Buddhist Medicine and Its Circulation
Summary and Keywords
“Buddhist medicine” is a convenient term commonly used to refer to the many diverse ideas and practices concerning illness and healing that have emerged in Buddhist contexts, or that have been embraced and carried by that religion as it has spread throughout Asia and beyond. Interest in exploring the relationship between mind and body, understanding the nature of mental and physical suffering, and overcoming the discomforts of illness goes back to the very origins of Buddhism. Throughout history, Buddhism has been one of the most important contexts for the cross-cultural exchange of diverse currents of medicine. Medicine associated with and carried by Buddhism formed the basis for a number of local healing traditions that are still widely practiced in much of East, Southeast, and Central Asia. Despite the fact that there are numerous similarities among these regional forms, however, Buddhist medicine was never a cohesive or fixed system. Rather, it should be thought of as a dynamic, living tradition with a few core features and much local variation. Local traditions of Buddhist medicine represent unique hybrid combinations of cross-culturally transmitted and indigenous knowledge. In the modern period, such traditions were thoroughly transformed by interactions with Western colonialism, scientific ideas, and new biomedical technologies. In recent decades, traditional, modern, and hybrid forms of medicine continue to be circulated by transnational Buddhist organizations and through the global popularization of Buddhist-inspired therapeutic meditation protocols. Consequently, Buddhism continues today to be an important catalyst for cross-cultural medical exchange, and it continues to exert a significant influence on healthcare practices worldwide.
What is “Buddhist Medicine”?
Interest in exploring the relationship between mind and body, understanding the nature of mental and physical suffering, and overcoming the discomforts of illness goes back to the very origins of Buddhism. Ostensibly preserving an oral tradition that had been in circulation since the death of the Buddha in northeastern India three or four centuries earlier, the earliest extant Buddhist texts were set down in the Pāli language in 1st-century bce Sri Lanka.1 While the Pāli tradition was developing in Sri Lanka, Buddhist groups were also producing texts in other parts of the Indian subcontinent. Over the course of the 1st millennium ce, these texts came to be recorded in various Sanskrit and Sanskrit-like local languages (Prakrits). Some of this earliest layer of Buddhist literature is still extant in the original Indic languages, while much of what is not is recoverable from Chinese and Tibetan translations. Across this diverse corpus, healing and medicine are significant themes.
The extant monastic disciplinary codes (i.e., the vinaya) of several of these Indian sects consider the practice of healing—especially for personal gain, and particularly when practiced by female monastics—a “worldly art” unbecoming of one who had renounced the world.2 Nevertheless, early Buddhist literature on the whole gives the impression that medical knowledge and healing practices were valued.3 In texts containing doctrinal teachings (Pāli sūtta; Skt. sūtra), anatomical and physiological terminology are frequently found in descriptions of meditation practices and other ascetic discourses.4 Such texts tend to describe the human body as an amalgamation of Four Great Elements (Skt. mahābhūta or dhātu; i.e., earth, water, fire, and wind).5 They see the imbalance of those Elements as a principle cause of disease, often also mentioning the tridoṣa, the three so-called “peccant humors” (literally, doṣa means “defects” or “faults”) of wind, bile, and phlegm that are linked to such imbalances.6 A range of texts discusses the medicinal foods, drinks, and other substances that monks were explicitly allowed to obtain, store, make, and consume.7 In both the vinayas and sūtras, narratives of the Buddha or close disciples caring for sick members of the sangha make clear that healing or nursing could be laudable, even noble, undertakings (though healing the laity was still not condoned).8 Moreover, throughout early Buddhist writings, medical metaphors are frequently utilized in unequivocally positive ways, including the frequent assertion that the Buddha is a “Great Physician” who cures the suffering of mankind.9
Buddhist engagement with medical and healing knowledge became even more notable within the Mahāyāna (i.e., the “Great Vehicle”) movement that began to emerge in the first centuries ce. While few examples of Mahāyāna texts related to medicine or healing are extant from India,10 from the 2nd century ce through the end of the first millennium, Chinese translators recorded the importation of scores of volumes of scriptures and commentaries that are highly relevant to this subject.11 Tibetan translations of both Indian and Chinese Buddhist materials commenced in the 7th century, also resulting in the preservation of much material that was subsequently lost in India.12 Influential new scriptures such as the Sūtra of Golden Light, the Mahāparinirvāṇa Sūtra, the Bhaiṣajyaguru Sūtra, the Vimalakirtī-Nirdeśa Sūtra, and the Lotus Sūtra carried Mahāyāna perspectives on illness and healing far and wide across Asia. On the whole, the Mahāyāna literature suggests that healing became one of the central concerns for this type of Buddhism. Far from restricting the sangha from practicing, Mahāyāna devotees both monastic and lay were repeatedly enjoined to care for the sick with compassion and selflessness.13
Mahāyāna Buddhism also promised that deities such as Avalokiteśvara Bodhisattva (Ch. Guanshiyin; Tib. Spyan ras gzigs), Bhaiṣajyaguru Buddha (i.e., “Master of Medicines”; Ch. Yaoshifo; Tib. sman bla), and a host of others could be called upon through prayer, ritual, and visualization practices to assist in times of crisis.14 These powerful beings could appear in person, in a vision, or in a dream in order to eradicate the illnesses of the faithful. They could be called upon to empower medicines, water, or other healing implements. Mahāyāna texts also promised that health and longevity could be achieved through basic practices such as contemplation of Buddhist doctrine, chanting of scriptures, moral restraint, moderation of diet, and meditation, as well as through incantations, exorcisms, and other rituals.15 Advanced practice of the Dharma could bring permanent relief from the suffering associated with illness—or, in certain circles, the complete transcendence of the ordinary physical body altogether. All of these practices became mainstays of the Mahāyana ritual repertoire.
Beginning in the mid-1st millennium ce, a third wave of innovation swept across the Buddhist world that is varyingly referred to as Tantric or Vajrayāna Buddhism.16 Mature forms of Indian Tantra (Buddhist and otherwise) included a revolutionary new approach to health and healing. In addition to being a material structure constructed out of the Four Elements, the body now also was a conduit for a variety of “winds” (Skt. prāṇa; Ch. feng or qi; Tib. rlung) that provided connectivity between the mind, the body, the senses, and the cosmos at large.17 These winds coursed through the body via particular channels (Skt. nāḍī; Ch. mai; Tib. rtsa) and could be collected in vortices or “wheels” (Skt. cakra; Ch. lun; Tib. ‘khor lo) with rich symbolic and transformative significance. Buddhist practices to maintain health and cure disease now included a wide variety of visualizations, meditations, and exercises for the body and breath that could cultivate and circulate these subtle (i.e., supra-anatomical) energies. Learning powerful mantras (i.e., potent sounds or syllables that harnessed cosmic powers), assuming certain mudrās (i.e., bodily postures or mental attitudes), and ritually identifying with deities could also purify the body of all illnesses and defilements. The most adept tantric practitioners were thought to be able to extract the essence of the mundane objects of the physical world (including medicines, minerals, and even the wind), gathering from these objects a subtle nectar (Skt. amṛta; Ch. ganlou; Tib. bdud rtsi) with which they could spiritually nourish themselves.18 Mastery over these various tantric practices—which were commonly transmitted through secretive esoteric lineages—was said to lead rapidly to health, longevity, and even complete immortality.
Taken collectively, the entire range of ideas and practices discussed thus far in this section—the Four Elements and related concepts, cultivation of the bodily winds, notions about Buddhist medical deities (including their hagiographies, rituals, and iconography), the practice of establishing dispensaries and hospices within monastic complexes, the idea that monks and laypeople could fulfill their bodhisattva vows by becoming efficacious healers, and a complex of important medical metaphors and narrative tropes—are often loosely referred to as “Buddhist medicine.” Today, many scholars and devotees of Buddhism use this term to refer to knowledge about disease, healing, and the body that was transmitted along with Buddhism from the Indian subcontinent to the rest of Asia. This is a modern neologism that is not found in early Buddhist texts, and it is not universally accepted among scholars.19 Elsewhere, the present author has been critical of the common usage of this term insofar as it implies a conceptual homogeneity or doctrinal uniformity in the way that Buddhist traditions in India, China, and other societies approached medicine. Quite to the contrary, the reception of Buddhist medical ideas throughout the Asian continent occasioned countless acts of adaptation, transformation, and even outright rejection that were locally specific and historically contingent.
This objection notwithstanding, the term “Buddhist medicine” may be convenient as a general term for Buddhist understandings of illness and cure, much the same way that we loosely can use the term “Buddhist art” to refer to over two thousand years of artistic engagement with Buddhist motifs and patterns of transmission without detracting from the diversity of the local instantiations. Such terminology assists us in making comparisons between divergent Buddhist societies (i.e., examining the differences and similarities between Japanese and Sri Lankan Buddhist art), as well as in distinguishing Buddhist modes of cultural production from non-Buddhist ones (i.e., examining the differences and similarities between Buddhist and non-Buddhist art in Japan). Like Buddhist art, the subject of “Buddhist medicine” is best approached as ever changing and ever transforming, and both socially and culturally embedded. It has a few core features, but much local variation across time and space. The term also involves a more expansive use of the term “medicine,” explicitly encompassing a wide range of health-seeking practices and blurring the boundaries between religious and scientific domains of knowledge.20
Buddhist medicine, if such a thing exists, necessarily has extremely porous boundaries. Many of the core aspects of Buddhist medicine discussed above are not, in fact, uniquely Buddhist, but are shared in some form or another with other Eurasian medical traditions. For example, Buddhist notions of the Four Elements and the associated concept of tridoṣa overlap in obvious ways with the mainstream classical Indian medicine of Āyurveda.21 These doctrines are also closely related to the core principles of both Greco-Roman and Islamic medicine.22 On the other hand, Vajrayāna Buddhist forms of subtle-body cultivation share similarities with ideas described in the Upaniṣads written in first millennium BCE India, with other tantric and yogic systems that developed in the medieval period, and, more obliquely, with Chinese forms of self-cultivation practiced in Daoist circles.23 A closer study of these neighboring traditions remains outside the scope of the current article. Nevertheless, it is clear that certain ideas and practices derived from or related to these other traditions came to be embedded in Buddhist texts.
Precisely due to the propensity of Buddhist authors and practitioners to interact with various local and regional sources of healing knowledge, the spread of Buddhism became an important catalyst for cross-cultural medical exchange. The early histories of many of these ideas and practices are difficult to ascertain from our contemporary vantage point, but after they were picked up by Buddhists and recorded in reliably dated texts historians can trace how these ideas and practices were developed and circulated around premodern Asia. Although all too often overlooked, the study of Buddhist texts is therefore highly relevant for a global history of medicine focused on cross-cultural exchange.
The Circulation of Buddhist Medicine in the Premodern Period
The circulation of Buddhist medicine in the premodern period can be divided into two more or less distinct phases. The first is a period of geographic expansion that took place between the 1st century CE and about 1200 ce, during which time Buddhism spread throughout Asia and facilitated one of the most extensive and well-documented cases of cross-cultural medical exchange in world history. By all appearances, Buddhism was a proselytizing religion with a universalist ethos from the earliest times, and it spread widely in India in the centuries following its inception.24 With the consolidation of the Silk Roads and trans-Asian maritime routes, long-distance exchange intensified and Buddhism began to spread beyond the Indian subcontinent as well.25 Medicine, which often played a major role in Buddhist proselytizing activities, was actively spread to new lands along with other aspects of the religion during this period. For example, Chinese and Tibetan accounts tell of many missionary monks arriving from South Asia who became famed for their medical knowledge and skills—and some for whom healing became their primary claim to fame.26 A number of East Asian and Tibetan monastics eventually made the trip in the opposite direction, traveling to India and elsewhere in the Buddhist world to study, observe, and gather texts related to medicine, health, and longevity.27 Such individual travel by monks on pilgrimage joined the transmission of texts, institutions, and material culture as important mechanisms for the transregional exchange of Buddhist medicine.
With the increased volume of long-distance travel and cross-cultural exchange, various centers of medical learning emerged around the Buddhist world.28 The most famous was the monastic university (Skt. mahāvihāra) at Nālandā (fl. 5th century to c.1200). This site was visited by the Chinese pilgrim Yijing (635–713), whose observations about the medical and health-maintenance practices of the great Indian monastery were dispatched back to China.29 Another important node in the network was Dunhuang. Located at the confluence of several branches of the Silk Road, this city served as a nexus for the transit of goods and people in and out of China.30 In the early 20th century, the monastic ruins at Dunhuang was the site of the discovery of a massive collection of multilingual manuscripts. Dated between the 4th century and c. 1100, tens of thousands of recovered writings cover a variety of topics, including many focusing on various traditions of Chinese and Buddhist medicine.31 A network of commercial, religious, and medical exchanges connected centers such as Nālandā and Dunhuang with the East Asian capitals, oases along the Silk Roads, Southeast Asian entrepôts, and other cities across Asia, with Buddhism playing a principal role in these circulations.32
The reception of Buddhist medicine was different in each place to which it spread. Buddhism was just one feature of the healthcare landscape in East Asia, and its proponents had to aggressively compete with the healing activities of other influential groups (such as Daoists, various local spirit cults, the state cult, etc.).33 These facts notwithstanding, Buddhist medicine quickly became highly influential at all levels of society in China, Japan, and Korea.34 Healing deities—particularly Bhaiṣajyaguru—became major presences in medieval social, artistic, and political life.35 At the individual level, caring for the sick became recognized both as a basic moral requirement of a self-proclaimed bodhisattva (lay or monastic aspirant) and as conducive to one’s own good health through the salubrious effects of karmic merit.36 At the institutional level, monasteries and lay organizations organized hospitals, dispensaries, mass rituals, charitable fundraisers, and other activities geared toward health and protection from illness.37 Such initiatives were supported by elites and rulers, from the local to the imperial level across East Asia. With both wide popularity and official support, Indian concepts introduced via Buddhism came to be incorporated into mainstream Chinese medical doctrine, from whence they impacted medical traditions across East Asia.38
Outside of East Asia, Tibetan medicine is the most well-studied of the Buddhist-inflected medical traditions that took shape in this period.39 The lion’s share of Tibetan medical tradition derived from a combination of Indian religious and medical inputs. In fact, translations of twenty-two Indian medical classics were incorporated into the Tibetan Buddhist canon.40 These treatises cover topics as varied as internal medicine, pediatrics, gynecology and obstetrics, toxicology, surgery, pharmacology, alchemy, and veterinary medicine. The most significant Tibetan medical treatise, known as the Four Tantras (rGyud bzhi), was composed in the 12th century.41 It drew heavily on Āyurveda but also synthesized materials borrowed from indigenous, Chinese, Central Asian, Persian, and possibly even European medical traditions.42 However eclectic its sources, the framing of this knowledge was Buddhist. Though its authenticity as Buddha’s word was continually debated and it was never included in the Buddhist canon, the text definitively represents itself as a teaching delivered by an emanation of Bhaiṣajyaguru.43
The “long first millennium” between the 1st century ce and about 1200 represents the apogee of Buddhist medicine’s spread in Asia and its period of greatest influence as a catalyst for cross-cultural medical exchange. However, even while Buddhism remained highly influential in the 8th and 9th centuries, in certain parts of Asia the tides had already begun to turn. Facilitated by increasing Muslim dominance of the trade routes, Islam began emerging as the most significant cultural influence in much of Central Asia.44 Medical traditions overtly associated with Buddhism were not likely to be practiced or supported in areas that were becoming Islamized.45 By about the year 1200, Islam had spread across Eastern India, Nālandā had been sacked by Muslim armies, and the other great Indian centers of Buddhist learning had fallen as well. Southeast Asia, East Asia, and the Himalayan region still remained Buddhist strongholds, but tans-Asian commercial exchanges were now primarily being conducted by Muslim merchants.46 By this time, distinct regional forms of Buddhism had emerged. Each of these regions had embraced different forms of Buddhism (Theravāda, Mahāyāna, and Vajrayāna respectively), and, now disconnected from India, each operated in relative isolation from one another.
The period of the expansion of Buddhist medicine in the first millennium gave way to a period of regional consolidation and divergence in the second. To be sure, the cross-cultural exchange of healing ideas, practices, and medicinals continued between Buddhist societies, and Buddhist medicine continued to be as cosmopolitan as ever. Scholars have only now begun to trace out these exchanges and much more work needs to be done in this area; however, it has been established that Mongol interest in Tibetan Buddhism, Japanese and Vietnamese engagements with Yuan and Ming China, and Sino-Tibetan relations in the Qing era all contributed in various ways to the continuing circulation of medical knowledge in Buddhist hands.47 These examples notwithstanding, there was in this era nothing like the massive cross-continental transfers of knowledge and institutions that had occurred during the long first millennium. Until the modern period initiated a new era of global mobility for Buddhists, circuits of exchange tended to operate on a smaller scale and were largely limited to a particular region or territory.
Aspects of medicine that Buddhism had introduced throughout Asia continued in this era to play a role in structuring medical thought and practice locally. Nonetheless, with the Indian holy land no longer exerting a centripetal force, Buddhist concepts and approaches to health and healing underwent accelerated processes of adaptation, development, and transformation. The historical investigation of Buddhist medicine in the second millennium thus requires close investigation of what Buddhists did, thought, and said at the local or regional level, with special attention to how they understood the relationship between transregional Buddhist traditions and indigenous knowledge.
In East Asia, for example, certain aspects of the Indian transmission that had been embraced in the medieval period were now largely replaced with indigenous medical ideas in Buddhist discourses.48 In the second millennium ce, most Buddhist thinkers were more interested in working with the native concepts of qi and yin-yang than with foreign medical doctrines such as the Four Elements and tridoṣa. Buddhist monasteries remained sites for healing and protection, monks and nuns continued to be known for curing illness, and South Asian medicines became permanently integrated into the East Asian pharmacopoeia.49 At the same time that such aspects of Buddhist medicine were widespread, however, the language through which these practices and institutions were explained throughout East Asia tended to depend heavily on indigenous Chinese terminology.
Meanwhile in Tibet, medicine in this era was marked by local innovation and development.50 Although the Four Tantras and other texts mentioned above formed the basis of the tradition throughout the premodern period, authors in the 16th and 17th centuries began to challenge received wisdom and religious authority. Such initiatives dovetailed with reform efforts promulgated by the regent to the fifth Dalai Lama, Desi Sangyé Gyatso (1653–1705), who fostered an intellectual climate that encouraged testing the boundaries of traditional models and epistemologies.51 Authors in these circles were particularly interested in questioning the sacred status of the Tibetan medical classics and in verifying Tantric subtle anatomy through textual analysis and empirical observation.52
In other parts of Asia, imported Indian ideas and practices often received significant official support, which consequently laid the foundation of local systems of learned medicine that predominated throughout the premodern period. These local forms of Buddhist-inflected medicine have not received as much attention from scholars as East Asia and Tibet; however, they were similarly indebted to a combination of eclectic Buddhist transmissions and local innovations. King Jayavarman VII (c.1120/25 to c. 1220) of the Khmer Empire, for example, built a network of over one hundred ārogyaśālā, or “health-houses” that were adorned with statues of Bhaiṣajyaguru and attendant bodhisattvas, and that were staffed by monastic healers specializing in herbal medicine.53 In Sri Lanka, scholar-monks of the Theravāda order were among the most important medical authors and teachers. They were responsible for major medical treatises such as the Casket of Medicine (Bhesajjamañjūsā), Ocean of Medical Compositions (Yogārṇavaya), and Garland of Jewels of Medical Treatment (Prayogaratnāvaliya), all written in the 13th century.54 Mongolian medicine from the 14th century onwards developed through the combination of materials from Buddhist sūtras, Tibetan medical texts, aspects of indigenous shamanism, as well as Chinese medicine.55 The Thai medical corpus, the Study of Medicine (Phaetthayasaht songkhro), compiled in the mid-19th century based on earlier manuscripts, incorporated numerous Buddhist concepts and even attributed several of its constituent texts to Jīvaka Komārabhacca, legendary physician to the Buddha.56
These are only some scattered examples to illustrate the ongoing influence of Buddhism on medical traditions throughout Asia in the second millennium CE. Other historical traditions not mentioned here (Nepalese, Bhutanese, Burmese, Lao, etc.) are equally important chapters in this story. All of these Buddhist-influenced and -inspired traditions share important features: They all tend to revolve around the basic Indian medical doctrines of the Four Elements and the tridoṣa. They all understand the Elements to be affected by the fluctuations of the seasons, diet, regimen, environmental factors, and specific pharmaceutical interventions. They all integrate the fundamental Buddhist insight that mental wellbeing plays a major role in maintaining and regaining physical health, and advocate a variety of meditations and other contemplative practices to positively affect one’s health. They all accommodate aspects of Buddhist ritual, such as chanting of scripture, incantations and mantras, talismans and amulets, exorcisms, empowerments, binding rites, and consecrated water and medicines. They all look to certain Buddhist heroes or deities (Bhaiṣajyaguru, Avalokiteśvara, Jīvaka, particular monks, or the Buddha himself) as the source of their authority and transformative power. Finally, they all historically have been closely connected with monastic power structures, and to have been practiced, systematized, and written about by members of the sangha.
The many similarities between all of these traditions notwithstanding, it is critical to emphasize that there are also important discrepancies between them concerning the details of even the most basic doctrines. Taken as a whole, the received texts, archaeologically recovered manuscripts, and other extant historical evidence about these regional medical traditions tell us in no uncertain terms that Indian medical doctrines and practices circulated widely and were highly influential, and that Buddhism played a major role in their dissemination and popularization across Asia. However, differences between these traditions reflect both the diversity of the Buddhist transmissions as well as the regional variations in how knowledge was received and localized in different parts of Asia.
Modernizing and Globalizing Buddhist Medicine
More detailed discussion of the modernization of Buddhism itself in the colonial and post-colonial periods is beyond the scope of the current article. For our purposes, it is enough to note that—due both to contact with Western missionaries and colonial authorities, as well as to internal dynamics of modernization—this period saw the complete transformation of Buddhism in virtually every corner of the Asian continent. Likewise, both through contact with Western medical ideas and public health institutions, as well as through local developments, the very nature of what counted as “health” and “medicine” also changed significantly over the same period.57 These processes of modernization transformed the relationship between Buddhism and medicine in complex ways. Institutions specializing in Buddhist medicine continued to exist all over Asia in the modern period, but they each had to negotiate the fraught and changing relationships between Buddhist doctrines, traditional medical therapies, and the modern scientific worldview.58
These dynamics played out differently in different places. For example, dramatic transformations of Buddhism’s relationship with medicine took place in the context of Western influence and rapid industrialization in 19th century Japan. In the Mieji era (1868–1912), an unbridled enthusiasm for “Western learning” caused most Buddhist healing to be outlawed altogether. Penal codes passed in 1874 and 1907 proscribed incantations, prayers, talismans, holy water, and other rituals.59 In 1963, the Japanese supreme court relaxed the laws somewhat; however, Buddhist practices remained illegal if they replaced, rather than complemented, modern biomedical therapy. Meanwhile, in China, early 20th century reformers—especially those associated with the influential monk Taixu (1890–1947)—attempted to reinterpret the Dharma in order both to make it fit better with modern science while still providing an alternative to scientific materialism.60 In this environment, certain Buddhist ideas that seemed to fit with scientific theories were highlighted as “evidence” of the Buddha’s prescience and empiricism. The longstanding Buddhist notion that there were 84,000 tiny invisible creatures floating in every drop of water, for example, was marshaled as evidence that the Buddha had observed microbes thousands of years before the dawn of bacteriology. The same circle of reformers was also influential in refashioning Buddhist teachings on the nature of the mind in light of the emerging Western science of psychology.
Western colonization of Buddhist societies brought opportunities for Europeans to come in contact with Buddhist ideas. However, reports from the colonial era indicate that if Western explorers, merchants, and administrators were aware of Buddhist medicine, it neither garnered their respect nor their admiration. Western commentators most often mentioned monastic healers or therapies associated with Buddhism in the course of criticizing Asia’s idolatry, superstition, and backwardness.61 Serious, sustained interest in Buddhism did not take off until the last half of the 19th century, at which time various Asian religions began to be explored by Western “Orientalist” scholars, Theosophists, and other enthusiasts.62 Waves of Asian immigrants to Europe and the Americas in the 19th and 20th centuries also gave Westerners increasing opportunities for direct contact with Buddhist ideas and practices.63
Over the course of the late-19th to the mid-20th century, such modernizing interpreters of Buddhism began extracting the practice of meditation from its Buddhist institutional and doctrinal contexts, and recharacterizing it as a mental health practice that was compatible with scientific medicine and psychology.64 This process of cultural translation, which began with Asian apologists such as the abovementioned Taixu and the Burmese teacher Ledi Sayadaw,65 culminated in the standardized meditation protocol Mindfulness Based Stress Reduction (MBSR), created by the American John Kabat-Zinn in 1979 based on Buddhist models.66 Reams of clinical studies have now been published suggesting that MBSR and other meditation techniques derived from Buddhist practices can positively impact stress, addiction, and depression; increase memory and attention; slow the aging process; and improve one’s general sense of well-being.67 Aside from the scientific research, there has recently also been a meteoric rise in the number of popular media articles featuring the medical benefits of meditation.68 Indeed, many of the popular writings on Buddhism available at bookstores, in magazines, and online in the English language today explicitly highlight the health benefits of meditation as the chief (sometimes only) reason for taking up an interest in Buddhism.
In yet another loop of cross-cultural exchange, the international success of MSBR, the closely related Mindfulness Based Cognitive Therapy (MBCT), and other meditation systems that have been created in the West for therapeutic aims has now begun influencing the development of meditation workshops at Buddhist temples and meditation centers in Asia.69 There does remain an unsettled issue that is subject to much debate among scientists, psychologists, and Buddhists alike: To what extent do the Buddhist origins of a particular meditation practice matter, once it has been extracted from its original cultural and doctrinal context and has been fit into biomedical research models and other non-Buddhist institutional and ideological structures?70 Nevertheless, for the purposes of the current article, all of these developments can be considered examples of Buddhism’s ongoing implication in the circulation of medical ideas and practices into new cultural and social contexts.
The widespread global enthusiasm for the health benefits of meditation should not overshadow the fact that there remains a rich spectrum of other therapies that continue to enjoy popularity among Buddhist practitioners and devotees. Prayer, chanting, medicinal foods and herbs, subtle-body cultivation exercises, and the entire range of ritual prophylaxis and therapies continue to be routinely practiced among Buddhists in Asia and in the West alike.71 Sometimes, such practices are based on traditional models of the physical body built out of the Four Elements (or in East Asian contexts, out of qi). Sometimes, they are based on modern biomedical notions of the body composed of cells, chemicals, and DNA. More commonly, practitioners espouse hybrid understandings that combine Buddhist and scientific ideas in unique and idiosyncratic ways (such as the chanting of sūtras to lower cholesterol, for example, or visualizing one’s cardiologist to be an embodiment of Avalokiteśvara).72
In the past fifty years, a range of modernized forms of Buddhist medicine of various types have been promoted and spread by influential transnational groups. Buddhist organizations such as Sokka Gakkai International based in Japan, the Men-Tsee-Kang in the Tibetan diasporic community in India, the Shaolin Temple in China, various ministries of the government of Thailand, Lerab Ling in France, the Mind and Life Institute in the United States, and many more have been promoting certain ideas about health and healing to a range of international patients, practitioners, researchers, aficionados, tourists, and consumers. To take just one example, the Tzu-Chi Foundation is a global Buddhist charity and NGO founded in 1966 that is headquartered in Taiwan. Tzu-Chi specializes in providing healthcare to needy populations and those suffering in the wake of natural disasters. It has built hospitals and has organized mobile health clinics throughout Taiwan and at branch centers around the world, including in multiple sites in Latin America, the United States, and other Western countries. The medical care offered to patients at these facilities is thoroughly modern, biomedically sound, and unconnected with traditional Chinese or Indian medical thought, Buddhist or otherwise. At the same time, Buddhist values are the raison d’être of the organization, and Buddhist practice remains a major part of the organizational culture. Patients are invited to join in Dharma study groups and are also encouraged to make small daily donations in order to develop the Buddhist virtues of kindness and generosity.73 Organization officials and volunteers describe donations and volunteer service to the organization as a way of improving one’s karma, fulfilling one’s bodhisattva vows, and of becoming the “helping hands” of Avalokiteśvara.
Tzu-Chi is simply one example of a how Buddhist institutions have remained relevant to modern healthcare. Today, a number of Buddhist-inspired, Buddhist-influenced, and Buddhist-inflected forms of healing continue to be globally promoted by a range of transnational organizations and individual practitioners. All of this diversity, both historically and today, underscores the fact that we cannot take the term “Buddhist medicine” to be pointing to a specific set of doctrines or a particular view of the body. Nor is it a static or monolithic object of study. Buddhist medicine is a living tradition that is both centuries old and continually new. This perennially close relationship between Buddhism and medicine ensures that Buddhism continues to speak to one of humanity’s central concerns—our health—and also that it continues to exert a significant influence on healthcare practices wherever the religion is to be found.
Discussion of the Literature
By far the most prolific area of academic research related to Buddhist medicine has been clinical studies of meditation, which have exploded since the middle of the 20th century. Recently published metastudies represent the most accessible starting points for this literature. There are also several recently-published edited volumes that introduce the major clinical practices and discuss various issues that are central to this field.74
Research in other areas of Buddhist medicine has not succeeded in attracting a large number of scholars when compared with meditation—or, for that matter, with other subspecializations of Buddhist Studies such as philosophy or art. Nevertheless, in considering those publications that do exist, several “centers of gravity” can be identified. One area of interest is the ethnographic investigation of the nexus of Tibetan Buddhism, traditional Tibetan medicine, modern biomedical power structures, and the forces of globalization—particularly focused on how Tibetan practitioners and patients understand and navigate through these spaces.75 Another growing area of research concerns the overlap of Buddhist medicine and gender studies, specifically focusing on the development and circulation of Buddhist knowledge concerning embryology, obstetrics, and women’s medicine, as well as the role of women as healers in various forms of Buddhism.76 Finally, a cluster of recent articles and books has also focused on the history of Buddhist medicine in medieval East Asia prioritizing the translation and adaptation of Indian knowledge in China, as well as the local social and political contexts for the practice of Buddhist healing in both China and Japan.77
Despite these clusters, the existing literature on Buddhist medicine is at present largely fractured and unsynthesized.78 Most scientists studying the benefits of mindfulness and other meditation techniques lack the linguistic or disciplinary training to seriously investigate their original historical or doctrinal contexts. Scholars trained in religious studies and anthropology, on the other hand, tend to relate aspects of Buddhist medicine to a limited range of specialized issues within their own fields. Meanwhile, historians of medicine writing in Western languages have only rarely paid attention to Buddhism at all, and seem to have largely overlooked its importance as a catalyst for global medical exchange. In recent years, several conferences have taken place that have raised the profile of research on Buddhist medicine and have encouraged communication across these disciplinary divides.79 In addition, several edited volumes and special issues of journals have been published recently or are currently in production, which also aim to bring together scholars from across the spectrum to contribute to a more comparative and collaborative investigation of Buddhist medicine.80
Thus, it is fair to say that the study of Buddhist medicine is a promising area of inquiry, which only now is emerging as a cohesive field of research. While the bulk of the research has revolved around India, East Asia, and Tibet, particular countries that are especially underrepresented include Mongolia, Nepal, Korea, Laos, and Vietnam. Research has also tended to focus on either the ancient/medieval or the contemporary contexts, largely neglecting investigation of Buddhist medicine in the period in-between. Particularly notable omissions are studies of Buddhist medicine in the Mongol Empire, in late imperial China, or in premodern Southeast Asia. Also much needed is work on Buddhist influences on healthcare among Asian immigrants in Western countries.81 It is hoped that these topics will continue to attract interest and to receive support from an increasingly diverse scholarly community, so that some of these lacunae can begin to be addressed in the near future.
The author wishes to thank William McGrath for his comments on previous drafts of some sections of this article.
Primary sources are only infrequently available in English translation, so conducting research on Buddhist medicine beyond its modern Western forms requires command of at least one Asian language, and invariably requires familiarity with specialized terminology from both Buddhist and medical contexts. At present, there is only one publication that offers a wide selection of translated sources from across premodern Asia related to Buddhist medicine: an anthology recently published by the current author with Columbia University Press.82
Aside from that collection, several individual sources from the premodern period have been translated into English. These include translations of several major Buddhist scriptures or parts thereof (including the Bhaiṣajyaguru Sūtra, the Lotus Sūtra, the Vimalakīrti Sūtra, the Sūtra of Golden Light, and the Avataṃsaka Sūtra) that introduce medical deities and perspectives.83 Translations have also been done of important medical texts that circulated in Buddhist circles, including the Aṣṭāṅgahṛdaya-saṃhitā84 and the Siddhasāra,85 both of which were integrated into the Tibetan canon. Available translations also include several texts that remained unintegrated into the Buddhist canons but that attribute themselves to, quote extensively from, or otherwise bear witness to Buddhist medical knowledge. One significant example is the Bower Manuscript, a medical manual recovered from Buddhist sites on the Silk Road.86 Another is the Japanese compendium Essentials of Medicine (Ishimpō), which quotes Indian teachings on ethics, massage, recipes, and surgery.87 Several other medical compilations from East Asia also contain similar material.88 Also in this category is the aforementioned Casket of Medicine, from 13th-century Sri Lanka.89 See also a series of seminal works written or edited by Desi Sangyé Gyatso: his edition of the abovementioned Four Tantras;90 his Blue Beryl commentary on those tantras (which includes a set of seventy-nine painted thangkas illustrating the entirety of Tibetan medical culture);91 and Mirror of Beryl, his comprehensive history of medicine in Tibet (which in large part focuses on the important role of Buddhism in Tibetan medicine).92 A list of other translations available in Western languages can be found in the Oxford Bibliographies Online entry on “Buddhism: Medicine.”93
For researchers with adequate skills in Asian languages, the most accessible collections of premodern primary sources on Buddhist medicine are the standard collections of Buddhist writings. Well known to scholars of Buddhism, and readily available online, these include the Vipassana Research Institute’s Pāli canon available from the VRI website and Sutta Central;94 the Pāli and Sanskrit materials in the Göttingen Register of Electronic Texts in Indian Languages;95 the collections of East Asian sources made available online through the Chinese Buddhist Electronic Texts Association and the SAT Daizōkyō Text Database;96 and the Tibetan canons from the Tibetan Buddhist Resource Center and Columbia University’s American Institute of Buddhist Studies.97 A comparative display of Buddhist texts in Sanskrit, Chinese, Tibetan, English, and other languages is available in the Thesaurus Literaturae Buddhicae,98 and see also the multilingual collection of texts from the Silk Road on the International Dunhuang Project’s website.99 For readers of Chinese, a huge collection of texts published under the aegis of the Shaolin monastery claims to be a “complete” collection of relevant sources in that language.100
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Ṭhānissaro, Bhikkhu. The Buddhist Monastic Code II: The Khandhaka Training Rules Translated and Explained (2nd ed.). Valley Center, CA: Metta Forest Monastery, 2007.Find this resource:
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(1.) For an historical overview of the Buddhist canons, see Silk, Jonathan A., et al. Brill’s Encyclopedia of Buddhism: Volume 1, Literature and Languages (Leiden, The Netherlands: Brill, 2015). See also Daniel Veidlinger, “History of the Buddhist Canon,” Oxford Bibliographies Online: Buddhism, 2018.
(2.) David Fiordalis, “On Buddhism, Divination and the Worldly Arts: Textual Evidence from the Theravāda Tradition,” Indian International Journal of Buddhist Studies 15 (2014): 79–108. These rules seem to have been even stricter for nuns than they were for monks; see Amy Paris Langenberg, “Female Monastic Healing and Midwifery: A View from the Vinaya Tradition,” Journal of Buddhist Ethics 21 (2014): 152–187. See translations in C. Pierce Salguero, Buddhism and Medicine: An Anthology (New York: Columbia University Press, 2017), chs. 10–11.
(3.) See Joseph Mitsuo Kitagawa, “Buddhist Medical History,” in Healing and Restoring: Health and Medicine in the World’s Religious Traditions, ed. Lawrence E. Sullivan, 9–32 (New York and London: Macmillan, 1989); Kenneth G. Zysk, Asceticism and Healing in Ancient India: Medicine in the Buddhist Monastery (Delhi: Motilal Banarsidass, 1998), esp. 38–49; Bhikkhu Ṭhānissaro, The Buddhist Monastic Code II: The Khandhaka Training Rules Translated and Explained, 2nd ed. (Valley Center, CA: Metta Forest Monastery, 2007), ch. 5; Sylvain Mazars, Le bouddhisme et la médecine traditionnelle de l’Inde (Paris: Springer, 2008); Anālayo, “Healing in Early Buddhism,” Buddhist Studies Review 32, no. 1 (2015): 19–33; and Anālayo, Mindfully Facing Disease and Death: Compassionate Advice from Early Buddhist Texts (Cambridge, UK: Windhorse, 2016).
(4.) See, e.g., A. F. Rudolf Hoernle, Studies in the Medicine of Ancient India: Osteology, or, the Bones of the Human Body (New Delhi: Concept, 1984); and Jyotir Mitra, A Critical Appraisal of Ayurvedic Material in Buddhist Literature with Special Reference to Tripitaka (Varanasi: Jyotiralok Prakashan, 1985).
(5.) Accessible overviews of the doctrines of elements and related concepts is available in Mitra, Critical Appraisal; Paul Demiéville, Buddhism and Healing: Demiéville’s Article ‘Byō’ from Hōbōgirin, trans. Mark Tatz (Lanham, MD: University Press of America, 1985 ).
(6.) On the historical emergence and development of tridoṣa in early India, see Hartmut Scharfe, “The Doctrine of the Three Humors in Traditional Indian Medicine and the Alleged Antiquity of Tamil Siddha Medicine,” Journal of the American Oriental Society 119, no. 4 (1999): 609–629.
(7.) See, e.g., Zysk, Asceticism and Healing, 73–83; and Ṭhānissaro, Buddhist Monastic Code, ch. 5. The medical section of the Pāli Vinaya is translated in full in I. B. Horner, The Book of the Discipline (Vinaya-Piṭaka), vol. 4 (Oxford: Pali Text Society, 2000), 269–350. See also translation of the medical section of the vinaya of the Mahīśāsaka school in Salguero, Anthology, ch. 13.
(8.) See, e.g., Zysk, Asceticism and Healing, 84–116; Horner, Book of Discipline, 431–434; Koichi Shinohara, “The Moment of Death in Daoxuan’s Vinaya Commentary,” in The Buddhist Dead: Practices, Discourses, Representations, eds. Bryan J. Cuevas and Jacqueline Stone (Honolulu: University of Hawai‘i Press, 2007); and Salguero, Anthology, chs. 18–20.
(9.) See, e.g., Phyllis Granoff, “The Buddha as the Greatest Healer: The Complexities of a Comparison,” Journal Asiatique 299, no. 1 (2011): 5–22; sections of Anālayo, Mindfully Facing Disease; Salguero, Anthology, ch. 17.
(10.) See, e.g., Gregory Schopen’s discussion of the Gilgit manuscripts in Schopen, “The Bhaiṣajyaguru-Sūtra and the Buddhism of Gilgit” (PhD diss., Australian National University, 1978); and Salguero, Anthology, ch. 20—although, note Schopen’s cautions against presuming that the Bhaiṣajyaguru cult was important for the practice of healing or medicine in India.
(11.) See discussion of this literature in Paul Demiéville, Buddhism and Healing; C. Pierce Salguero, Translating Buddhist Medicine in Medieval China (Philadelphia: University of Pennsylvania Press, 2014), esp. 67–95; C. Pierce Salguero, “A Missing Link in the History of Chinese Medicine: Research Note on the Medical Contents of the Taishō Tripiṭaka,” East Asian Science, Medicine, and Technology 47 (2018).
(12.) Specifically on Sanskrit medical texts in the Tibetan Canon, see Vaidya Bhagwan Dash, Tibetan Medicine: With Special Reference to Yoga Śataka (Dharamsala: Library of Tibetan Works & Archives, 1985).
(13.) See, e.g., C. Pierce Salguero, “Fields of Merit, Harvests of Health: Some Notes on the Role of Medical Karma in the Popularization of Buddhism in Early Medieval China,” Asian Philosophy 23, no. 4 (2013): 341–349; and Salguero, “Healing and/or Salvation? The Relationship Between Religion and Medicine in Medieval Chinese Buddhism” (Working Paper Series of the HCAS “Multiple Secularities—–Beyond the West, Beyond Modernities”), 4 (2018).
(14.) See, e.g., Raoul Birnbaum, The Healing Buddha (Boulder, CO: Shambhala, 1989); Birnbaum, “Chinese Buddhist Traditions of Healing and the Life Cycle,” in Healing and Restoring: Health and Medicine in the World’s Religious Traditions, ed. Lawrence E. Sullivan (New York: Macmillan, 1989); Salguero, Translating Buddhist Medicine, 35–36, 82–86, 128–133; and Salguero, Anthology, esp. chs. 25, 26, 31.
(15.) A range of these so-called esoteric practices related to healing is described in Edward L. Davis, Society and the Supernatural in Song China (Honolulu: University of Hawai‘i Press, 2001); Michel Strickmann, Chinese Magical Medicine (Stanford, CA: Stanford University Press, 2002); Richard D. McBride II, “Esoteric Buddhism and its Relation to Healing and Demonology,” in Esoteric Buddhism and the Tantras in East Asia, eds. Charles D. Orzech, Henrik H. Sørensen, and Richard K. Payne (Leiden, The Netherlands: Brill, 2011), 208–214; and Benedetta Lomi, “Dharanis, Talismans, and Straw-Dolls: Ritual Choreographies and Healing Strategies of the Rokujikyōhō in Medieval Japan,” Japanese Journal of Religious Studies 41, no. 2 (2014): 255–304. See also translations in Salguero, Anthology, esp. chs. 27–30, 32, 33, 35.
(16.) A general introduction to the emergence of Tantra in India and its spread abroad is available in Geoffrey Samuel, Origins of Yoga and Tantra: Indic Religions to the Thirteenth Century (Cambridge, UK: Cambridge University Press). Tantric forms of Buddhist healing are briefly mentioned in Michael Slouber, Early Tantric Medicine (New York: Oxford University Press, 2016); and discussed in more detail in Vesna A. Wallace, The Inner Kālacakratantra: A Buddhist Tantric View of the Individual (Oxford: Oxford University Press, 2001).
(17.) On subtle-body practices in Buddhism, see especially Kurtis R. Schaeffer, “The Attainment of Immortality: From Nathas in India to Buddhists in Tibet,” Journal of Indian Philosophy 30 (2002): 515–533; Ian A. Baker, “Embodying Enlightenment: Physical Culture in Dzogchen as Revealed in Tibet’s Lukhang Murals,” Asian Medicine: Tradition and Modernity 7, no. 1 (2012): 225–264; Barbara Gerke, “On the ‘Subtle Body’ and ‘Circulation’ in Tibetan Medicine,” in Religion and the Subtle Body in Asia and the West, ed. Geoffrey Samuel and Jay Johnston (New York: Routledge, 2013); and Janet Gyatso, Being Human in a Buddhist World: An Intellectual History of Medicine in Early Modern Tibet (New York: Columbia University Press, 2015), 193–249. See also translations in Salguero, Anthology, ch. 40–42.
(18.) See, e.g., Frances Garrett, “The Alchemy of Accomplishing Medicine (sman sgrub): Situating the Yuthok Heart Essence (G.yu thog snying thig) in Literature and History,” Journal of Indian Philosophy 37 (2009): 207–230. See discussion and translation of chülen practice in Salguero, Anthology, ch. 42.
(19.) The term is particularly prevalent in East Asia (Ch. foyi 佛醫, fojiao yixue 佛教醫藥; Jp. bukkyō igaku 仏教医学). See discussion of the history of the term and its precedents in C. Pierce Salguero, “Reexamining the Categories and Canons of Chinese Buddhist Healing,” Journal of Chinese Buddhist Studies 28 (2015): 35–66. Also cf. Janet Gyatso’s objections to my use of the term in her review of my 2014 book in History of Religions 57, no. 1 (2017): 96–99.
(20.) This article will not take up the task of rigorously defining the word “medicine,” or of distinguishing it from “healing” or other similar words. My basic position is that any approach to human health whose doctrines and practices are systematically articulated, codified, and institutionalized is worthy of the label “medicine,” regardless of however unscientific it may appear from the modern perspective. Buddhist approaches to health and healing satisfy all of these criteria.
(21.) See, discussion in Demiéville, Buddhism and Healing, 65–76; Natalie Köhle, “A Confluence of Humors: Āyurvedic Conceptions of Digestion and the History of Chinese ‘Phlegm’ (tan 痰),” Journal of the American Oriental Society 136, no. 3 (2016): 465–493; Salguero, Anthology, ch. 4.
(22.) For a comparison of Greek and Indian understandings of the Elements, see Thomas McEvilley, The Shape of Ancient Thought: Comparative Studies in Greek and Indian Philosophies (New York: Allworth Press, School of Visual Arts, 2002), 300–309.
(23.) On subtle-body traditions in non-Buddhist India, see especially David Gordon White, The Alchemical Body: Siddha Traditions in Medieval India (Chicago: University of Chicago Press, 1996); Kenneth G. Zysk, “The Bodily Winds in Ancient India Revisited,” Journal of the Royal Anthropological Institute N.S. 13, Suppl. 1 (2007): 105–115; and Samuel, Origins of Yoga and Tantra. The evidence for historical connections with China is summarized and evaluated in the latter on pp. 278–285.
(24.) See Jason Neelis, Early Buddhist Transmission and Trade Networks: Mobility and Exchange Within and Beyond the Northwestern Borderlands of South Asia (Leiden, The Netherlands: Brill, 2011).
(25.) See, e.g., Ann Heirman and Stephan Peter Bumbacher, eds., The Spread of Buddhism (Leiden, The Netherlands: Brill, 2007); and John R. McRae and Jan Nattier, eds., “Buddhism Across Boundaries: The Interplay of Indian, Chinese, and Central Asian Source Materials,” Sino-Platonic Papers 222 (2012).
(26.) See Arthur F. Wright, “Fo-tu-têng: A Biography.” Harvard Journal of Asiatic Studies 11, no. 3–4 (1948): 312–371; entries in Fu Fang 傅芳 and Ni Qing 倪靑, eds., Zhongguo foyi renwu xiaozhuan 中囯佛医人物小传 (Xiamen, China: Lujiang chubanshe, 1996); C. Pierce Salguero, “‘A Flock of Ghosts Bursting Forth and Scattering’: Healing Narratives in a Sixth-Century Chinese Buddhist Hagiography,” East Asian Science Technology & Medicine 32 (2010): 89–120; Salguero, Translating Buddhist Medicine, 133–139; and Salguero, Anthology, ch. 21.
(27.) See Lin Li-kuang, “Puṇyodaya (Na-Ti), un propagateur du tantrisme en Chine et au Cambodge, à l’époque de Hiuan-Tsang,” Journal Asiatique 227 (1935): 83–97; and Tansen Sen, “In Search of Longevity and Good Karma: Chinese Diplomatic Missions to Middle India in the Seventh Century,” Journal of World History 12, no. 1 (2001): 1–28; certain entries in Fu and Ni, Zhongguo foyi renwu xiaozhuan.
(28.) C. Pierce Salguero, “Toward a Global History of Buddhism and Medicine,” Buddhist Studies Review 32, no. 1 (2015): 41–42.
(29.) Translations of this text are available in Li Rongxi, Buddhist Monastic Traditions of Southern Asia: A Record of the Inner Law Sent Home from the South Seas (Berkeley, CA: Numata Center, 2000); see esp. chs. 27–29, newly translated in Salguero, Anthology, ch. 16.
(30.) On Dunhuang, see Rong Xinjiang, Eighteen Lectures on Dunhuang (Leiden, The Netherlands: Brill, 2013); Susan Whitfield, Life Along the Silk Road, 2nd ed. (Berkeley: University of California Press, 2015); and Valerie Hansen, The Silk Road: A New History with Documents (New York: Oxford University Press, 2016).
(31.) For discussion of Buddhist medicine at Dunhuang, see Chen Ming, Dunhuang chutu huhua yidian “Qipo shu” yanjiu (Hong Kong: Xinwenfeng chuban, 2005); and Catherine Despeux, “Institutions médicales et thérapeutes à Dunhuang et à Turfan,” in Médecine, religion, et société dans la Chine médiévale: Étude de manuscrits chinois de Dunhuang et de Turfan, ed. Catherine Despeux (Paris: Collège de France, Institut des Hautes Études Chinoises, 2010). See translations of Dunhuang texts related to Buddhism and medicine in Salguero, Anthology, chs. 29, 31, 44, 47. Dunhuang manuscripts related to Chinese medicine are discussed in Medieval Chinese Medicine: The Dunhuang Medical Manuscripts, eds. Vivienne Lo and Christopher Cullen (London: RoutledgeCurzon, 2005). Many of these texts are available digitally at the International Dunhuang Project’s website.
(32.) On trade, see Xinru Liu, Ancient India and Ancient China: Trade and Religious Exchanges, AD 1–600 (Delhi: Oxford University Press, 1991 ); Wang Gungwu, The Nanhai Trade: The Early History of Chinese Trade in the South China Sea (Singapore: Times Academic Press, 1998 ); and Annette L. Juliano and Judith A. Lerner, Nomads, Traders and Holy Men Along China’s Silk Road (Turnhout, Belgium: Brepols, 2002).
(33.) Such competitions are described in Davis, Society and the Supernatural; Strickmann, Chinese Magical Medicine; Christine Mollier, Buddhism and Taoism Face to Face: Scripture, Ritual, and Iconographic Exchange in Medieval China (Honolulu: University of Hawai‘i Press, 2008); and Salguero, Translating Buddhist Medicine.
(34.) See overview of Buddhist Medicine in China and Japan in C. Pierce Salguero, “Buddhism & Medicine in East Asian History,” Religion Compass 8, no. 8 (2014): 239–250. More detailed examples are discussed in, e.g., Donald Baker, “Monks, Medicine, and Miracles: Health and Healing in the History of Korean Buddhism,” Korean Studies 18 (1994): 50–75; Davis, Society and the Supernatural; Strickmann, Chinese Magical Medicine; Edward R. Drott, “Gods, Buddhas, and Organs: Buddhist Physicians and Theories of Longevity in Early Medieval Japan,” Japanese Journal of Religious Studies 37, no. 2 (2010): 247–273; Christoph Kleine and Katja Triplett, eds. Special Issue: “Religion and Healing in Japan,” Japanese Religions 37, no. 1–2 (2012); Chen Ming, Zhonggu yiliao yu wailai wenhua (Beijing: Peking University Press, 2013); Benedetta Lomi, “Dharanis, and Straw-Dolls: Ritual Choreographies and Healing Strategies of the Rokujikyōhō in Medieval Japan,” Japanese Journal of Religious Studies 4, no. 1–2 (2014): 255–304; Salguero, Translating Buddhist Medicine; Stephen R. Teiser, Yili yu fojiao yanjiu (Ritual and the Study of Buddhism), forthcoming; and Stephen R. Teiser, Curing with Karma: Healing Liturgies in Early Chinese Buddhism, forthcoming.
(35.) For the Japanese context, see Yui Suzuki, Medicine Master Buddha: The Iconic Worship of Yakushi in Heian Japan (Leiden, The Netherlands: Brill, 2012).
(36.) Salguero, “Fields of Merit”; and Teiser, Curing with Karma.
(37.) On Buddhist charities, including medical charities, in East Asia, see Kenneth Ch’en, The Chinese Transformation of Buddhism (Princeton, NJ: Princeton University Press, 1973), 158–171, 294–303; Demiéville, Buddhism and Healing, 57–60; Whalen W. Lai, “Chinese Buddhist and Christian Charities: A Comparative History,” Buddhist-Christian Studies 12 (1992): 5–33; Jacques Gernet, Buddhism in Chinese Society: An Economic History from the Fifth to the Tenth Centuries, trans. Franciscus Verellen (New York: Columbia University Press, 1995 ), 217–227; and Nathan Sivin, Science and Civilisation in China, vol. 6.6 “Medicine” (Cambridge, UK: Cambridge University Press, 2000), 54–55.
(38.) Influences on Chinese medicine are discussed in, e.g., Vijaya Deshpande, “Indian Influences on Early Chinese Ophthalmology: Glaucoma as a Case Study,” Bulletin of the School of Oriental and African Studies 62, no. 2 (1999): 306–322; Deshpande, “Ophthalmic Surgery: A Chapter in the History of Sino-Indian Medical Contacts.” Bulletin of the School of Oriental and African Studies 63, no. 3 (2000): 370–388; Deshpande, “Nāgārjuna and Chinese Medicine.” Stvdia Asiatica 4–5 (2003–2004): 241–257; Chen Ming, “Zhuan nü wei nan: Turning Female to Male, an Indian Influence on Chinese Gynaecology?” Asian Medicine 1, no. 2 (2005): 315–334; Chen Ming, “The Transmission of Foreign Medicine via the Silk Roads in Medieval China: A Case Study of the Haiyao bencao,” Asian Medicine 3, no. 2 (2007): 241–264; Deshpande, “Glimpses of Āyurveda in Medieval Chinese Medicine,” Indian Journal of History of Science 43, no. 2 (2008): 137–161; and Vijaya Deshpande and Fan Ka-wai, Restoring the Dragon’s Vision: Nagarjuna and Medieval Chinese Ophthalmology (Hong Kong: City University of Hong Kong, 2012).
(39.) See overview of the field in Theresia Hofer, ed., Bodies in Balance: The Art of Tibetan Medicine (Seattle: Rubin Museum of Art and University of Washington Press, 2014).
(40.) These are outlined in Dash, Tibetan Medicine, 9–16.
(41.) See history of the text in Todd Fenner, “The Origin of the rGyud bzhi: A Tibetan Medical Tantra,” in Tibetan Literature: Studies in Genre, ed. José Ignacio Cabezon and Roger R. Jackson (Ithaca, NY: Snow Lion, 1996), 458–469; Kurtis R. Schaeffer, “Textual Scholarship, Medical Tradition, and Mahayana Buddhist Ideals in Tibet,” Journal of Indian Philosophy 31 (2003): 621–641; Frances Garrett, “Buddhism and the Historicising of Medicine in Thirteenth-Century Tibet,” Asian Medicine 2, no. 2 (2006): 204–224; Yang Ga, “The Origins of the Four Tantras and Account of its Author, Yuthog Yonten Gonpo,” in Bodies in Balance, ed. Hofer, 154–177; and Gyatso, Being Human in a Buddhist World, 143–191.
(42.) On the eclecticism of Tibetan medicine more generally, see also Ronit Yoeli-Tlalim, “Central Asian Mélange: Early Tibetan Medicine from Dunhunag,” in Scribes, Texts, and Rituals in Early Tibet and Dunhuang, ed. Brandon Dotson, Kazushi Iwao, and Tsuguhito Takeuchi (Wiesbaden: Reichert Verlag, 2013), 53–60.
(43.) On the debates over the text’s authorship, see Gyatso, Being Human in a Buddhist World, 143–192; and Salguero, Anthology, ch. 42.
(44.) Johannes Elverskog, Buddhism and Islam on the Silk Road (Philadelphia: University of Pennsylvania Press, 2010).
(45.) On the influence of Islamic medicine in the eastern parts of Asia, see, e.g., Paul D. Buell, “How did Persian and Other Western Medical Knowledge Move East, and Chinese West?: A Look at the Role of Rashīd al-Dīn and Others,” Asian Medicine: Tradition and Modernity 3, no. 1 (2007): 279–295; Carla Nappi, “Bolatu’s Pharmacy Theriac in Early Modern China,” Early Science and Medicine 14 (2009): 737–764; Dan Martin, “Greek and Islamic Medicines’ Historical Contact with Tibet: A Reassessment in View of Recently Available but Relatively Early Sources on Tibetan Medical Eclecticism,” in Islam and Tibet, Interactions along the Musk Route, eds. Anna Akasoy, Charles Burnett, and Ronit Yoeli-Tlalim (Aldershot, Hants: Ashgate, 2010), 117–143; Andrew Edmund Goble, Confluences of Medicine in Medieval Japan: Buddhist Healing, Chinese Knowledge, Islamic Formulas, and Wounds of War (Honolulu: University of Hawai‘i Press, 2011), 46–66; and Ronit Yoeli-Tlalim, “Galen in Asia?,” in Brill’s Companion to the Reception of Galen, ed. Petros Bouras-Vallianatos and Barbara Zipser (Leiden, The Netherlands: Brill, 2018).
(46.) Tansen Sen, Buddhism, Diplomacy, and Trade: The Realignment of Sino-Indian Relations, 600–1400 (Honolulu: Association for Asian Studies and University of Hawai‘i Press, 2003); and Christopher I. Beckwith, Empires of the Silk Road: A History of Central Eurasia from the Bronze Age to the Present (Princeton, NJ: Princeton University Press, 2009), 140–162.
(47.) See Goble, Confluences of Medicine; Stacey A. Van Vleet, Medicine, Monasteries and Empire: Tibetan Buddhism and the Politics of Learning in Qing China (PhD diss., Columbia University, 2015); and Salguero, Anthology, ch. 57; C. Michele Thompson’s ongoing work in progress on the Vietnamese monk-physician Tue Tinh.
(48.) Salguero, Translating Buddhist Medicine, 141–148.
(49.) See, e.g., Yi-Li Wu, “The Bamboo Grove Monastery and Popular Gynecology in Qing China,” Late Imperial China 21, no. 1 (2000): 41–76; Chen Yunü, “Buddhism and the Medical Treatment of Women in the Ming Dynasty: A Research Note,” Nan Nü 10 (2008): 279–303; and Duncan Ryūken Williams, The Other Side of Zen: A Social History of Sōtō Zen Buddhism in Tokugawa Japan (Princeton, NJ: Princeton University Press, 2005), 86–116. See also translations in Salguero, Anthology, chs. 55 and 56.
(50.) See, inter alia, essays in Mona Schrempf, Soundings in Tibetan Medicine: Anthropological and Historical Perspectives (Leiden, The Netherlands: Brill, 2007), 345–426; Olaf Czaja, “On the History of Refining Mercury in Tibetan Medicine,” Asian Medicine: Tradition and Modernity 8, no. 1 (2013): 75–105; and Hofer, Bodies in Balance, 178–245.
(51.) Gyatso, Being Human in a Buddhist World; and Gyatso, “The Authority of Empiricism and the Empiricism of Authority: Medicine and Buddhism in Tibet on the Eve of Modernity,” Comparative Studies of South Asia, Africa and the Middle East 24, no. 2 (2004): 83–96.
(52.) Gyatso, Being Human in a Buddhist World; and Salguero, Anthology, ch. 62.
(53.) Kieth Rethy Chhem, “Bhaisajyaguru and Tantric Medicine in Jayavarman VII Hospitals,” Siksācakr: Journal of the Center for Khmer Studies 7 (2005): 8–18; Chhem, “La médecine au service du pouvoir angkorien: Universités monastiques, transmission du savoir et formation médicale sous le règne de Jayavarman VII (118–1220 A.D.),” Canadian Journal of Buddhist Studies 3 (2007): 95–124; and Claude Jacques, “Les édites des hôpitaux de Jayavarman VII,” Études Cambodgiennes 13 (1968): 14–17. See also translation of Jayavarman’s edict in Salguero, Anthology, ch. 24.
(54.) Liyanaratne, Jindasa, “Buddhism and Traditional Medicine in Sri Lanka,” Pacific World new series 11 (1995–1996): 124–142; and Liyanaratne, Buddhism and Traditional Medicine in Sri Lanka (Dalugama, Kelaniya: Kelaniya University Press, 1999).
(55.) Vesna A. Wallace, “The Method-and-Wisdom Model of the Medical Body in Traditional Mongolian Medicine,” Arc—The Journal of the Faculty of Religious Studies, McGill University 40 (2012): 1–22.
(56.) The compilation of the Thai medical canon is discussed in Jean Mulholland, Medicine, Magic, and Evil Spirits (Canberra: Australian National University, 1987), 7–19. In addition, see the newly available Digital Library of Northern Thai Manuscripts. An overview of Thai medicine is presented in C. Pierce Salguero, Traditional Thai Medicine: Buddhism, Animism, Yoga, Ayurveda, rev. ed. (Bangkok: White Lotus Press, 2016). For list of titles in the Thai medical canon, see 101–102; for the history of their compilation, see 15–17; on Jīvaka’s role as a patriarch and spiritual guide in Thai medicine, see 33–40. On the latter, see also C. Pierce Salguero, “Honoring the Teachers, Constructing the Tradition: The Role of History and Religion in the Waikrū Ceremony of a Thai Traditional Medicine Hospital,” in Shaping Practitioners and Fashioning Health Citizenship: Medicine and Health in Southeast Asia, eds. Hans Pols, Michele Thompson, and John Harley Warner (Singapore: National University of Singapore Press, forthcoming). On Jīvaka outside of Thailand, see Zysk, Asceticism and Healing, 52–61, 120–127; and C. Pierce Salguero, “The Buddhist Medicine King in Literary Context: Reconsidering an Early Medieval Example of Indian influence on Chinese Medicine and Surgery,” History of Religions 48, no. 3 (2009): 183–210.
(57.) For overviews of Buddhist modernism, see David L. McMahan, The Making of Buddhist Modernism (New York: Oxford University Press, 2008); and McMahan, ed., Buddhism in the Modern World (Abingdon: Routledge, 2012). Some influential works on the modernization of Asian medicine include, inter alia, Bridie J. Andrews, The Making of Modern Chinese Medicine, 1860–1960 (Vancouver: University of British Columbia Press, 2014); Vincanne Adams, Mona Schrempf, and Sienna R. Craig, Medicine Between Science and Religion: Explorations on Tibetan Grounds (New York: Berghhan, 2010); and Kavita Sivaramakrishnan, Old Potions, New Bottles: Recasting Indigenous Medicine in Colonial Punjab (1850–1945) (New Delhi: Orient Longman, 2006).
(58.) See discussion and translation of relevant materials in C. Pierce Salguero, Buddhism and Medicine: An Anthology of Modern and Contemporary Sources (New York: Columbia University Press, forthcoming).
(59.) Jason Ananda Josephson, “An Empowered World: Buddhist Medicine and the Potency of Prayer in Meiji Japan,” in Deus in Machina: Religion, Technology, and the Things in Between, ed. J. Stolow (New York: Fordham University Press, 2010).
(60.) Erik J. Hammerstrom, The Science of Chinese Buddhism: Early Twentieth-Century Engagements (New York: Columbia University Press, 2015).
(61.) Good examples of this type of literature can be seen in Keith Norman MacDonald, The Practice of Medicine Among the Burmese: Translated from Original Manuscripts with an Historical Sketch of the Progress of Medicine from the Earliest Times (Edinburgh: MacLachlan and Stewart, 1879); Dan Beech Bradley “Siamese Practice of Medicine (1865 Bangkok Caledar).” Reprinted in Sangkhomsat Parithat 5, no. 3 (1967): 83–94; E. A. Sturge, “Siamese Theory and Practice of Medicine,” Philadelphia Medical Times, 18 October 1884; and C. Beyer, “About Siamese Medicine,” Journal of the Siam Society 4, no. 1 (1907): 1–9.
(62.) See, e.g., Stephen R. Prothero, The White Buddhist: The Asian Odyssey of Henry Steel Olcott (Bloomington: Indiana University Press, 1996); Paul G. Hackett, Theos Bernard, the White Lama: Tibet, Yoga, and American Religious Life (New York: Columbia University Press, 2013); and Joseph Cheah, Race and Religion in American Buddhism: White Supremacy and Immigrant Adaptation (New York: Oxford University Press, 2011), 19–35.
(63.) Ronald Takaki, A History of Asian Americans: Strangers from a Different Shore (Boston: Little, Brown, 1989); Sucheng Chan, Asian Americans: An Interpretive History (Boston: Twayne, 1991); and Cheah, Race and Religion, esp. 80–92.
(64.) Although the general outlines of this story have been told in several places, see in particular Jeff Wilson, Mindful America: The Mutual Transformation of Buddhist Meditation and American Culture (New York: Oxford University Press, 2014). The main author to have engaged in depth with the role of health in the Western reinvention of Buddhism in the 19th-and early 20th-century Unites States is Wakoh Shannon Hickey. See her dissertation, “Mind Cure, Meditation, and Medicine: Hidden Histories of Mental Healing in the United States” (Duke University, 2008); revised and expanded in her forthcoming book Mind Cure: How Meditation Became Medicine (Oxford University Press).
(65.) On Taixu, see Erik Hammerstrom, Science of Chinese Buddhism; on Ledi Sayadaw, see Erik Braun, The Birth of Insight: Meditation, Modern Buddhism, and the Burmese Monk Ledi Sayadaw (Chicago: University of Chicago Press, 2013).
(66.) Wilson, Mindful America, 78–84.
(67.) Wilson, Mindful America, 95–103. A keyword search for “mindfulness” on the U.S. National Institutes of Health’s database, PubMed, conducted on February 28, 2017 retrieved 4054 results. Recent metastudies providing overviews of meditation research are available in M. de Vibe, A. Bjørndal, E. Tipton, et al., “Mindfulness based stress reduction (MBSR) for improving health, quality of life and social functioning in adults,” Campbell Systematic Reviews (2012): 3; Madhav Goyal, Sonal Singh, Erica M. S. Sibinga, et al. Meditation Programs for Psychological Stress and Well-Being, Comparative Effectiveness Review no. 124 (Rockville, MD: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services, 2014). See also Fabrizio Didonna, ed., Clinical Handbook of Mindfulness (New York: Springer, 2008); and Kirk Warren Brown, J. David Creswell, and Richard M. Ryan, eds., Handbook of Mindfulness: Theory, Research, and Practice (New York: Guilford Press, 2015). A range of critiques and discussions of mindfulness from humanities and social science perspectives is collected in J. Mark G. Williams and Jon Kabat-Zinn, eds., Special Issue: “Mindfulness: Diverse Perspectives on its Meaning, Origins, and Multiple Applications at the Intersection of Science and Dharma,” Contemporary Buddhism 12 (2011); and Ronald E. Purser, David Forbes, Adam Burke, eds., Handbook of Mindfulness: Culture, Context, and Social Engagement (Springer, 2016).
(68.) Wilson, Mindful America, 104–158. A recent Google search for “Buddhist health” retrieved 31 million results, a clear indication of the mass popularity of this subject. Search conducted February 28, 2017.
(69.) For evidence of the spread of mindfulness in Asia, one only has to Google the keyword “MSBR” or “MBCT” plus the name of any major Asian city. The influence of Western models on Buddhist organizations and trainings in Asia has been explored in Ryan Bongseok Joo, “Countercurrents from the West: ‘Blue-Eyed’ Zen Masters, Vipassanā Meditation, and Buddhist Psychotherapy in Contemporary Korea,” Journal of the American Academy of Religion 79, no. 3 (2011): 614–638.
(70.) Such issues are raised in Wilson, Mindful America, 84–95; and Ira P. Helderman, “Drawing the Boundaries between ‘Religion’ and ‘Secular’ in Psychotherapists’ Approaches to Buddhist Traditions in the United States,” Journal of the American Academy of Religion 84, no. 4 (2016): 937–972; and countless articles and blog posts in popular outlets such as Lion’s Roar, the Huffington Post, and elsewhere where mindfulness is a frequent topic of discussion.
(71.) Specifically on the United States, see, e.g., Hongyu Wu, “Buddhism, Health, and Healing in a Chinese Community” (2002); P. D. Numrich, “Complementary and Alternative Medicine in America’s ‘Two Buddhisms,’” in Religion and Healing in America, ed. Linda L. Barnes and Susan S. Sered (Oxford and New York: Oxford University Press, 2005); and M. Baumann, “Protective Amulets and Awareness Techniques, or How to Make Sense of Buddhism in the West,” in Westward Dharma: Buddhism Beyond Asia, ed. C. S. Prebish and M. Baumann (Berkeley: University of California Press, 2006). The current author has a research project underway cataloging the practice of Buddhist medicine at several dozen temples in the city of Philadelphia; see http://www.jivaka.net.
(72.) Source: interviews with Buddhist medical practitioners and patients in Thailand, Korea, and the United States, conducted by the author 2012–2016.
(73.) Source: interview with representatives of Tzu-Chi, conducted by the author on July 29, 2015.
(74.) See citations in note 67.
(75.) The scholars who have most actively contributed to this area include Vincanne Adams, Sienna Craig, Stephan Kloos, Mona Schrempf, Geoffrey Samuel.
(76.) The scholars who have most actively contributed to this area include Anna Andreeva, Frances Garrett, Robert Kritzer, Amy Paris Langenberg, and Benedetta Lomi.
(77.) The scholars who have most actively contributed to this area include Catherine Despeux, Edward Drott, Andrew Goble, Stephen R. Teiser, Katja Triplett, and the present author.
(78.) A forthcoming work by the present author, tentatively titled Buddhism and Medicine: A Global History, maps out the state of the research on Buddhist medicine globally and stitches these pieces together into a coherent narrative. The current article is essentially a summary of that project. See also Salguero, “Toward a Global History,” which lays some of the groundwork.
(79.) These have included meetings in Tangshan, China (organized by the University of British Columbia and People’s University of China in 2009), at the University of California, Berkeley (organized by the Center for Buddhist Studies in 2012), at the Donghwasa Temple in Daegu, Korea (organized by Columbia University in 2013), at the University of Leeds (organized by the United Kingdom Association of Buddhist Studies in 2014), and at the University of British Columbia (organized by the Program in Buddhism and Contemporary Society in 2015).
(80.) See Kleine and Triplett, Religion and Healing in Japan; both volumes of Salguero, Anthology; and C. Pierce Salguero and William A. McGrath, eds., Special Issue: “Buddhism and Healing in East Asia,” Asian Medicine: Journal of the International Association for the Study of Traditional Asian Medicine 12, no. 1/2 (2017).
(81.) On the latter, see citations in note 71, and C. Pierce Salguero (ed.), Varieties of Buddhist Healing in Multiethnic Philadelphia. 2018.
(82.) Salguero, Anthology. The second volume is forthcoming at the time of this writing.
(83.) See Raoul Birnbaum, The Healing Buddha (Boulder: Shambhala, 1989); Burton Watson, trans., The Lotus Sutra (New York: Columbia University Press, 1993), 280–289; Watson, trans., The Vimalakirti Sutra (New York: Columbia University Press, 1997), 64–74; R. E. Emmerick, The Sūtra of Golden Light (Suvarṇabhāsottamasūtra), 3rd ed. (Oxford: Pali Text Society, 2004), 75–80; Prods Oktor Skjaervø, This Most Excellent Shine of Gold, King of Kings of Sutras: The Khotanese Suvarṇabhāsottamasūtra (Cambridge, MA: Harvard University Department of Near Eastern Languages and Civilizations, 2004), 287–301; and Salguero, Anthology, chs. 4 and 9.
(84.) Partial translations are found in Dominik Wujastyk, The Roots of Ayurveda (London: Penguin Books, 2003), 193–251; and Claus Vogel, Vāgbhata’s Aṣṭāngahṛdayasaṃhitā: The First Five Chapters of Its Tibetan Version (Wiesbaden: Franz Steiner, 1965). A full translation of somewhat less scholarly quality is found in K. R. S. Murthy, Vagbhata’s Astanga Hrdayam: Text, English Translation, Notes, Appendix and Indices (Varanasi: Krishnadas Academy Oriental Publishers, 2000).
(85.) See full translation in R. E. Emmerick, The Siddhasāra of Ravigupta (Wiesbaden: Steiner, 1982).
(86.) Full translation in A. F. Rudolf Hoernle, The Bower Manuscript (New Delhi: Aditya Prakasha, 1987); partial translation in Wujastyk, Roots of Ayurveda, 147–60.
(87.) Partially translated in Emil Hsia, Ilza Veith, and Robert Geertsma, The Essentials of Medicine in Ancient China and Japan: Yasuyori Tamba’s Ishimpo (Leiden, The Netherlands: Brill, 1986).
(88.) See translations in Salguero, Buddhism and Medicine, chs. 52–55. See also Deshpande and Fan, Restoring the Dragon’s Vision, although these translations can be problematic.
(89.) Jindasa Liyanaratne, The Casket of Medicine (Bhesajjamañjūsā), vol. 1 (Oxford: Pali Text Society, 2002).
(90.) Partially translated in Barry Clark, The Quintessence Tantras of Tibetan Medicine (Ithaca, NY: Snow Lion Publications, 1995); and Men-Tsee-Khang, The Basic Tantra and the Explanatory Tantra of Tibetan Medicine (Dharamsala: Men-Tsee-Khang, 2011).
(91.) See reproduction of thangkas with translations of textual content in Yuri Parfionovitch, Gyurme Dorje, and Fernand Meyer, Tibetan Medical Paintings: Illustrations to the Blue Beryl Treatise of Sangye Gyamtso (1653–1705) (New York: Harry N. Abrams, 1992).
(92.) Translated in Gavin Kilty, Mirror of Beryl: A Historical Introduction to Tibetan Medicine (Boston: Wisdom Publications, 2010).
(100.) Shi Yongxin and Li Liangsong, eds., Zhongguo fojiao yiyao quanshu, 101 vols. (Beijing: Zhongguo shudian, 2011), although see critique of the claims this collection makes and its principles of compilation in Daniel Bruton-Rose, “Desiderata for the Principles of Compilation of a Canon of Buddhism and Medicine: A Consumer’s Guide to the Zhongguo Fojiao yiyao quanshu (Complete Works of Chinese Buddhist Medicine and Pharmacopeia, 2011),” Asian Medicine: Journal of the International Association for the Study of Traditional Asian Medicine 12, no. 1/2 (2017): 203–232.