yu (Jivaka) was very happy, because he knew that this twig was certainly the king doctor wood. Then he gave the child his wood fire back, which as he had received money and had kept his wood left very happy.

However, Ki Yu (Jivaka) was having the following thoughts:” Who am I going to heal now? This kingdom is small and it is on the border. The best would be that I went back to my country of origin to start practicing medicine.” And so he went back to the kingdom of Pokiato (Saketa). In the city of Pokiato, there was an important public figure, whose wife had been constantly suffering from migraines for twelve years; all the doctors had been treating her without being able to heal her. Ki Yu (Jivaka) heard about her and went to her home, he said to the door man:” Tell your master that a doctor is at the door”. The doorman went in and passed the message. When the public figure’s wife asked what did the doctor looked like, he answered that he was a young man. She thought that if old, experienced doctors couldn’t heal her, a young one would be even more incapable. She ordered the doorman to tell that she did not need a doctor now. He went out and told Ki Yu (Jivaka):”I gave your message to my master, but his wife answered that she did not need a doctor.” Ki Yu (Jivaka) insisted:”Go tell your Master’s wife that she only allowed me to treat her, if she is healed, she can give me what she wants.” When the doorman had reported those words, the lady thought that she did not risk anything and ordered the doorman to let him in. When Ki Yu (Jivaka) was with the public figure’s wife, he asked her about her sufferings, she answered that she was suffering in such and such way. “How did your illness start?
– It started in such and such circumstances
– Is your illness old or new?
– It started in such time.”
After all these questions, Ki Yu (Jivaka) declared:”I can heal you.” Then he took a good remedy and fried it in butter, then, he poured it in the woman’s nose. The butter came out from the patient’s mouth mixed with saliva. She collected it all in a vase and kept the butter after separating it from the saliva, which she discarded. When he saw her behaving like this, Ki Yu (Jivaka) felt sad because he was thinking:”If she is this thrifty for a little bit of soiled butter, what will she do when time comes to reward me?” The patient noticed his preoccupations and asked him:” Are you afflicted? “After his positive answer, she asked him about the reason of his affliction. “I was thinking, he told, that if you are this thrifty when it comes to a little bit of soiled butter, it would be even worse when time comes to reward me, this is why I am becoming sad.” The woman answered:” Keeping a household is not easy. What was the point of throwing this butter that could still be used to light a lamp? That is why I collected it. As for you, focus on healing my illness, no need to be afflicted.” He treated her and she was healed. Then the wife of a public figure gave him four hundred thousand ounces of gold as well as slaves and maids, and chariots with horses.

After Ki Yu (Jivaka) received all these riches, he went back to the royal city (Rajagrha) and went to Prince Wou Wei’s (Abhaya) residence. He told the doorman:”Tell the Prince that Ki Yu (Jivaka) is outside.” The doorman passed the message and the prince ordered to invite Ki Yu (Jivaka ) in at once. When he was inside, he bowed with his head on the floor, and after paying tribute he sat on the side. He gave the prince a detail tale of what had happened to him and declared that he wanted to give all the riches he had acquired to the prince.The prince convinced him not to by telling him he should not give him such a gift and by encouraging him to use this fortune on himself.

This is how Ki Yu’s (Jivaka) first recovery happened.

At the time, in the kingdom of Kiuchanmi (Kaucambi) there was the son of a notable whose intestine got tied together in his tummy when he was playing on a wheel, what he was eating and drinking could not be digested of eliminated anymore. No one in this kingdom could cure him. Locals heard that there was a great doctor who was excellent at healing patients in the kingdom of Mokie (Magadha), and sent a message to the King:” The son of a notable of the Kingdom of Kiuchanmi (Kaucambi) is ill, Ki Yu (Jivaka) can cure him, we are asking, O King, that you sent him to us.”Then King Ping Cha (Bimbisara) called Ki Yu (Jivaka) and asked him: “The son of a notable of the kingdom of Kiuchanmi (Kaucambi) is ill, can you cure him?” Because he answered that he could, the king continued:” Because you are able to cure him, I authorise you to go and treat him.” Then Ki Yu (Jivaka) got on a chariot and went to Kiu Chan Mi (Kaucambi). The son of the notable was already dead when he arrived, some musician were escorting his body. When he heard the noise, Ki Yu (Jivaka) asked:” What are this music and those drum sounds for?” Someone next to him answered:” The son of the notable you came for is dead. What you can hear is the music of the musicians escorting him.” Ki Yu (Jivaka) could differentiate all the sounds and said:” Go tell to bring this body back, it is not a corpse.” They came back as soon as the order was given. Ki Yu (Jivaka) came off his chariot, took a very sharp knife and cut open the child’s stomach. He opened where the intestine was tied up and showed the mother, father and all relatives, and told them:” His intestine got tied together like this because of playing on a wheel, therefore food and drinks were not digested anymore, but it does not mean he is dead.” He untied the intestine and put it back to its place, then he stitched the stomach and the flesh went back together, he rubbed it with a balm. The wound healed instantly and hair grew back, so much so that the scare looked like there had never been a wound. After that, the son of the notable rewarded Ki Yu (jivaka) by giving him four hundred thousand ounces of gold. His wife also gave him four hundred thousand ounces of gold, and so did the notable and his wife.

Ki Yu (Jivaka) was thinking:” I must acknowledge the role of my master. I am going to take those sixty hundred thousand ounces of gold and give them to the great master in the kingdom of To Cha Che Lo (Taksacila), Pinkialo (Pingala).” After reflecting, he took his gold and went to see his master. He honoured him by putting his face on his feet and offered the gold with the following words:” I wish, master, that you would accept this.” His master told him:”You better make an offering, I do not need this money.” As Ki Yu (Jivaka) insisted, Pinkialo( Pingala) accepted the gold. Ki Yu ( Jivaka) said good bye and left after honouring his feet.

At the time, in the kingdom, lived the fifteen year old daughter of a kialoyue  grhapati), on her wedding day, she suddenly had a very acute headache and died. Ki Yu (Jivaka) was informed and went to her home, he asked her father:”What common illness caused this young girl to die early?” The father answered:” Ever since she was a child, my daughter was experiencing headaches which grew stronger by the day, this morning the pain was so intense that she died.” Ki Yu (Jivaka) entered the room and with the help of the king doctor (wood), he lit the inside of the girl’s head and saw worms, which were multiplying. There were several hundreds of them. The worms were devouring her brain, and because they had eaten all of it, she had died. Then Ki Yu (Jivaka) cut her head open with a golden knife, took all the worms out and locked them in a jar. Then he rubbed the wound with three kinds of supernatural oils. The first one fixed the damage caused in her bones by the worm bites, the second one regenerated the brain, and the third one healed the wound caused by the knife. Then Ki Yu (Jivaka) told the girl’s father:” Let her rest peacefully and make sure that she does not get scared. She should be completely healed and back to normal within ten days. I will come again when this time has passed.” After Ki Yu (Jivaka) left, the girl’s mother started crying and screaming:” My child died a second time, did anyone ever survive after having their skull cut open? How could the father let this man take our child?” The father stopped her and said:” When Ki Yu (Jivaka) was born, he was holding in his hand a bag of acupuncture needles; later he gave up some high function to practice medicine, and he did this for the greater good of all living things. He is a king doctor appointed by the sky, how could he do something unreasonable? He recommended that you did not scare the patient, but now, on the contrary, you are crying and screaming and risk to upset and scare her, because of you, our child will not be able to live.” Upon these words, the mother stopped complaining and both parents took care of their daughter. She remained still for seven days. On the seventh day, at dawn, she sighed and woke up as if she had been sleeping. She said:” I cannot feel any headache anymore, and all my body is at ease. Who healed me?” Her father told her:” You were already dead when the king doctor Ki Yu (Jivaka) came to give you a cure, he opened your head and took all the worms out, this is how you could revive.” He opened the jar and showed her the worms. When she saw them, the girl was horrified and grateful for her good fortune. She said:” Great is Ki Yu’s (Jivaka) divine power! I cannot wait to acknowledge his good deed.” Her father said:” Ki Yu (Jivaka) promised he would come today.” Moments later, Ki Yu (Jivaka) arrived. She honoured him by putting her face on his feet, she kneeled and joined hands and said: “ O Ki Yu (Jivaka) I wish to become your maid, and serve you until death to acknowledge the good deed you performed by bringing me back to life.” Ki Yu (Jivaka) answered:” I am a master doctor, and I go everywhere to cure people. I do not have a home. How would I use a maid? If you really want to reward me for the service I paid you, give me five hundred ounces of gold, not that I would use this gold, but this is the reason I am asking you this: anybody who has studied has to thank their master, even if my master did not teach me what I know, I am still his pupil, and after I have received your gold, I will give it to him.” The girl took five hundred ounces of gold and gave them to Ki Yu (Jivaka) who accepted them and gave them to his master.

After that, Ki Yu (Jivaka) informed the king of his intention to go visit his mother for some time. So he arrived into the kingdom of Weiyeli (Vaicali). There was in this kingdom the son of a kialoyue (Vaicali) who liked to practice martial arts. He had made an over seven feet tall wooden horse and was training to jump on its back, he could jump on it from the beginning and with time he was becoming more and more skilled. But all of a sudden, one day, I went over his target, lost his balance, fell on the ground and died. Ki Yu (Jivaka) was informed, he went to him straight away and used the king doctor wood to light the inside of his stomach, he observed that his liver had turned upside down. The chi was blocked and could not go through; this was what had caused his death. Ki Yu (Jivaka) cut his stomach open with a golden knife, and dipping his hand inside to explore and put things in order, he turned the liver around. Then he rub the patient with three kinds of divine balms, the first one repaired the spots his hand had felt, the second one let the chi and breath flow again, the third healed the wound caused by the knife. After he finished, he told the father:” Make sure to not scare him. He should be healed in three days.” His father followed the instructions, let the patient rest, took care of him and looked after him. When the third day came, the boy sighed and woke up, he looked like he had just woken up from a sleep, and he could get up straight away. Not long after that, Ki Yu (Jivaka) came back, the boy met him happily, he paid tribute to him, putting his face on his feet, went on his knees and said:” O Ki Yu (Jivaka) I wish to become your slave and serve until death to thank you for the good deed you made by bringing me back to life.” Ki Yu (Jivaka) replied:” I am a master doctor, the families of my patients are fighting to serve me. How would I use a slave? My mother worked very hard to raise me, and I did not have a chance to thank her for her kindness she showed taking care of me. Therefore, if you want to thank me for my services, give me five hundred ounces of gold that I would use to reward my mother for her kindness. So he took this gold and gave to his mother, Daughter of Mango Tree, and went back to the kingdom of Loyueche (Rajagrha).

After Ki Yu (Jivaka) had healed these four people, he became famous all across the Empire, and no one ignored him. In the south, there was a big kingdom, which was 8,000 lis away from Loyueche (Rajagrha), King Pin Cha and all the other little kings were his vassals. The king of this kingdom had been sick for several years . He was suffering from rage attacks. He looked at men with disdain and made them perish. When someone raised their eyes to see him, he was killing them, when someone was bowing their head and did not raise it again; he was killing them as well. Men who walked too slowly, he was killing them, those who walked to fast, he was killing them too, people who were serving by his side did not know what to do with their hands and feet. When a master doctor was preparing a remedy for him, the king was scared that he would put poison in it and kill him. He had killed countless people for various reasons, ministers, women from the harem and doctors. However, his illness was getting worse day after day, the poison was attacking his heart, he was suffocating and had a short breath, and he was feeling like his body was burning. He heard about Ki Yu (Jivaka) and wrote a letter to king Pingcha (Bimbisara) to notify that he was requesting for Ki Yu (Jivaka) to come to him. Ki Yu (Jivaka), who had heard that this king had killed numerous doctors, was very scared, as for king Pingcha (Bimbisara) he was feeling for Ki Yu (Jivaka) and was scared that he would be killed, so he did not want to let him go, but at the same time he was scared of being punished. Father and son were hugging each other in despair and did not know what to do. Eventually, king Pingcha (Bimbisara) took Ki Yu (Jivaka) with him and took him to the Buddha, he honoured him by putting his face on his feet, and said to the Buddha:” O Honoured of the World, this king has got a bad temper and I am afraid he might have the king doctor die, should he go to him?” The Buddha answered to Ki Yu (Jivaka):” In a previous life, you and I made a pact to work together to save the all universe: I would heal the illnesses of the soul, and you would heal the diseases of the body. I became Buddha, this is why, as per our wish, you should gather all beings before me (so I can heal them). The king is critically ill and he asked you from afar, why wouldn’t you go? Go rescue him quickly, make up a good remedy to cure his disease. This king is not going to kill you.”

After receiving the Buddha’s blessing, Ki Yu (Jivaka), went to the king, he took his pulse and lit his body thanks to the king doctor (wood), and noticed that the blood and the chi in his five viscera and his one hundred blood vessels were mixed-up, it was caused by the venom of a snake in his body. Ki Yu (Jivaka) said to the king:” I can cure your illness, and when I am finished, I can guaranty that you will be healed. However, I need to go in and see the queen-mother in order to discuss the composition of the remedy with her. If I cannot see the queen-mother, the remedy cannot be prepared properly.” Hearing these words, the king could not understand the reason and wanted to lose his temper, however, because he was ill and knew Ki Yu’s (Jivaka) reputation and he had mandated him to come in hope to get some help; he also considered that Ki Yu (Jivaka) was a young child and should not have ill intentions, he accepted his conditions. He mandated an eunuch to introduce him to the queen-mother.

Ki Yu (Jivaka) told the queen-mother:” The King’s disease can be cured, but now the remedy must be prepared, and because the recipe must remain a secret, it is important to exclude assistants. The queen-mother sent the eunuchs away. Then Ki Yu told to the queen-mother:” When I examined the king, I realised that the chi in his body has been poisoned by a snake, it seems like there is something not human. Whose son is the king? Queen-mother, please tell me the truth, and I will be able to heal him, if you don’t tell me, the king will never recover.” The queen-mother told him:”A long time ago, I was in the room with the golden columns. I went to sleep during the day. Suddenly some being came on me. I was kind of confused, in a state between dream and reality, it seemed like I have had a nightmare. I had sex with this being, and suddenly I saw a big snake, it was over thirty feet long and was going away from me. Then I realised that I was pregnant, the king is probably the son of this snake. I was ashamed of this adventure; this is why I did not say a word. But now, young man, you understood what happened. Your science is wonderful! [If the king can be healed, I wish to entrust you with the king’s life], what remedy should be used?” Ki Yu (Jivaka) answered:” I need melted butter.
– Alas young man; cried the queen-mother; refrain from speaking about melted butter, because the king hates the smell of it, and also hates hearing the word pronounced. You can count by the hundreds, even the thousands the men who died for speaking about melted butter. If you talk about it now, you will probably be killed. If you gave it to the king to drink, you will never get it to go down his throat. I wish that you used some other remedy.” Ki Yu (Jivaka) answered:” Melted butter fights the poison, therefore, people who are ill because of poison will hate smelling melted butter. If the king’s illness was not serious and caused by some other poison, I would have been able to cure him with some other remedies, but because the venom of the snake is violent and has affected all of his body, we can only destroy it with melted butter. Now we need to transform the melted butter and purify it to make it a taste less liquid. The king will drink it naturally, without suspecting anything, the remedy will go down his throat, and he will be healed, don’t worry.”

Ki Yu (Jivaka), went out to see the king, he told him:” I just had an interview with the queen-mother, I gave her the recipe of the remedy, she is going to prepare it, it will be ready in two weeks, but I have five requests. If you agree on what I am about to ask you, your illness will be cured, but if you refuse, it will be incurable.” After the king had asked him about his requests, Ki yu (Jivaka) said:” First, I want you to get from your army stock, some cloth that you have not worn yet, secondly, I wish to be allowed to come and go as I wish without being controlled. Third, I request to be allowed to see the queen-mother and the queen alone every day, fourth, I want that, when you drink the remedy, you drank all of it without stopping half way, fifth, I would like the royal white elephant that can go eight thousand li.”

Hearing those words, the king lost his temper and said:” Child, how dare you make those requests? I demand that you gave a good reason for each of them, if you fail, you will be beaten to death. How dare you ask for my new cloth? You probably want to kill me, wear my cloth and pretend to be me!” Ki Yu (Jivaka) answered:” It is necessary to be clean and pure to make the remedy, however, my cloth is soiled, this is why I would like to wear a king’s outfit when I prepare the remedy.” The king understood and said:” Very well, but why would you want to come and go as you please without control? Won’t you take advantage and bring some soldiers who will attack and kill me? Ki Yu (Jivaka) answered: “ Many time before, you have employed master-doctors, but you were suspicious of all of them and did not trust them, then you killed them and you did not take their remedies, so much so that, when I arrived, all the ministers were saying that you would make me die as well. However, because your illness is very serious, I am afraid that some people outside would make trouble, but if I can come and go as I please without control, people outside will know that your highness is trusting me, and thus will take my remedy and heal. They will not dare thinking about revolution.” The King said:” Very well. But why do you want to see my mother and my wife alone every day? Is it that you want to corrupt them?” Ki Yu (Jivaka) answered:” O King, you have killed so many people on many occasions, thus, your subject, big or small, are all scared and they do not wish for the recovery of the king. Therefore, there is no one I could trust. If I teamed with one of them to prepare the remedy, they would take advantage of a second of inattention to throw in some poison without me noticing. It would be serious. This is why, when I was thinking about who I could trust, I could only think of your mother and your wife. I need to be introduced to the queen-mother and the queen to prepare the remedy with them, it will be ready after cooking for fifteen days, I want to get in to check that the fire is well balanced every day.”Very well, but why do you want me to drink all the remedy in one go? Isn’t it that you want to put some poison and you fear that I would notice?” Ki Yu (Jivaka) answered:” The dosage of each ingredient in the remedy follows strict proportions, the vapours and taste must work simultaneously, if you stop half way, there will be no more links between the elements of the remedy.” The king said:”Very well, but why do you want my elephant? This elephant is the gem of my kingdom, it can walk eight thousand lis per day, I won power over the other kingdoms thanks to him. Don’t you want to steal it to bring it home and then attack my kingdom with your father?” Ki Yu (Jivaka) answered:” On the southern border of your country, in the mountains, there is a wonderful medicinal herb growing four thousand lis from here, it is necessary that you ate this herb after drinking the remedy. I want the elephant to gather this herb leaving. I want to leave in the morning and come back in the evening to make sure you can still feel the taste of the remedy.” After receiving answers, the king gave him everything he had asked for.

Ki Yu (Jivaka) started to purify the butter by cooking it, after fifteen days, he has made it look like fresh water, he obtained five tenth bushels. Then he went out with the queen-mother and the queen, he was holding the medicine. He announced to the king that he could drink and expressed the desire that the white elephant was prepared and kept in front of the palace, the king agreed. When the king saw that the medicine looked like fresh water and was odourless and tasteless, he did not know that it was melted butter, moreover, because the queen-mother and the queen had witnessed the preparation, he was convinced that it wasn’t poison, and so he drank everything in one go as previously agreed. Ki Yu (Jivaka) and went straight back to the kingdom of Loyueche (Rajagrha), however, after travelling for three thousand lis, because he was young and not very resistant, he could not bear the speed of the race, he got dizzy and was very tired, then he stopped and went to sleep.

After midday, the king did a burp and smelt the melted butter; he lost his temper and screamed:” This little boy dared to make me have melted butter, I was wondering why was asking for my white, but it was because he wanted to run away from me.” The king had a minister named Crow (Kaka) who was a brave man, his supernatural power allowed him to catch up with the elephant by foot. The king called Crow and told him:” Chase this boy and bring him to me alive, I want him beaten to death in my presence. However, you are always lacking frugality and you are eating and drinking eagerly, that’s why you were named Crow. People like this master doctor often like to serve poison, so, if this boy offers you food, do not eat it.”

Crow received the instructions and went. He reached Ki Yu (Jivaka) in the mountain and told him:” Why did you make the king eat melted butter and pretended it to be a remedy? This is the reason why the king ordered me to chase you and ask you to come back, come back with me quickly, if you apologize and admit your fault, you might have a chance to remain alive, but if you try to escape, I will kill you straight away, and you cannot escape.” Ki Yu (Jivaka) thought:” Despite finding a way to get this elephant, I cannot escape with it anymore; I need to come up with a new stratagem. How can I follow this man?” He said to Crow:” I have not eaten anything since this morning, if I take the road to go back, I will certainly die, it would be good if you gave me some time to find some fruit to eat and water to drink in the mountain. When I will be full, I’ll go to death!” Because he could see that Ki Yu (Jivaka) was a young boy, scared by the idea of death and who was expressing himself with difficulty, Crow felt sorry for him and gave him what he was asking for, saying:” Eat quickly and we are going to go, we cannot stay here for a long time.” Then, Ki Yu (Jivake) took a pear and ate half of it, but he poured some of the poison he had under his nail on the other half and put the pear down on the ground. He also took a cup of water, and after drinking half of it, he put the rest of the poison in what was left, and put the cup back on the ground. Then he said with a sigh:” This pear and this water are divine remedies, their fragrance is pure and they are delicious, eating and drinking them is making your body healthy, all the diseases heal, and at the same time, your breath and strength are doubled. It is a pity that we can’t find them at the kingdom’s capital so that all the inhabitants can enjoy them, it is unfortunate that they remain unknown from the mountain men.” After he had finished talking, he left to the mountain to look for more fruit. Crow was a glutton, and he had heard Ki Yu (Jivaka) praise those divine remedies, and finally, he had seen Ki Yu (Jivaka) himself drink and eat, so much so that he was thinking that these foods were certainly not poisoned, he took what was left of the pear and ate it, he also finished the water. He immediately started to suffer from diarrhoea, which made his stool look like water. He fell on the ground and laid down. Every time he was getting up, he was feeling dizzy and falling down, he was unable to move.

Ki Yu (Jivaka) told him:” The king took my medicine, and therefore he is likely to be cured, but for now, the remedy has not worked yet, and the venom has not been completely destroyed yet. If I went to him now, he would kill me. You did not know this and wished to seize me to fulfil your mission, this is why I made you ill. But this illness is not serious, refrain from moving, and in three days, you will feel better, but if you get up to go after me, your death will be assured.” He got on the elephant and left. In the first village he crossed, he said to the leader of five men:” There is over there, a messenger of the king who fell suddenly ill, go and get him quickly and bring him to your home, take good care of him, give him a soft bed, give him porridge and make sure he doesn’t die. If he died, the king would destroy your kingdom.” After these words he left and went back to his country. The leader of the five men followed the orders that had been given to him, he brought Crow back and looked after him. After three days, the poison had been completely eliminated, Crow went to see the king, he bowed to the ground in front of him and said:” Truth is I am a fool, I didn’t follow your highness’s recommendations, and I trusted Ki Yu’s (Jivaka) words, I drank and ate what he had left of fruit and water, I have been affected and got diarrhoea for three days. Only now I am feeling better. I know that I deserve death.”

During the three days before Crow returned, the King had healed from his disease, he had pondered his actions and had regretted sending Crow away. When he saw him come back, he was feeling torn between compassion and joy. He told him:” Thanks to you, the young boy wasn’t brought back here when I was irate, and when I would have him most certainly beaten to death.  I benefited from his actions and I am back to life. My perversity would have been terrible if I had made him died instead of rewarding him.” Then the king started to feel remorse about all the people he had unfairly killed on many occasions. He gave them honorary funerals, exempted their families from taxes, and gave them money. I wanted to see Ki Yu (Jivaka) again and say thank you for his good deed, and so he sent some messengers to fetch ki Yu (Jivaka), despite knowing that the king was healed, he remained fearful and didn’t want to go back. Ki Yu (Jivaka) went to the Buddha again, he put his head on his feet to show respect, and told him:” O honoured of the world, the king sent some messengers who came to call me, should I go? “ The Buddha answered:” Ki Yu (Jivaka), in a previous life, you promised to perform a praiseworthy action, how could you stop half way? You need to go now, and when you have cured this king’s external disease, I will cure his inside illness.” And then, Ki Yu (Jivaka) followed the messengers.

When the King saw Ki Yu (Jivaka) he was very happy, he made him seat with him, and told him, holding his arm:” Thanks to what you did for me, I was granted a new life, how can I reward you? I want to split my kingdom and give you half. I will give you half of the beautiful women in my harem, half of the precious items in my warehouse and half of my treasures, I want you to accept.” Ki Yu (Jivaka) said:” I used to be a crown prince, even if it was in a small kingdom, the population and riches I would have had were more than enough, but I didn’t enjoy governing a kingdom, and this is why I asked if I could become a doctor. I need to travel to heal my patients, what would I do with land, women and treasures? They wouldn’t be of any use to me. O King, earlier, when you granted me my five wishes, I was able to cure your outside disease, now, if you granted me one more wish, your inside illness could be removed.” The king answered:” I am ready to receive your instructions, please express your wish.”

Ki Yu (Jivaka) said:” I am asking you, O King, to invite the Buddha to come and to receive the wise law from him.” He took the opportunity to sing the praises of the Buddha to the king, and to explain the peculiar elevation of his function. Hearing his words, the king said happily:” I want to send my minister Crow on the white elephant to get the Buddha. Can I make him come this way?” Ki Yu (Jivaka) answered:” No need for the white elephant. The Buddha understands everything, he can read the thought of men from afar. Content yourself with practising abstinence and purification for a while, then prepare some offerings, burn perfumes, and praise looking in the direction of the Buddha, then stand on your knees and express your invitation: the Buddha will come by himself”.

The king followed this advice, and the following day, the Buddha arrived with a procession of one thousand two hundred and fifty bhiksus. After he finished eating, he explained the sacred scriptures to the king: then the mind of the king opened up and he felt the true and real wisdom without equal (anuttara samyak sambodhi). All the inhabitants of the kingdom came to receive the five defences and left after paying tribute.

Here is another story about Daughter of Mango Tree: ever since birth, she has been extraordinary. When she grew up, she proved herself to be intelligent, she had studied with her father and knew the theory of the holy books. She even knew more about the movement of stars than her father, moreover, she was practicing the musical arts and was singing like a deva of Brahma. Five hundred daughters of kialoyue (grhapati) and brahmanes joined her to study and to make her their great master. Daughter of Mango Tree, was always followed by her pupils and was celebrating and spreading the word of the holy books. Sometimes she was going for walks in parks or along lakes to play music. People in the country, who did not understand her behaviour, started gossiping about her; they were saying that she was depraved and her five hundred pupils had been nicknamed “the bunch of depraved”.

When Daughter of Mango tree was born, were born in the same kingdom and at the same time Daughter of Siu Man (sumana) and Daughter of Potan (udambara). Daughter of Siu Man (sumana) was born in a flower of siuman. In this kingdom, there was a kialoyue (grhapati) who was pressing siuman (sumana) flowers to make some perfumed oil, but on the side of the stone used to express the oil, an excrescence appeared suddenly, at first it was as big as a crossbow bullet and it was growing day after day until it reached the size of a fist. Then the stone exploded and in the hole, a conglomerate, which looked like a glow-worm, exited quickly and fell on the ground, after three day, a siuman plant grew, three days later, this plant grew a flower, and when the flower bloomed, there was a little girl in the centre of it. The kialoyue  (grhapati) took her in and fed her, she was named Daughter of Siuman, when she grew up she became extremely beautiful, she was also talented and intelligent, only Daughter of Mango Tree could compare.

At the time, there was another Brahman. A blue lotus grew spontaneously in his pool. The flower was especially big and was growing by the day until it was the size of a five bushels jar. When the flower bloomed, a little girl could be seen in the centre. The Brahman took her in and fed her. She was named Daughter of Potan (udambara) when she grew up she became very beautiful, she was talented and intelligent, just like Daughter of Siuman.

Having heard about the beauty of the two young girls, the kings of various kingdoms kept coming and asked them to get married, but the two young girls were answering:” We weren’t born from a foetus, we came out of flowers, we are not like ordinary women, what is the point of following a man of this world to get married?” Then, when they heard about the intelligence of Daughter of Mango Tree and found out that her birth had been similar to their, they both left their father and mother to serve Daughter of Mango Tree and ask her to become her pupils. Because of their understanding of the holy books and their wisdom, they were better than the other five hundred pupils.

At the time, the Buddha came to the kingdom of Weiyeli (Vaicali), Daughter of Mango Tree, followed by her five hundred students, when she met him, she praised him with her face and kneeled. Then she said:” I wish, O Buddha, that you came to my garden to eat tomorrow.” The Buddha agreed in silence. Daughter of Mango Tree went home and prepared the offerings. When the Buddha came into town, the king met him as well and after praising him, he kneeled and said:” I wish that you came to my palace to eat tomorrow.” The Buddha answered:” Daughter of Mango Tree has already invited me, you’re coming after her.” The king said:” I am the king of this country, I came to invite you with all my heart, I was hoping that you’d accept. Daughter of Mango Tree is a depraved girl, every day, with five hundred other depraved girls, her students, she is committing illegal actions. How can you reject me to accept her invitation?”

The Buddha answered:” Daughter of Mango Tree is not depraved. In a previous life, she acquired great honours for making offerings to three hundred thousands bhuddas, back then, she, Daughter of Suiman and Daughter of Potan were sisters. Daughter of Mango Tree was the eldest, Daughter of Suiman was the second, and Daughter of Potan was the youngest. They were born in a powerful and very wealthy family, showing each other good example, the sisters were making offerings to five hundred bhiksunis, everyday they were preparing food and drinks for them, and made cloths for them to wear. They made sure they didn’t lack anything. It lasted until the end of their lives. Those three sisters had made the following vow:” In our future life, we wish to meet the Buddha and be granted to be reborn by spontaneous transformation, without going through the foetus stage and be kept from any impurity.” Now, according to their previous wish, they were born at the time I am on earth. Also, despite making donations to the bhiksuni, because they were from a powerful and wealthy family, their words were sometimes too light, sometimes they were making fun of the bhiksuni, saying:” Dear nuns, you have been looking sad for a long time, you may want to get married, but held back by our donations and our care, you cannot express your passion.” This is why these young ladies are going through this pain, even though they dedicate everyday to the promotion of the holy books, they are subject to the unfair accusation of being depraved. As for the five hundred students, they had teamed up with the girls and helped them to make the offerings, and they had enjoyed it as much, this is why they were born with them, the result of their actions has followed them.

At the time, Ki Yu (Jivaka) was the son of a poor family, when he saw Daughter of Mango Tree make offerings, it brought a lot of admiration and joy in his heart, but because he did not possess anything, he started sweeping for the bhiksunis. Every time he was making the place clean and tidy he was making this vow:”If only I could sweep this easily all the diseases and impurity that are in people’s bodies in this world.” Daughter of Mango Tree, who was compassionate poverty and approved of his efforts, always called him her son. When a bhiksuni was sick, she would always make Ki Yu (Jivaka) get the doctor and prepare the potion or remedy. She was saying:” If only you could get the reward of this good deed with me in a future life.” When Ki Yu (Jivaka) was getting the doctor, the patient always healed. Then Ki Yu (Jivaka) made a wish:” I wish to be in a future life, a great king doctor, and always cure the illnesses of the four elements of the body of every human being and heal all of those I will go to.” Thanks to his past actions, he has now become the son of Daughter of Mango Tree and everything is according to his previous vow.”

Hearing the words of the Buddha, the king kneeled and apologised for his mistakes, he also postponed the invitation to the day after. The next day, the Buddha arrived in Daughter of Mango Tree’s garden with all the bhiksus, he informed her about the honours she had gained thanks to her previous vow, when they heard the holly books, the three girls could feel their intelligence bloom and rejoiced with the five hundred students. They took orders to practice good conduct and dedicated all their energy and time to it, all of them were granted the wisdom of arhat.

The Buddha said to Ananda:”You need to keep those teachings to read them to the pupils of the four classes, and to avoid losing them. May all living beings think about their actions, their words and their thoughts, may they not become arrogant or behave too freely. Because she teased the bhiksunis in the past, Daughter of Mango Tree was wrongly accused of being depraved. Therefore, you need to keep watch over what your body, your mouth and your thoughts do. Always make excellent wishes, those who will hear you will enjoy your company and will accept your example faithfully and joyfully. Do not make false accusations, because you would fall in such hells were you would be subjected to such punishment as being reborn as an animal, then after going through hundreds and thousands of cycles, you will be born poor and despised, won’t be able to hear the real law, be born in an heretic family, always meeting a mean king and having a disabled body. Therefore you need to practice those teachings, memorise and recite them, and do not allow them to be lost in the future.”

Then Ananda stood up, he paid tribute to the Buddha’s feet by pressing his head against them, he kneeled, joined his hands and said to the Buddha:” O Honoured of the World, what is the name which should be given to the sutra in which this point of the doctrine is explained?” The Buddha answered:” The name of this Sutra is: Sutra about the Avadana on Daughter of Mango Tree and Kiyu (Jivaka). Practice the doctrine that has just been showed to you; make offerings to bhiksus and bhiksunis, give medicine, get doctors, rejoiced with others that because they made a wish in the past they are now receiving their reward. Observe all of that.”

After the Buddha had pronounced this sacred text, the big assembly, composed of the eight categories that are, men, devas, nagas, and so on, started to practice the principles joyfully.

Notes:

1 This Sutra was translated under the second Han dynasty by Ngan CheKao (the Arsacid) who came to China in the year 148 AD and worked on translations until the year 170 AD.

2 In the Kattaharijataka (Jataka #7), king Brahmadatta even gives his golden ring to a woman with whom he had an accidental encounter and told her :”if you have a girl, use the price of this ring to feed her, but if you have a boy, bring me the ring and the child.”

3 In order to make sure it would not be assumed that she had had a relashionship with an other man and to make sure the child would be recognised to be King Bimbisara’s.

4 To say thank you for taking him in

5 The Tibetan text, translated by Schiefner, informs us that this king was Shanda Pradyota

Global Asian Medicines, Religion & Medicine

“Health” in the Buddhism and Science Dialogue

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This is a syndicated post that first appeared on Patheos.com.

In the current dialogue between Buddhist traditions and the sciences—an engagement dominated by Tibetan and Zen Buddhists on one side and psychologists and neuroscientists on the other—the subject of health is featured prominently. However, despite the shared term, participants aren’t actually talking about the same thing.

Early proponents of the Buddhism-science dialogue, like Paul Ekman, Richard Davidson, Matthieu Ricard, and Alan Wallace, have focused on the theme of psychological health. One prominent outcome of this dialogue has been the mindfulness movement, which has grown out of the clinical study of Buddhist-based meditation practices. Recently, Buddhist scholars such as Robert Sharf and Jared Lindhahl have pointed out the ways in which Buddhism and mindfulness diverge on meanings of health and well-being.

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Definitions of health, as they enter into a field of knowledge, also participate within fields of power, with social and economic consequences. The gay and lesbian social movements, for example, had to fight to remove homosexuality as a mental illness in the Diagnostic and Statistical Manual of Mental Disorders, in order to gain the right to be recognized as healthy. It took another 16 years for the World Health Organization (WHO) to remove homosexuality from its International Classification of Diseases in 1990. Conversely, individuals may wish to receive the unhealthy label because of the rights gained from such recognition, especially in the case of gray area or borderline conditions such as migraines, fibromyalgia, or chronic fatigue syndrome.

The current focus is on an individualized health, where the burden is placed primarily on individual autonomy to strive for improvement and maintenance. The power structure of contemporary society shifts responsibility away from corporations that are responsible for pollution and government policy that allow them to get away with it (or pay for carbon offsets) towards individuals who bear the consequences. In other words, social ills are pathologized or medicalized as individual disease. Reflecting on these assumptions of health is a first step in changing these conditions.

The concept of health is by no means easy to pin down. But just as with the definition of religion, so notoriously elusive, tackling and constantly revisiting definitions of health may uncover the unexamined assumptions that mask its social power. Definitions delineate and set bounds, but that is not the end goal. The intent is not to arrive at a perfect, unchanging definition of health, but rather illuminate what it means to be healthy and why.

Scientific studies of Buddhist meditation and mindfulness practices examine how they can promote mental and somatic health. Clinical research on these practices have done the most studies on stress, anxiety, depression, hypertension, cardiovascular diseases, and substance abuse disorders. Looking for the philosophical foundation of health on which this body of research rests allows us to examine how the Buddhism and science dialogue does not have a consistent idea of health.

The first definition to consider is by the WHO, drafted in 1946 and still unchanged: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” WHO, it should be noted, bases its approach in the Western scientific model of medicine, as evidenced by their exclusion of all else as complementary/alternative medicine. And like its conception of medicine, WHO’s definition of health assumes a paradigm situated in Western modernity. This definition of health, however, has been criticized as being vague, idealistic, conflating health with happiness, and difficult to operationalize or measure. Since scientific research need physically measurable and operationalized definitions, this is not the likely foundational model. For example, Erika Rosenberg et al.’s 2015 study that shows how meditation impacts compassion could not simply claim subjects showed more sadness when viewing upsetting images. Rather, they had to record physical data from all 44 muscle groups on the face to make the case that the subjects were indeed sad. This emphasis on concrete data suggests that the WHO’s difficult-to-operationalized definition does not support these studies.

A more likely candidate for  the philosophical foundation of such research is a negative formulation of health, which defines health as the absence of disease, in contradistinction to WHO’s positive formulation. Bjørn Hofmann argues there is no positive definition of health in the philosophy of Western medicine because the field can function without it. Christopher Boorse articulated a definition that accommodates scientific research: a biostatistical definition of health.

In his widely cited 1977 essay Health as a Theoretical Concept, Boorse gives the following definition: “health is normal functioning, where the normality is statistical and the functions biological.” For example, since the biological function of the heart is to pump blood, an individual is healthy if her heart is able to perform within a statistical range compared to  her peers. Boorse champions the biostatistical definition of health as “value-free”, which he considers a benefit, based on his desire to provide an objective scientific definition. However, his view has been criticized as not truly value-free, and also has been opposed by those who argue for “value-laden” accounts of health and illness. Problems with taking this definition for granted include reifying a statistical norm, which excludes the differently abled, neuroatypical, and other underrepresented minority groups (statistical, and otherwise) as healthy.

It is important to note the lack of attention towards this term in the Buddhism and science dialogue, despite its common usage. The surface compatibilities between the two conceptions of health dissolve upon further investigation, which reveals deep incongruities. For example, the studies on how Buddhism-based meditation can alleviate anxiety and prevent depression relapse presume the latter are unhealthy mental conditions. The contemporary understanding of these states associate them with loss of value, hopelessness, despair, distress, shame, and anger. Sharf develops Gananath Obeyesekere’s observation that these states reflect a good Buddhist who has overcome ignorance and are signs of Buddhist mental health, defined as wisdom and insight into the predicament of samsaric reality: that to live is to suffer. Lindhahl questions if the way suffering is addressed in mindfulness-based interventions is the same as how Buddhism addresses suffering. He notes that there is no agreed upon operationalized definition of suffering in psychology. Rather, there are components such as stress, anxiety, and depression. And the resulting reduction of suffering for the purposes of mental health rests in large part on reduction of symptoms. In contrast, he argues Buddhist models of health explains the origin of suffering, and thus the way to reduce, alleviate, or overcome it towards health and well-being, is in relation to ignorance, craving, and karma.

The Buddha said that health (arogya, literally the absence of illness), is “the highest gain (labha).” He is portrayed in the canon as the “king of physicians” (vaidyaraja), concerned with healing sentient beings from physical illness and soteriological dis-ease. The Four Noble Truths have been compared to four stages of medical treatment: diagnosis (the truth of dukkha), etiology (cause of dukkha), prognosis (cessation of dukkha), and cure (path to cessation). Pierce Salguero (2014) provides the following summary:

From its very inception in northeastern India in the last centuries BCE, the Buddhist tradition has advocated a range of ideas and a repertoire of practices that are said to ensure health and well-being. Early Buddhism also provided devotees with certain types of rituals to comfort the sick and dying, ascetic meditations on the structure and function of the body, and monastic regulations on the administration and storage of medicines. Buddhist texts also frequently used metaphors and narrative tropes concerning disease, healing, and physicians in discourses explaining the most basic doctrinal positions of the Dharma. As Buddhism developed in subsequent centuries, a number of healing deities were added to the pantheon, monastic institutions became centers of medical learning, and healer monks became famed for their mastery of ritual and medicinal therapeutics.

The above examples reveal that although Buddhism is concerned with health, its models of health are difficult to reconcile with the paradigm of health assumed by most researchers in this dialogue, who are conducting studies on how meditation affects health and well-being. To elaborate, the Pali canon mentions demons, imbalance of the four elements, and tridosa (the “three defects” or “three disturbances”)—Wind, Bile, and Phlegm—as causes of physical disease and suffering. Mental illnesses are caused by illusions or wrong views (greed, ill will, pride). In addition, Buddhist conceptions of health are intricately tied to ethics and karma. Unethical conduct may lead to karma that causes physical illness.

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Though Buddhist meditation has been researched as a means to lower blood pressure and stress, in early Chinese Buddhism, meditation was prescribed as an activity to get rid of negative karma. According to Zhiyi’s classification of the causes of illness, one etiological category was improper meditative practice. Some Chinese and Japanese Buddhists warned of meditation sickness (禪病 Ch. chánbìng, Jp. zenbyō). Willoughby Britton’s work on “The Varieties of Contemplative Experiences” highlights potential adverse effects of meditation in Buddhist and other contexts. Thus, while meditation is currently promoted for health, it can have the opposite effect.

Even if one is not interested in Buddhist soteriology, or Buddhist conceptions of karma (which entails rebirth and is not a psychologized karma of “secular” or “atheist” Buddhist interpretations), looking to Buddhist models of health is a step away from accepting the contemporary biostatistical model. It is an open question if and how much Buddhist models can influence the current model. Nevertheless, raising this topic is a first step if the dialogue between Buddhism and science wishes to learn from each other.

What does a society look like if it treats the Buddhist poisons of greed and hatred quite literally as causing mental illnesses? What happens if people are deemed unhealthy when such greed and hatred leads to a lack of meaningful relationships to other sentient beings and the environment? Should there be more attention towards social defects and imbalances as causes of disease? While Buddhist societies in the past will never live up to a romanticized ideal, the supposed goal of the dialogue is toward mutual understanding and improvement.

Rather than leaving the term health unexamined, investigating science and Buddhism’s convergences and divergences on health sheds light on the relationship between the two fields, which are not monolithic unchanging entities. There may be few psychologists today who, taking after Freud, consider religion in general as a neurosis, or like his student Franz Alexander, understand the Buddhist obsession with self-absorption as mental illness. Yet, some scientists—like biologist Richard Dawkins and neuroscientist Sam Harris, or other “militant/new atheists”—consider religion as a social ill. On the other side, there are Buddhists like Tsültrim Lodrö, a contemporary Tibetan Buddhist scholar and head of a monastic college who criticizes the sciences as less rational than Buddhism. To invert Alexander, it is not difficult to imagine Buddhists who see modern psychology’s obsession with ego-self-development as deluded mental illness.

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Looking at health also clarifies the relationship between Buddhism and mindfulness. Touted as a panacea, mindfulness has been advocated as mental hygiene, one of the newest health fads. Critics of the Mindfulness movement question what sort of mental health the practice of nonjudgmental, present-centered awareness cultivates. To obviate the problems with an unreflective definition of health, elucidating this term will lead to new directions in healthcare and clinical research, and provide fodder for the dialogue. It will challenge what it means for individuals, communities, and societies to be healthy.

 

Boorse, Christopher. 1977. “Health as a Theoretical Concept” Philosophy of Science 44 (4): 542-573.

Rosenberg, Erika L., et al. 2015. “Intensive Meditation Training Influences Emotional Responses to Suffering.” Emotion 15 (6): 775–90.

Salguero, C. Pierce. 2014. “Buddhism & Medicine in East Asian History.” Religion Compass 8 (8): 239–50.

Chinese & East Asian Medicines

HOLISM, CHINESE MEDICINE AND SYSTEMS IDEOLOGIES: REWRITING THE PAST TO IMAGINE THE FUTURE

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This chapter explores the articulations that have emerged over the last half- century between various types of holism, Chinese medicine and systems biol- ogy. Given the discipline’s historical attachments to a definition of ‘medicine’ that rather narrowly refers to biomedicine as developed in Europe and the US from the eighteenth century onwards, the medical humanities are not the most obvious starting point for such an inquiry. At the same time, they do offer one advantage over neighbouring disciplines like medical history, anthropology or science and technol- ogy studies for someone like myself, a clinician as well as a historian and anthropologist: their strong commitment to the objective of facilitating better medical practice. This promise furthermore links to the wider project of critique, which, in Max Horkheimer’s definition of the term, aims at change and emancipation in order ‘to liberate human beings from the circumstances that enslave them’. If we take the critical medical humanities as explicitly affirming this shared objective and respon- sibility, extending the discipline’s traditional gaze is not a burden but becomes, in fact, an obligation.

With that in mind, this chapter seeks to accomplish three inter-related goals. It is first an inquiry into the historical processes whereby Chinese medicine, holism and systems biology have come to be entangled with each other in the present. The term holism is not originally Chinese and was only applied to Chinese medicine from the 1950s onward. Whether or not systems biology, the computational and mathematical modelling of complex biological systems, is holistic, as some of its proponents claim, also remains a contested issue. Holism clearly means different things to different people. Yet, in the early twenty-first century, those engaged in constructing an interface between Chinese medicine and systems biology widely agree that their project not only honours the holistic foundations of their respective traditions, but also is, in fact, driven by this shared commitment to holism and the development of a scientifically based personalised medicine. This raises the question of how this consensus was achieved and what it denotes.

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Chinese & East Asian Medicines

The Treatment of Otitis Media with TCM

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This is a syndicated post that original appeared at http://www.sixfishes.com

Cara O. Frank, L.OM.

The following is an excerpt and re-working from the chapter on the treatment of Non-suppurative otitis media from my book TCM Case Studies, Eye, Ear, Nose and Throat Disorders, from Peoples Medical Publishing House. The book also contains chapters on acute suppurative otitis, chronic suppurative otitis. If you find this information helpful, I encourage you to study the entire chapter, as it contains case studies and other helpful information.

Non-suppurative otitis media refers to the first phase of a middle ear infection. Many cases occur after a common cold and are part of the sequelae of an upper respiratory infection. 1 Most cases are viral in nature. Symptoms include mild pain that is worse at night along with a sensation of popping in the ears and deafness. Treatment consists of pain management with non-steroidal anti-inflammatory drugs (NSAIDS). Since most cases are viral, antibiotics generally don’t improve outcomes and are associated with side effects. Tympanostomy tubes may also be placed in the eardrum if there are more than three episodes in six months. 2

In TCM, otitis media falls into the category of ěr zhàn (耳胀, ear distention) or ěr bì (耳闭, ear block), an otolaryngological condition caused by external pathogenic invasion or retention of pathological toxins. It is characterized by symptoms of distention, fullness and a sensation of blockage inside the ear, accompanied by tinnitus with a deterioration of hearing. Classical texts define it as wind-type hearing loss, sudden hearing loss or hearing loss due to qi blockage. It is equivalent to non-purulent otitis media in Western medicine.

This is an extremely common complaint in clinical practice. the condition is very responsive to treatment with Chinese medicine.

There is close relationship between ear distention and ear block. Ear distention is seen in the initial onset of the infection and exhibits excessive-type symptoms. Usually caused by external pathogenic invasion and obstruction of channel qi, it is characterized by a feeling of distention in the ear with pain specific to the auricular region. In comparison, ear block is a chronic condition, often caused by retention of pathogenic toxins. It is related to spleen and kidney deficiency, and exhibits symptoms of deficiency-excess complex patterns. It is characterized by a sensation of blockage inside the ear, with impaired hearing. If treatment of ear distention is delayed, it can develop into ear block.

COMMON CLINICAL PATTERNS AND FORMULAS

The following are the main patterns of the differential diagnosis and treatment, however there are more choices in the pattern descriptions.

External pathogenic wind invasion with channel qi obstruction: ModifiedYín Qiào Săn (Lonicera and Forsythia Powder) or Sān Ào Tāng (Rough and Ready Three Decoction)

Liver-gallbladder damp-heat steaming the auricular orifice: Modified Lóng Dăn Xiè Gān Tāng (Gentian Liver-Draining Decoction)

Spleen deficiency and damp congestion with damp turbidity encumbering the ear: Modified Shēn Líng Bái Zhú Săn (Ginseng, Poria and Atractylodes Macrocephalae Powder)

Accumulation of toxins with qi and blood stagnation: Modified Tōng Qiào Huó Xuè Tāng (Orifice-Freeing Blood-Quickening Decoction)

1.External pathogenic wind invasion with channel qi obstruction resulting in impaired diffusion and downbearing of the lung and obstruction of the ear orifice:

The middle ear belongs to the lung system. Wind-cold or wind-heat attacks the exterior and hides in the lungs, leading to impaired diffusion and downbearing of the lung and pathogenic qi congestion in the clear orifice. The wind-cold type can be accompanied by a stuffy nose, clear nasal discharge, sneezing and headache or whole body soreness. The tongue coating will be thin and white with a floating, tight pulse. The treatment principle is to course wind, dissipate coldness, diffuse congestion and open the orifices. The formula should be Sān Ào Tāng (Rough and Ready Three Decoction) modified with jīng jiè (Herba Schizonepetae), fáng fēng (Radix Saposhnikoviae) and shí chāng pú (Rhizoma Acori Tatarinowii).

The wind-heat type includes symptoms of a stuffy nose, thick nasal discharge, headache and a sore throat. The tongue coating will be thin and yellow. The pulse is floating and rapid. The treatment principle is to course wind, dissipate heat, diffuse the lungs and open the orifices. The formula is modified Liù Wèi Tāng (Six-Ingredient Decoction) or Yín Qiào Săn (Lonicera and Forsythia Powder). If the patient’s tympanic cavity also has fluid, it is often due to impaired diffusion and downbearing of the lung from fluid stagnation. The treatment principle should focus on coursing wind and diffusing the lungs. Add medicinals for further lung diffusion, water dispersal and resolution of dampness such as tíng lì zǐ (Semen Lepidii; Semen Descurainiae), ché qián zǐ (Semen Plantaginis) and zé xiè (Rhizoma Alismatis).

2.Pathogens blocking the shaoyang channels with ear orifice obstruction:

The three yang channels of hand and foot plus the hand jueyin pericardium channel all cross the ear. The hand and foot shaoyang channels have the closest relationship with the ear. This condition is often caused by the external contraction of the six excesses, with pathogens entering shaoyang channel, leading to channel qi stagnation and pathogen blockage of the ear. It mainly manifests as auricular swelling and obstruction accompanied by a bitter taste in the mouth and a dry throat. The tongue coating is thin and yellow, and the pulse is wiry. The treatment principle should be to clear and diffuse shaoyang, open the orifices and nourish the ear. The formula selection for this pattern is Xiăo Chái Hú Tāng (Minor Bupleurum Decoction) or modified Tōng Qì Săn (Qi-Freeing Powder) from the Correction of Errors in Medical Works (Yī Lín Găi Cuò, 医林改错). In this condition, patients will not present with the typical symptoms of lung dysfunction such as cough, nasal discharge or a floating pulse.

3.Phlegm turbidity stagnation and ear orifice obstruction:

This pattern is mainly characterized by fluid accumulation in the tympanic cavity. It can reoccur often and last for long periods without typical symptoms of exterior patterns. Usually due to impairment of splenic movement and transformation, it results in disorders of fluid metabolism, leading to water-dampness retention in the ear. The treatment principle should focus on percolating water and resolving dampness by using modified Zhū Líng Tāng (Polyporus Decoction) or Zé Xiè Tāng (Alisma Decoction). Choose modified Shēn Líng Bái Zhú Săn (Ginseng, Poria and Atractylodes Macrocephalae Powder) if spleen deficient patterns are more prominent. If the patient has sticky accumulative fluid or thick fluids glued to the ear, then qi-moving, dampness-drying, phlegm-dissolving and nodule-dissipating medicinals should be added. Examples of such medicinals are bàn xià (Rhizoma Pinelliae), xuán shēn (Radix Scrophulariae), mŭ lì (Concha Ostreae) and zhè bèi mŭ (Bulbus Fritillariae Thunbergii).

With an accumulation of heat caused by phlegm turbidity, huāng qín (Radix Scutellariae), jīn yín huā (Flos Lonicerae Japonicae) and mŭ dān pí (Cortex Moutan) should be added to clear heat and eliminate pathogens, or clear heat and dissolve toxins. This type of pattern may be diagnosed in Western medicine as a low-grade infection of the middle ear cavity. Western medical theory attributes this condition to allergic response or endocrine dysfunction. Therefore, in the case of recurrent fluid accumulation without resolution, high doses of huáng qí (Radix Astragali), dăng shēn (Radix Codonopsis) and bái zhú (Rhizoma Atractylodis Macrocephalae) should be added to fortify the spleen and drain dampness. Alternately, add fù zĭ(Radix Aconiti Lateralis Praeparata), bā jǐ tiān (Radix Morindae Officinalis) and suŏ yáng (Herba Cynomorii) to warm the kidney and spleen. These medicinals may play an important role in regulating the endocrine system and ameliorating the allergic response.

4.Congealing of phlegm and stagnant blood congestion, and blockage in the ear orifice:

Due to the tendency of this condition to become chronic, the patient will often present with signs of stagnation, such as a tongue body with stagnant spots and a dusky, purplish color. There may also be obvious sticky discharge glued to the ear from the tympanum, thickening and becoming more turbid in the tympanic membrane, with decreased mobility. Treatment should focus on invigorating blood, transforming stasis, eliminating phlegm and dissipating nodules. Select modified Èr Chén Tāng (Two Matured Substances Decoction) and Bŭ Yáng Huán Wŭ Tāng (Yang-Supplementing and Five-Returning Decoction).

5.Qi deficiency resulting in dysfunction of the ear orifice

In this category, the patient presents with exudative type otitis media along with typical symptoms seen in spleen qi deficiency patterns. This is mostly seen in chronic cases and characterized by cloudy and sunken eardrums without any obvious fluid accumulation. The formula selection is modified Shēn Líng Bái Zhú Săn (Ginseng, Poria and Atractylodes Macrocephalae Powder) or Bŭ Zhōng Yì Qì Tāng (Center-Supplementing and Qi-Boosting Decoction), with added shí chāng pú (Rhizoma Acori Tatarinowii) to open the orifice. For patients with qi deficiency along with externally contracted cold symptoms, pathogen-eliminating medicinals such as chái hú (Radix Bupleuri), chuān xiōng (Rhizoma Chuanxiong), jīng jiè (Herba Schizonepetae) and bái zhĭ (Radix Angelicae Dahuricae) should be added. For patients presenting with kidney deficiency, medicinals such as bā jǐ tiān (Radix Morindae Officinalis), tù sī zĭ (Semen Cuscutae) and bŭ gŭ zhī (Fructus Psoraleae) should be added.

MODIFY LIKE A BOSS

For all patterns, in addition to the primary formula, be sure to include chái hú, which acts as an envoy to direct the formula to the shaoyang channels that surround the ear.

  • Because the disease usually involves pain, include medicinals that regulate the qi, such as chái hú, xiāng fù (Rhizoma Cyperi) and chuān xiōng.
  • To open obstruction in the channels, consider medicinals that unblock the channels and quicken the collaterals, such as shí chāng pú, dì lóng, lù lù tōng andbái jiāng cán(Bombyx Batryticatus).
  • Because the infection and inflammation is in the upper body, consider medicinals that clear fire toxin that are also light and diffusing in nature, such as jīn yín huā, lián qiào, jīng jiè and bò he. The first two are especially important as they expel pus and clear wei-level fevers.
  • When there is fire toxin or damp heat from liver and gallbladder, use bitter cold medicinals that downbear fire, such as huáng qín (Radix Scutellariae) and lóng dăn căo (Radix et Rhizoma Gentianae). Huáng qín is especially important because of its relationship with chái hú, which, as discussed above, guides medicinals to the ear via its shaoyang channel relationship.
  • Damp-obstruction is a major disharmony that must be resolved. This can be treated with many of the medicinals detailed in the above. However, three stand out as being especially effective: Huáng qí (Radix Astragali) not only boosts the qi and stabilizes the exterior, it also expels pus. Yì yĭ rén drains dampness and expels pus. Shí chāng pú is effective for opening the orifices to improve hearing.
  • The final key: if the otitis media is chronic with persistent discomfort, consider the possibility that there is blood stasis. This diagnosis is made not because there is ear trauma, but rather it reflects the chronicity of the case. Medicinals such as dāng guī (Radix Angelicae Sinensis), chuān xiōng and chì sháo (Radix Paeoniae Rubra) are important in this situation. The former medicinal has a relationship with huáng qí in the formula Dāng Guī Bŭ Xuè Tāng (Chinese Angelica Blood-Supplementing Decoction). The actions of the formula are to expel pus and resolve abscesses. Another formula to consider is Bŭ Yáng Huán Wŭ Tāng (Yang-Supplementing and Five-Returning Decoction) that includes all the medicinals listed above. Its action is to boost the qi and promote the circulation of blood in channels. Furthermore, the more chronic the otitis media, the more the practitioner should consider medicinals that reduce nodulation by resolving phlegm and invigorating the blood.

Tan Jing-shu’s approach: 

Modern TCM has accumulated extensive clinical experience in treating this condition. Professor Gan Zu-wang of the Nanjing University of Chinese Medicine especially emphasized treating the lungs by using a modified Sān Ào Tāng (Rough and Ready Three Decoction). The late, famous integrative otolaryngopharyngeal expert Tan Jing-shu advocated the practice of integrating TCM and Western medicine etiology and pathology. The pathological characteristics of this condition are infection and allergic reactions in the middle ear in terms of Western medicine, and qi stagnation and blood stasis in terms of TCM. Based on this theory he developed a formula known as the “Anti-Exudates Ear Formula” which yielded good clinical results. For patients with cumulative fluids in the middle ear, the theory focused on promoting urination and orifice opening.

Anti-Exudates Formula (empirical formula from Tan Jing-shu)

Formula: Kàng Shèn Ěr Fāng (Anti-Exudates Formula)

[抗渗耳方]

柴胡 chái hú 10g Radix Bupleuri
香附 xiāng fù 10g Rhizoma Cyperi
川芎 chuān xiōng 15g Rhizoma Chuanxiong
石菖蒲 shí chāng pú 15g Rhizoma Acori Tatarinowii
白术 bái zhú 15g Rhizoma Atractylodis Macrocephalae
茯苓 fú líng 15g Poria
金银花 jīn yín huā 15g Flos Lonicerae Japonicae
黄芪 huáng qí 30g Radix Astragali
当归 dāng guī 12g Radix Angelicae Sinensis
黄芩 huáng qín 12g Radix Scutellariae
水蛭 shuĭ zhì 5g Hirudo
炮山甲 páo shān jiă 5g Squama Manitis
泽泻 zé xiè 20g Rhizoma Alismatis

The actions of this formula are to fortify the spleen, disinhibit water, transform stasis, unblock the collaterals, clear heat, dissolve toxins, move qi and open the orifices to treat difficult and chronic cases of exudative otitis media.

[Formula Analysis]

Bái zhú, zé xiè, fú líng and huáng qí fortify the spleen and resolve dampness to treat the root of accumulating fluid exudates from the middle ear.

Tōng Qì Săn from the Correction of Errors in Medical Works plus shí chāng pú, shuĭ zhì and páo shān jiă move qi, transform stasis and open the orifices to benefit the opening of the tympanic cavity.

Jīn yín huā and huáng qín clear heat, dissolve toxins and have anti-bacterial and anti-toxic effects.

Huáng qí, bái zhú and dāng guī benefit qi, nourish blood, support the upright qi and secure the root to regulate the immunity.

Formula analysis

Tan Jing-shu’s Anti-Exudates Formula is like a hybrid of all the formulas that we have discussed in the chapter. The formula opens with Tōng Qì Tāng. Huáng qín and chái hú act as envoys to the ear, and from there, the formula incorporates bái zhú, huáng qí and fú líng to supplement the spleen qi. Fú líng also pairs with zé xiè to percolate dampness. Jīn yín huā clears fire toxin and expels pus. Dāng guī and huáng qí invigorate the qi and blood and expel pus. Going even further with this pair: if we add chuān xiōng and páo shān jiă (Squama Manitis), we then create the formula Tòu Nóng Săn (Pus-Expelling Powder). Summarizing the characteristics of Dr. Tang’s formula: its primary actions are to regulate the qi and blood, and expel pus using predominantly acrid flavors. In comparison to the primary case, both formulas include Tōng Qì Tāng; however, in the chapter’s primary case history it was combined withYín Qiào Săn to release exterior wind heat. In contrast, Anti-Exudates Formula is strictly a formula for internal patterns. 3

END NOTES

1.Ear Infections in Children. National Institute on Deafness and Other Communication Disorders,National Institute of Health, NIH Publication No. 13-4799, Updated February 2013. from:http://www.nidcd.nih.gov/health/hearing/earinfections

2.Otitis Media. National Institute of Health, NIH Publication 97-4216, Updated October 2000. from:http://www.nidcd.nih.gov/StaticResources/health/healthyhearing/tools/pdf/otitismedia.pdf

3.Li Fan-cheng, Xu Shao-qin. A Hundred TCM Clinical Masters in Modern China: Tan Jing-shu. Beijing: China Press of Traditional Chinese Medicine, 2007: 148-169