http://www.UrbanDharma.org ...Buddhism for Urban America


The Urban Dharma Newsletter... September 16, 2003


In This Issue: Special Issue / Buddhism and Health

1. Is Buddhism Good for Your Health? ...By STEPHEN S. HALL / September 14, 2003
2. Buddhism, Medicine, and Health ...Ven. Master Hsing Yun

3. Temple/Center/Website- of the Week: None
4. Book/Movie Review: None


1. Is Buddhism Good for Your Health? ...By STEPHEN S. HALL / September 14, 2003


In the spring of 1992, out of the blue, the fax machine in Richard Davidson's office at the department of psychology at the University of Wisconsin at Madison spit out a letter from Tenzin Gyatso, the 14th Dalai Lama. Davidson, a Harvard-trained neuroscientist, was making a name for himself studying the nature of positive emotion, and word of his accomplishments had made it to northern India. The exiled spiritual leader of Tibetan Buddhists was writing to offer the minds of his monks -- in particular, their meditative prowess -- for scientific research.

Most self-respecting American neuroscientists would shrink from, if not flee, an invitation to study Buddhist meditation, viewing the topic as impossibly fuzzy and, as Davidson recently conceded, ''very flaky.'' But the Wisconsin professor, a longtime meditator himself -- he took leave from graduate school to travel through India and Sri Lanka to learn Eastern meditation practices -- leapt at the opportunity. In September 1992, he organized and embarked on an ambitious data-gathering expedition to northern India, lugging portable electrical generators, laptop computers and electroencephalographic (EEG) recording equipment into the foothills of the Himalayas. His goal was to measure a remarkable, if seemingly evanescent, entity: the neural characteristics of the Buddhist mind at work. ''These are the Olympic athletes, the gold medalists, of meditation,'' Davidson says.

The work began fitfully -- the monks initially balked at being wired -- but research into meditation has now attained a credibility unimaginable a decade ago. Over the past 10 years, a number of Buddhist monks, led by Matthieu Ricard, a French-born monk with a Ph.D. in molecular biology, have made a series of visits from northern India and other South Asian countries to Davidson's lab in Madison. Ricard and his peers have worn a Medusa-like tangle of 256-electrode EEG nets while sitting on the floor of a little booth and responding to visual stimuli. They have spent two to three hours at a time in a magnetic resonance imaging machine, trying to meditate amid the clatter and thrum of the brain-imaging machinery.

No data from these experiments have been published formally yet, but in ''Visions of Compassion,'' a compilation of papers that came out last year, Davidson noted in passing that in one visiting monk, activation in several regions of his left prefrontal cortex -- an area of the brain just behind the forehead that recent research has associated with positive emotion -- was the most intense seen in about 175 experimental subjects.

In the years since Davidson's fax from the Dalai Lama, the neuroscientific study of Buddhist practices has crossed a threshold of acceptability as a topic worthy of scientific attention. Part of the reason for this lies in new, more powerful brain-scanning technologies that not only can reveal a mind in the midst of meditation but also can detect enduring changes in brain activity months after a prolonged course of meditation. And it hasn't hurt that some well-known mainstream neuroscientists are now intrigued by preliminary reports of exceptional Buddhist mental skills. Paul Ekman of the University of California at San Francisco and Stephen Kosslyn of Harvard have begun their own studies of the mental capabilities of monks. In addition, a few rigorous, controlled studies have suggested that Buddhist-style meditation in Western patients may cause physiological changes in the brain and the immune system.

This growing, if sometimes grudging, respect for the biology of meditation is achieving a milestone of sorts this weekend, when some of the country's leading neuroscientists and behavioral scientists are meeting with Tibetan Buddhists, including the Dalai Lama himself, at a symposium held at M.I.T. ''You can think of the monks as cases that show what the potential is here,'' Dr. Jon Kabat-Zinn, an emeritus professor of medicine at the University of Massachusetts Medical School who has pioneered work in the health benefits of meditation, says. ''But you don't have to be weird or a Buddhist or sitting on top of a mountain in India to derive benefits from this. This kind of study is in its infancy, but we're on the verge of discovering hugely fascinating things.''

In the 2,500-year history of Buddhism, the religion has directed its energy inward in an attempt to train the mind to understand the mental state of happiness, to identify and defuse sources of negative emotion and to cultivate emotional states like compassion to improve personal and societal well-being. For decades, scientific research in this country has focused on the short-term effects of meditation on the nervous system, finding that meditation reduces markers of stress like heart rate and perspiration. This research became the basis for the ''relaxation response'' popularized by Prof. Herbert Benson of Harvard in the 1970's. Buddhist practice, however, emphasizes enduring changes in mental activity, not just short-term results. And it is the neural and physical impact of the long-term changes, achieved after years of intense practice, that is increasingly intriguing to scientists.

''In Buddhist tradition,'' Davidson explains, '''meditation' is a word that is equivalent to a word like 'sports' in the U.S. It's a family of activity, not a single thing.'' Each of these meditative practices calls on different mental skills, according to Buddhist practitioners. The Wisconsin researchers, for example, are focusing on three common forms of Buddhist meditation. ''One is focused attention, where they specifically train themselves to focus on a single object for long periods of time,'' Davidson says. ''The second area is where they voluntarily cultivate compassion. It's something they do every day, and they have special exercises where they envision negative events, something that causes anger or irritability, and then transform it and infuse it with an antidote, which is compassion. They say they are able to do it just like that,'' he says, snapping his fingers. ''The third is called 'open presence.' It is a state of being acutely aware of whatever thought, emotion or sensation is present, without reacting to it. They describe it as pure awareness.''

The fact that the brain can learn, adapt and molecularly resculpture itself on the basis of experience and training suggests that meditation may leave a biological residue in the brain -- a residue that, with the increasing sophistication of new technology, might be captured and measured. ''This fits into the whole neuroscience literature of expertise,'' says Stephen Kosslyn, a Harvard neuroscientist, ''where taxi drivers are studied for their spatial memory and concert musicians are studied for their sense of pitch. If you do something, anything, even play Ping-Pong, for 20 years, eight hours a day, there's going to be something in your brain that's different from someone who didn't do that. It's just got to be.''

Jonathan D. Cohen, an expert on attention and cognitive control at Princeton, has been intrigued by reports that certain Buddhist adepts can maintain focus for extended periods. ''Our experience -- and the laboratory evidence is abundant -- is that humans have a limited capacity for attention,'' he says. ''When we try to sustain attention for longer periods of time, like air-traffic controllers have to do, we consider it incredibly effortful and stressful. Buddhism is all about the ability to direct attention flexibly, and they talk about this state of sustained and focused attention that is pleasant, no longer stressful.''

If nothing else, the meeting at M.I.T. this weekend shows that Davidson, one of its principal organizers, has managed to persuade a lot of marquee names to join him in making the case that it has become scientifically respectable to investigate these practices. Participants include mainstream scientists like Eric Lander, a leader of the human genome project; Cohen, a prominent researcher into the neural mechanisms of moral and economic decision-making; and Daniel Kahneman, the Nobel-Prize-winning Princeton economist who has pioneered research into the psychology of financial decision-making.

''Neuroscientists want to preserve both the substance and the image of rigor in their approach, so one doesn't want to be seen as whisking out into the la-la land of studying consciousness,'' concedes Cohen, who is chairman of a session at the M.I.T. meeting. ''On the other hand, my personal belief is that the history of science has humbled us about the hubris of thinking we know everything.''

The ''Monk experiments'' at Madison are beginning to intersect with a handful of small but suggestive studies showing that Buddhist-style meditation may have not only emotional effects but also distinct physiological effects. That is, the power of meditation might be harnessed by non-Buddhists in a way that along with reducing stress and defusing negative emotion, improves things like immune function as well.

The power of the mind to influence bodily function has long been of interest to scientists, especially connections between the nervous, immune and endocrine systems. Janice Kiecolt-Glaser and Ronald Glaser, researchers at Ohio State University, for example, have done a series of studies showing that stress typically impairs immune function, though the exact woof and weave of these connections remains unclear.

Interestingly enough, the Buddhist subjects themselves are largely open to scientific explanation of their practices. ''Buddhism is, like science, based on experience and investigation, not on dogma,'' Matthieu Ricard explained in an e-mail message to me last month. The religion can be thought of as ''a contemplative science,'' he wrote, adding, ''the Buddha always said that one should not accept his teachings simply out of respect for him, but rediscover their truth through our own experience, as when checking the quality of a piece of gold by rubbing it on a piece on stone, melting it and so on.''

In July, I joined Davidson and several colleagues as they stood in a control room and watched an experiment in progress. On a television monitor in the control room, a young woman sat in a chair in a nearby room, alone with her thoughts. Those thoughts -- and, more specifically, the way she tried to control them when provoked -- were the point of the experiment.

Davidson hypothesizes that a component of a person's emotional makeup reflects the relative strength, or asymmetry, of activity between two sides of the prefrontal cortex -- the left side, which Davidson's work argues is associated with positive emotion, and the right side, where heightened activity has been associated with anxiety, depression and other mood disorders.

His research group has conducted experiments on infants and the elderly, amateur meditators and Eastern adepts, in an attempt to define a complex neural circuit that connects the prefrontal cortex to other brain structures like the amygdala, which is the seat of fear, and the anterior cingulate, which is associated with ''conflict-monitoring.'' Some experiments have also shown that greater left-sided prefrontal activation is associated with enhanced immunological activity by natural killer cells and other immune markers.

When one scientist in the control room said, ''All right, here comes the first picture,'' the young woman visibly tensed, gripping her elbows. Electrodes snaked out of her scalp and from two spots just below her right eye. And then, staring into a monitor, the young woman watched as a succession of mostly disturbing images flashed on a screen in front of her -- a horribly mutilated body, a severed hand, a venomous snake poised to strike. Through earphones, the woman was prompted to modulate her emotional response as each image appeared, either to enhance it or suppress it, while the electrodes below her eye surreptitiously tapped into a neural circuit that would indicate if she had successfully modified either a positive or negative emotional response to the images.

''What's being measured,'' Davidson explained, ''is a person's capacity to voluntarily regulate their emotional reactions.''

Daren Jackson, the lead researcher on the study, added, ''Meditation may facilitate more rapid, spontaneous recovery from negative reactions.''

The visiting monks, as well as a group of meditating office workers at a nearby biotech company, have viewed these same gruesome images for the same purpose: to determine what Davidson calls each individual's ''affective style'' (if they are prone, for example, to hang onto negative emotional reactions) and if that style can be modulated by mental effort, of the sort that meditation seeks to cultivate. It is the hope of Davidson and his sometime collaborator Jon Kabat-Zinn that the power of meditation can be harnessed to promote not only emotional well-being but also physical health.

Since founding the Stress Reduction Clinic at the University of Massachusetts Medical School in 1979, Kabat-Zinn and colleagues have treated 16,000 patients and taught more than 2,000 health professionals the techniques of ''mindfulness meditation,'' which instructs a Buddhist-inspired ''nonjudgmental,'' total awareness of the present moment as a way of reducing stress. Along the way, Kabat-Zinn has published small but intriguing studies showing that people undergoing treatment for psoriasis heal four times as fast if they meditate; that cancer patients practicing meditation had significantly better emotional outlooks than a control group; and not only that meditation relieved symptoms in patients with anxiety and chronic pain but also that the benefits persisted up to four years after training. Kabat-Zinn is conducting a study for Cigna HealthCare to see if meditation reduces the costs of treating patients with chronic fatigue syndrome, fibromyalgia and irritable bowel syndrome.

For the time being, meditation science is still stuck in a cultural no-man's land between being an oxymoron and something more substantive. ''We're very early in the research,'' said Davidson, who admitted that ''the vast majority of meditation research is schlock.'' But a well-designed study published in July by Davidson, Kabat-Zinn and their colleagues provides further evidence that the topic is legitimate.

In July 1997, Davidson recruited human subjects at a small biotech company outside Madison called Promega to study the effects of Buddhist-style meditation on the neural and immunological activity of ordinary American office workers. The employees' brains were wired and measured before they began a course in meditation training taught by Kabat-Zinn. It was a controlled, randomized study, and after eight weeks, the researchers would test brain and immune markers to assess the effects of meditation.

There was reluctance among some employees to volunteer, but eventually, about four dozen employees participated in the study. Once a week for eight weeks, Kabat-Zinn would show up at Promega with his boom box, his red and purple meditation tape cassettes and his Tibetan chimes, and the assembled Promega employees -- scientists, marketing people, lab techs and even some managers -- would sit on the floor of a conference room and practice mindfulness for three hours.

In July, the results of the experiment at Promega were published in the journal Psychosomatic Medicine, and they suggest that meditation may indeed leave a discernible and lasting imprint on the minds and bodies of its practitioners. Among the Promega employees who practiced meditation for two months, the Wisconsin researchers detected significant increases in activity in several areas of the left prefrontal cortex -- heightened activity that persisted for at least four months after the experiment, when the subjects were tested again. Moreover, the meditators who showed the greatest increase in prefrontal activity after training showed a correspondingly more robust ability to churn out antibodies in response to receiving a flu vaccine. The findings, Kabat-Zinn suggested, demonstrated qualitative shifts in brain activity after only two months of meditation that mirror preliminary results seen in expert meditators like monks.

These results are still embraced cautiously, at best. Indeed, the Wisconsin study took five years to publish in part because several higher-profile journals to which it was submitted refused even to send it out for peer review, according to Davidson. And yet, by the time the study was over, the subjective experience of participants complemented the objective data: meditation ultimately left people feeling healthier, more positive and less stressed. ''I really am an empiricist in every aspect of my life,'' said Michael Slater, a molecular biologist at Promega. ''I doubt dogma, and I test it. I do it at the laboratory bench, but also in my personal life. So this appealed to me, because I could feel the reduction in stress. I could tell I was less irritable. I had more capacity to take on more stressors. My wife felt I was easier to be around. So there were tangible impacts. For an empiricist, that was enough.''

Granted, that's not enough for many other people, especially the scientific skeptics. But Slater made an offhand comment that struck me as a highly convincing, though thoroughly unofficial, form of peer review. ''My wife,'' Slater said quietly, ''is dying for me to start meditating again.''

Stephen S. Hall is the author, most recently, of ''Merchants of Immortality: Chasing the Dream of Human Life Extension.''

2. Buddhism, Medicine, and Health ...Ven. Master Hsing Yun


I. Introduction

Since the origin of the world, birth, aging, illness, and death have been unavoidable.  Prince Siddhartha learned of this truth when he ventured beyond his palace and visited the poor area of town.  Here, amidst beggars, sick people, and decrepit elders, he saw the reality of life.

Immediately, a desire arose in his heart to relieve the pain and suffering of these people. Thus, he renounced his life of luxury and became a monk, hoping that through meditation and cultivation he could find solutions for the poor and ailing people.

From the beginning, the Buddha realized that just as one can suffer from physical disease, one could also suffer from an unhealthy mindset.  To cure both diseases of the body and mind, the Buddha devoted his entire life to passing down the knowledge of the Tripitaka (1).  While the Buddha sought to cure both physical and mental illness, emphasis was placed upon the mind.  

He used the knowledge of the Dharma to heal the illness that arose from the three poisons: greed, anger, and ignorance.  The Buddha’s medicine treats disease starting from the patients’ minds, curing them of the three poisons.  Psychologists also treat illness by working with their patient’s mental state, but this is quite different from the Buddhist practice of treating the mind.  

According to Buddhism, the pure and wondrous Dharma is the perfect medication for an ailing mind, as well as a sick body. 

Keeping both the mind and body healthy is important, for the body is the vehicle in which we can practice the Dharma.  Like all things, the mind and the body are interdependent; the health of the mind influences the health of the body, and vice versa – the health of the body influences the health of the mind.  With a healthy body as a tool, we can cultivate a compassionate heart and a clear mind.  With a cultivated mind, we are able to examine ourselves, clearly see the nature of our problems, and then work to resolve them.  We will then be approaching the path to true health. 

II. Buddhism and Medical Science

In the sutras, we can find analogies that describe the Buddha as the doctor, knowledge of the Dharma as the medicine, monastics as the nursing staff, and all people as the patients.  According to this medical analogy, Buddhism is considered a medication with a broad meaning – a medication that can cure the ailments in all aspects of life.  In general, but with exceptions, Western medicine functions within a much smaller framework.  Western medicine typically approaches illness through physical symptoms.  This approach tends to temporarily reduce the suffering and remove the symptoms for a period, but a lack of symptoms does not mean that the root cause has been identified and removed.  Therefore, the complete elimination of the disease has not occurred. Buddhism offers patients not only symptomatic relief, but also spiritual guidance to ensure overall and long-lasting health.

While Western researchers have conducted massive studies on pathology, pharmacology, immunology, and anatomy, enabling them to develop more sophisticated medical techniques, scientists still doubt that religion can help explain the cause of a disease.  Without validating the role of religion in disease, scientists remain quite distant from the definition of disease, its causes, and its treatments as understood from a religious perspective.  According to Buddhism, it is not enough to approach to medicine in a manner that simply eradicates symptoms; the spiritual aspect of disease and its mind-based causes and remedies must be the primary consideration.  

Only recently have science and religion started to communicate and blend in a manner that is beginning to narrow the gap between a scientific approach to disease and one rooted in religion.  For instance, the U.S. government coordinated international conferences on “The Relationship Between Religion and Health.”  Also, Harvard Medical School offers a class entitled “The Essence of Medicine.”  Religion is gradually influencing the biological, psychological, and social medicine of Western society.  Buddhism has played a significant role in uniting spirituality and medicine in the West.

In the East, religion has impacted the field of health and medicine for a much longer time.  Eastern medical practitioners never doubted the role of religion in disease; the two have been integrated for thousands of years.  Out of thousands of documents in the Tripitaka, a significant number contain records about Buddhist medicine.  When this canon of discourses and sutras was brought to China, the most salient aspects of Indian Buddhism blended with the most highly regarded aspects of Chinese medicine.  Through modifications and improvements contributed by numerous Buddhist masters from the past and present, the Chinese Buddhist medical system has evolved into the one that presently exists.  In the following pages, I will elaborate further on the Buddhist understanding of illness and disease and the Buddhist approach to medicine and healing.

III. The Buddha as the Great Doctor

When the Buddha was young, he learned the science of medicine (2).  He became very knowledgeable about the nature and cure of diseases.  According to the sutras, a famous physician named Jivaka further advanced his medical practice and mastered additional skills by learning from the Buddha and following the Buddha’s instructions.  Jivaka performed several remarkable surgical procedures, earning a respectable reputation in the medical field.  One of his well-known operations involved the repair of an obstructed colon.  Jivaka performed this surgery using a sequence of techniques similar to contemporary practices:  administering anesthesia, opening the abdominal region, repairing the colon, and finally, closing the incision with stitches.  Though a trained physician, Jivaka became even more competent in his mastery of medicine under the Buddha’s spiritual and medical guidance. 

In addition to records about the Buddha and Jivaka, numerous sutras such as The Sutra of Buddha’s Diagnosis, The Sutra of the Buddha as a Great Doctor, The Sutra on Relieving Piles, The Sutra on Healing Mental Distractions of Improper Meditation, The Sutra of Healing Dental Diseases, The Sutra of Dharani for Healing All Diseases, The Sutra of Dharani for Season’s Diseases, Suvarnaprabhasottama Sutra, Vinaya of the Five Categories, Vinaya of the Four Categories, Ten Recitations Vinaya, and Mahasanghavinaya, contain many other references to the Buddha’s knowledge about medicine.  The Buddha truly deserved to be regarded as the grand patriarch of Buddhist medicine.  He was capable of curing diseases not only of the body but also of the mind, which were his specialty.  Today, when a patient seeks a physician’s care for a physical ailment, the physician typically only pays attention to the painful symptoms in the body, ignoring both the causes and the suffering in the mind.  By not investigating and discovering the true roots of the disease, they only accomplish a fraction of real healing.  They do very little to heal the patients’ unhappiness, for they do not recognize and understand the true cause of the human life cycle of birth, aging, illness, and death.  They do not take into account that karma and mental constructs have something to do with the origins of illness.

The Buddha’s realization of what induces the perpetual cycle of rebirth and the stages of aging, illness, and death, enabled him to guide others to live with ultimate physical and mental health.  The Buddha eliminated disease by going to the heart of the cause and drawing upon his knowledge of the proper remedy.  In Anguttara-nikaya, the Buddha explained that an imbalance of chi (3), an overabundance of phlegm, and an increase or decrease in the body’s temperature could be treated with clarified butter, honey, and oil-based food respectively. 

Regarding mental health, greed, anger, and ignorance are understood as the three gravest psychological diseases.  The Buddha taught that greed could be cured by the contemplation of impurity, anger by the contemplation and practice of kindness, and ignorance by the contemplation of the true nature of all things and the cultivation of wisdom.  These are the medications that the Buddha encouraged everyone to use in order to heal the diseases of both body and mind.

In The Sutra of Buddha’s Diagnosis the Buddha explained that a doctor should progress through four steps when helping a patient.  Doctors must: 1) discover the origin of the illness, 2) achieve a thorough understanding of the illness, 3) prescribe the appropriate medication to cure the illness, and 4) completely cure the illness in a manner that prevents it from reoccurring.  In addition to mastering these four criteria, a good doctor should always act with a generous heart when treating patients, considering them as his or her dearest friends. 

The Buddha also identified five important practices for caretakers – nurses, family members, friends, and others – to be aware of as they cared for patients.  He encouraged caretakers to: 1) insure that the patients are tended to by good-hearted and skillful doctors, 2) wake up earlier and go to bed later than patients and always remain alert to the patient’s needs, 3) speak to their patients in a kind and compassionate voice when they are feeling depressed or uneasy, 4) nourish the patients with the proper food in the correct amounts and intervals according to the nature of the ailment and according to the doctor’s instructions, and 5) talk with skill and ease about the Dharma with the patients; instructing them in proper healthcare for the body and mind.

Lastly, the Buddha offered advice to patients in order to help them heal quickly and thoroughly.  He recommended that patients: 1) be cautious and selective about the food they eat, 2) consume food at the proper intervals, 3) stay in touch with their doctors and nurses, always acting kindly and graciously towards them, 4) keep an optimistic or hopeful outlook, and 5) be kind and considerate of those who are caring for you.  The Buddha believed that a cooperative effort from the doctors, caretakers, and patients yielded the best results from treatment.  The Buddha was not just an average doctor; he was an exceptional doctor who had vision and insight. 

IV. Medical Theories in Buddhism

According to Chinese medicine, diseases are caused by seven internal and six external elements.  The internal elements are extreme levels of happiness, anger, anxiety, a ruminating mind, sadness, fear, and shock.  The external elements are coldness, summer-heat, dryness, heat, dampness, and wind.  The seven internal elements, also referred to as emotions, are believed to cause illness because they directly impair the healthy functioning of the five main organs of human beings.  Extreme levels of either happiness or fear damage the heart, anger harms the liver, anxiety harms the lungs, a ruminating mind affects the spleen, and shock hurts the kidneys.  According to Chinese medicine, a healthy and balanced emotional life is essential in maintaining one’s physical health.  

Various Buddhist sutras describe the causes of disease in a similar manner.  For example, The Sutra of Buddha’s Diagnosis mentions that there are ten causes and conditions of sickness.  These reasons are: 1) sitting for too long a period without moving, 2) eating too much, 3) sadness, 4) fatigue, 5) excessive sexual desire, 6) anger, 7) postponing excrement, 8) postponing urination, 9) holding the breath, and 10) suppressing gas.  Approaching the causes of disease from a slightly different angle, The Discourse of Great Equanimity and Insightful Meditation points out six origins for disease.  They are described as: 1) an imbalance of the four elements (earth, water, fire, and wind), 2) irregular dietary habits, 3) incorrect meditation methods, 4) disturbances by spirits, 5) demon possession, and 6) the force of bad karma.  Illness that originates from most of these origins can be cured if people improve their diet, become more aware of their bodies’ natural processes, and get plenty of rest.  However, the last three causes 4) – 6) are related to karma, and one must work on improving his/her character and purifying his/her mind in order to be cured.  A person afflicted for the last three reasons needs to spend time in spiritual practice, repentance, and doing good deeds.  Only then will his/her illness begin to go away.  The Mahaprajnaparamita Sastra states that illness is caused either by internal or external causes and conditions.  Still, Visuddhimagga mentions additional causes of disease, but they are too numerous to list here.  All of the theories on the various causes of illness can be grouped into two main categories: A) the imbalance of the four elements and B) the presence of three poisons of greed, anger, and ignorance.  The following is a detailed discussion of these two classifications. 

A. The Imbalance of the Four Elements

According to Buddhism, the body is composed of four impermanent elements – earth, water, fire, and wind.  Only consciousness is reborn in one of the six realms.  This theory is the foundation of Indian Buddhist medical science.  Chinese medicine believes the body to be comprised of a unique system of subsidiary channels that transmits vital energy (chi), blood, nutrients, and other substances through the five organs and six internal regions in one’s body.  When this intricate circulation system is flowing properly, the four elements stay in balance, the major organs can perform their essential functions, and the body remains healthy.

The Discourse of Condensed Equanimity and Insightful Meditation states that each of the four elements is able to cause one hundred and one diseases, with a total of four hundred and four diseases possible.  Each element is connected to certain types of diseases.  For instance, the earth element is related to diseases that make the body become heavy, stiff, and painful, such as arthritis; the water element afflicts the body with diarrhea, stomach aches, and difficult digestion; the fire element causes fever, constipation, and problems urinating; lastly, the wind element is related to breathing difficulties and vomiting. 

The third volume of Nanhai Ji Gui Neifa Zhuan states that, “If diseases are related to the four elements, they are usually caused by overeating or overexertion.”  An imbalance of the four elements and the resulting illness can also occur due to a diet that is not in tune with the four seasons.  When the seasons change and the temperature varies from cool to cold to warm to hot, it is important to adjust our diet in a manner that enables the body to function at its best.  In The Suvarnaprabhasottama Sutra, a young man asked his father who was a doctor, “How do we cure the suffering of human beings and cure diseases that arise from the imbalance of the four elements?”  The doctor responded to his son by saying, “We live our lives through four seasons of three months, or six seasons of two months in some parts of the world.  Whether four or six, we must live according to the seasons, eating food that corresponds with hot and cold, warm and cool. In this way, our bodies will benefit.  A good doctor is well learned in prescribing the right food and medicine to adjust the four elements and nourish a patient’s body during a particular season.  When the season and the food are in balance, so too will the body be in balance.”  

Eating a reasonable amount and adjusting what we eat according to seasonal changes are two important factors in maintaining balance among the four elements and allowing chi to circulate unimpeded through our bodies.  We automatically dress differently when the seasons change in order to comfort and protect ourselves during a particular temperature change or weather conditions.  If we adopt this practice and adjust our diet with the weather and seasons, we help our bodies to stay balanced and guard against disease.

B. Greed, Anger, and Ignorance

Greed, anger, and ignorance, sometimes referred to as “the three poisons,” are also reasons why people are afflicted with sickness.  When one is stuck in any one of these destructive mental states, one opens the door and invites disease.  The Vimalakirti Sutra states, “All the diseases I have right now are derived from illusory thoughts I have had in the past ? because human beings are attached to a “self”, affliction and diseases have the chance to be born their bodies.”  When one allows oneself to be ruled by the three poisons, the psychological and physical health hazards are numerous and can be quite debilitating. The following descriptions provide insight into how greed, anger, and ignorance cause illness:

1. Greed

Greed is defined as an improper and excessive desire for something.  For example, one is more likely to overeat when one is having a favorite meal.  Such greed can then lead to an overly full stomach and the food will not be well digested.  Or, one may like food so much that he/she eats much too frequently.  This type of desire which cannot be satisfied can cause obesity, fatigue, and heart problems.  Greed is never without consequences.

People can also have excessive desires for sensory experience.  In The Discourse of Interpretation Great Equanimity and Insightful Meditation, it is stated that too much attachment to what we perceive through sound, smell, sight, taste, and touch can cause both psychological and physical illness.  A person may cling to the experience of these five sensations, which can cause an imbalance in our rational thoughts and disturb our ability to make moral choices.  Physical health problems can also arise. In the Buddhist health theory, those who are too attached to physical appearance will suffer from diseases of the liver.  Those who are too attached to sounds will suffer from kidney diseases.  Those who are too attached to aromas will suffer from lung diseases.  Those who are too attached to taste will suffer from heart diseases; and those who are too attached to the sensation of touch will suffer from spleen diseases.  Thus, when we encounter the multitude of sensations that are a natural part of daily life, it is best to maintain a balanced attitude and practice the Middle Path (4).  In order to maintain optimum physical and mental health, the Middle Path is also the best way to approach sleeping, eating, and exercising.  When one sleeps too much, one will not have a clear mind.  When one eats too much food that is high in cholesterol and sugar, one is gradually increasing the risk of poor health and could ultimately face chronic disease, such as diabetes or heart disease.  In today’s fast-paced society that promotes working excessively and watching hours of television, people do not exercise enough, and eventually, this has an adverse affect on their bodies.  Additionally, nowadays people are constantly exposed to a noisy and stressful environment, which can cause people to become sick more easily.  If one decreases one’s greed and desire and approaches life with the attitude of the Middle Path, one can lead a healthier life.

2.  Anger

The fourteenth volume of The Mahaprajnaparamita Sastra states that, “Anger is the most toxic emotion compared to the other two poisons; its harm far exceeds all of the other afflictions as well.  Of the ninety-eight torments (5), anger is the hardest one to subdue; among all psychological problems, anger is the most difficult to cure.”  Although anger is a psychological problem, it can also lead to severe physical consequences.  For example, when aversion and anger arise in a person, the blood vessels become constricted, causing a rise in blood pressure and thus increasing the risk of heart attack.

In writing about anger, Venerable Punengsong from the Qing Dynasty tells us,

A good doctor always finds out

        The cause of a sickness first.

      Anger is quite harmful

       To someone who is sick.

The relationship between a patient’s pulse

        And his illness is delicate.

With the correct prescription,

        We can heal ourselves of our illness.

As doctors examine their patients to determine the cause of illness and the proper medication to prescribe, one of the most essential ingredients of treatment is pacifying the patients’ emotions.  Anger causes poor circulation, which can have devastating effects on the entire body.  It acts as a blockade, causing the body and mind to be less receptive to treatment.  When agitated emotions subside and the patient is able to experience a sense of tranquility, recuperating is both easier and quicker.  Anger and hatred are particularly detrimental to the healing process, and in fact, often worsen the problem.

3. Ignorance

When one is ignorant, one is unable to understand or see things as they really are.  Many of us are like this when it comes to illness.  We are unable or unwilling to look at the root of the illness. Instead of pinpointing the true cause and effect that will help us to eradicate the illness, and instead of using wisdom to guide us to the proper care, we take a detour and become distracted by ineffective remedies.  We sometimes look for a “quick fix,” using unsubstantiated methods, unscientific therapies, and unsound doctors.  Meanwhile, the illness is usually causing us both physical and psychological suffering.  Using wisdom to investigate the actual cause of our illness will help us to set foot on the road to complete and long-lasting recovery.

While it is usually easy to detect the symptoms of a physical disease, we often remain ignorant of psychological diseases.  They follow us like a shadow.  We do not examine the constructs of our mind with wisdom and awareness, and poor psychological health follows.  If we remain blind to our psychological diseases, the problems can compound and cause more severe sickness within our bodies.  Modern scientists agree that anger, extreme happiness, anxiety, terror, sadness, and other emotions can impact one’s physical well being.  According to recent medical research, “When a person is unhappy, angry, or under pressure, his or her brain will release the hormones called adrenaline and nor-adrenaline, which can act as a toxin.”  In addition, if the body is influenced by extreme emotions for a long period of time, the illness induced by the emotional imbalance or stress is harder to cure.  For example, a digestive disorder rooted in a prolonged emotional condition is more difficult to cure than one caused by an external factor.  There is scientific evidence, not just religious theory, that emotions indeed impact the healthy functioning of the body.  Therefore, it is in our best interest to cultivate awareness of our emotional condition, handle our emotions well, and not become too attached to or controlled by them. 

In Buddhism, there are eighty-four thousand methods that are used to cure eighty-four thousand illnesses.  For instance, the Buddha taught that to eliminate greed, one can use the contemplation of impurity.  Once a person meditates on impurity, he or she will experience a decrease in desire.  The Buddha taught people afflicted with anger or hatred to practice universal kindness and compassion in order to reduce their hostility.  When they feel themselves becoming angry, they should become mindful of the meaning of compassion.  In doing so, they will understand that getting mad is not an appropriate or helpful response.  

Gradually, their angry words and thoughts will dissipate.

If people are ignorant, they should contemplate cause and effect and the law of impermanence, to help them nurture the mindset of non-attachment. Nothing arises outside of dependence origination and nothing that arises will last forever; all phenomena will one-day cease to exist.  Since everything behaves like dust, which comes and goes, what is the purpose of being attached to it?  Realizing there is no immunization for impermanence helps to reorient our minds from ignorance to wisdom and allows us to live with greater overall health. 

Master Hanshan Deqing from the Ming Dynasty said, “No one can get sick, age, die, or be born for you.  This suffering, only you must bear.  All bitterness and sweetness one must go through on one’s own.”  If we can accept the inevitability of suffering and impermanence with equanimity, it is like taking a dose of the finest medicine.  Thus, when we adjust our emotions, subdue our temper, and act generously toward others, we will find our way through life’s problems with more ease and reduce the chance of illness.  If we apply these principles of Buddhist medicine to nurture our minds and restore our bodies, generosity will emerge out of greed, compassion will emerge out of anger, wisdom will emerge out of ignorance, and health will emerge out of sickness.   When we treat the poisons of the mind and act with equanimity in all circumstances, there will be harmony of body and mind and disease will be kept at bay.

V. The Medicine of Buddhism

The occurrence of a disease is closely related to one’s mental health, physical health, spiritual health, behavior, habits, living environment, and even the society and culture in which one lives.  Harmonizing all of these elements and engaging in specific practices can help to bring about optimum health and prevent illness.  Gaining awareness about the cause of illness and conducting our lives in a manner that nourishes and maintains long-term good health can drastically improve our overall well-being.  The Buddha offers us several suggestions and practices that can serve as medicine for all aspects of our lives:

Practice Healthy Dietary Habits: A Chinese idiom states, “Troubles are caused by words flowing out of the mouth; illness is caused by food going into the mouth.”  Using caution and moderation in what we consume is an important practice for good health.  Before consuming any food, we should determine if the food is fresh, if it is thoroughly cleaned, and what would be a reasonable amount to eat.  The Sutra of Buddha’s Bequeath Teachings (Ch. I-chiao-ching Sutra) states, “When we eat, we should regard our food as medicine, for consuming too much or too little is not healthy.  A regular and proper dose can support our bodies, cure our hunger, relieve our thirst, and prevent us from becoming ill.  Like bees gathering honey, they take what they need, but they don’t consume the whole flower.”  As Xingshi Chao states, we should adjust the type of food we eat according to the season, consuming various combinations of food in order to maintain our body’s equilibrium.  Our bodies are susceptible to different ailments depending on the season, and a diet conscious of this fact offers a better chance of staying healthy.

The Regulation for Chan Monastery outlined five contemplations to be mindful of when we take our meals:

I consider the effort required

      To grow and prepare the food;

I am grateful for its sources.

       In observing my virtue;

If impeccable in mind and heart,

I shall deserve this offering.

I shall protect my heart

From being ensnared by faults;

I shall guard myself

Particularly against greed.

To cure my weakening body,

I shall consume this food as medicine.

To tread the path

Of spiritual cultivation;

I shall accept this food

As an offering.

One should maintain a balanced diet and approach food with a gracious attitude.  When our bodies are given the right amount of food, our digestive organs will function properly, and our body’s metabolism will be in prime condition, thus preventing digestive diseases and other health problems.  Being mindful of and grateful for the food we consume contributes to the health of our mind as well as our body. 

Meditation: Our mind is constantly exploring the world around us and as a result, illusory thoughts are always arising and ceasing.  Our over-active mind rarely gets a chance to rest.  The constant stream of thoughts we experience can affect our ability to concentrate without interruption and can have a negative affect on our daily life.  In addition to psychological health risks, one’s physiology can also be adversely affected by an overwhelming amount of mental activity.  The brain can cease to function properly due to our continual clutter of thoughts or an instance of severe mental excitation.  For example, when one experiences a tremendous surprise, the face may appear discolored, the hands and feet become cold, and one’s ability to concentrate normally will be impaired.  However, if this person can take a deep breath to slow down the heartbeat and calm the emotions, the presence of tranquility will return the body to its normal state and the chance for harming any vital organs will decrease.  

Through the meditative practice of breathing slowly and concentrating on the breath, one’s psychological and physiological well-being can dramatically improve.  In The Medicine Chan, written by a Japanese physician, three specific physical benefits derived from meditation were mentioned: 1) increased energy and a prolonged period of prime years 2) improved blood circulation, and 3) a renewed endocrine system (6).  Through meditation, our body achieves a greater state of balance and our breathing becomes regulated.  Our mind becomes focused, clear, and organized.  Desires are dissolved and improper thoughts are eliminated.  When our mind is clear and focused at all times, even as we walk, sit, and sleep, we will be calm and peaceful, which eventually results in a greater degree of overall health – both mental and physical.  Master Tiantai Zhizhe recognizes the significant impact that meditation can have on overall health.  He commented that if meditation is practiced on a regular basis and applied to daily occurrences with wisdom, all four hundred and four illnesses can be cured. 

With a mind that is free from the exhaustion and confusion of constant thoughts, we can accomplish significant things in our lives, instead of merely thinking about doing so.  Through acting, instead of just thinking, one can more authentically experience each moment and ultimately encounter the truth of life. 

Paying Respect to the Buddha: The benefits of paying respect to the Buddha are numerous and come in many forms, nurturing both physical and mental health.  Bowing to the Buddha increases the strength and flexibility of the body.  When one bows, one’s neck, hands, arms, waist, and legs stretch, giving the whole body an opportunity to exercise.  By stretching the body, stiffness decreases and blood circulation increases, thus reducing the chance of becoming ill. 

Although bowing results in distinct physical benefits, the act of bowing and the resulting benefits have more to do with our state of mind than our physical action.  Our mental presence when bowing is of utmost importance.  When we bow, we should show respect and sincerity, remaining deep in concentration as a slow bow is performed.  As we pay respect in this manner, we should contemplate the Buddha then expand our focus to include unlimited Buddhas in all directions.  When we pay respect to unlimited Buddhas, unlimited beings are benefited.  Ourselves, the Buddha – in fact all true nature is empty.  However, though empty, if one bows before the Buddha with a sincere and respectful heart, an amazing spiritual experience can take place.  Contemplating the truth of emptiness teaches us to reorient our self-centered way of being and realize that the notion of self is merely illusory.  Bowing, therefore, is performed not only to express our deepest gratitude to the Buddha and all Buddhas, but also an effective way to eliminate our ignorance, decrease our attachment to self, dissolve the burden of karma, and cultivate our spiritual practice.  As we can see, bowing is a health-giving gesture that nourishes both our body and mind. 

Repentance: Confession is another practice that helps to restore and maintain our health.  It is like clean water that washes away the dirt from one’s heart and the dust from one’s mind.  A story about a Tang Master named Wuda offers us an example of how confession can be a healing agent.  Master Wuda had a man killed in a previous life.  Seeking revenge in future lives, the man who was killed was reborn as a sore on Master Wuda’s foot.  No doctor could cure the sore because it was a manifestation of Master Wuda’s bad karma.  After seeking guidance from an Arhat who helped him to realize his wrongdoing, Master Wuda repented with a sincere heart, cleansed his wound with pure water, and the sore disappeared.  Only the heart of repentance could cure Master Wuda of his ailment.  Thus, all of us should repent our mistakes and misdeeds to the Buddha and vow not to repeat the same behavior and create more bad karma.  In addition, with the heart and mind of a bodhisattva, we may compassionately repent for all beings, thereby relieving their suffering as well as our own.  Psychologically, repentance is believed to release impure thoughts and worrisome guilt that act like toxins in our bodies. It alleviates our mental burdens and reduces the potential for illness. 

Reciting Mantras (7):  Mantras are powerful in curing diseases when recited with a sincere heart, deep concentration, and proper intentions.  The Great Compassion Mantra and the Medicine Buddha Mantra are two such examples.  When recited, each Mantra generates a tremendous amount of merit and has amazing healing and transforming effects. 

Reciting the Buddha’s Name: Many people are distressed by anxiety, agitation, improper desires, and delusional thought.  These torments not only disturb our psychological well-being and eventually take a toll on our physical health, they also hinder our ability to perceive the truth of life and attain enlightenment.  When we recite the name of the Buddha, the torment of improper and delusional thoughts will cease and our mental anguish will evaporate.  The heart calms down, the mind is awakened and purified, and no greed, anger, ignorance, or other toxins will arise, thus giving us greater protection from illness and delivering us from our ignorance.  Reciting the Buddha’s name also helps us to reduce our bad karma, eliminating as many misdeeds as there are grains of sand in the Ganges.  A Buddhist saying tells us, “Reciting the Buddha’s name once can diminish one’s bad karma, and bowing to the Buddha can increase one’s good karma.”  Thus, reciting the Buddha’s name is an effective practice for healing the distress of our minds and bodies, as well as benefiting our cultivation and awakening us to the truth of life.  

Using the Dharma as Medicine: Our world is ailing from a broad range of modern diseases that, while not actually classified as standard medical illnesses, still cause overwhelming suffering and need to be treated.  Some of these are environmental diseases, which include pollution, resource destruction, and loud noise, and societal diseases, including violence, harassment, materialism, kidnapping, and crime.  There are also, educational diseases, such as the physical and emotional abuse of students and the growing lack of respect for authority, and economic diseases, such as opportunism, greed, and corruption.  There also exist religious diseases, which could be explained as superstitious practices, religions that encourage harmful practices, and incorrect interpretations of religious concepts.  Relationship diseases refer to infidelity, polygamy, and rape, and mental diseases include jealousy, distrust, and resentment.  We may seek a doctor’s help for physical illness, but the diseases listed above can only be cured by our own efforts to develop our character, cultivate our wisdom, and practice the Dharma. Buddhism can be used as a medicine to cure our minds of destructive and unhealthy thoughts, which create the conditions for all of the diseases mentioned above.  A pure mind creates a pure world, and the wondrous Dharma is the perfect medicine to guide us to healthy thoughts, healthy behavior, and healthy lives. 

In particular, the six paramitas (8) can be used to cure six kinds of diseases in Buddhism: 1) Generosity cures greed, 2) Observing the precepts cures violation of the precepts, 3) Tolerance cures hatred, 4) Diligence cures laziness, 5) Meditation cures the frenzied mind, and 6) Prajna (wisdom) cures ignorance.  The medicine of the six paramitas enables us to treat our mind and generate peace and harmony in all aspects of our lives.  When we embrace the Dharma, we can resolve the conflicts in our daily life with more ease and develop a healthy mind and a gracious character. 

Master Wuchih created a recipe of ingredients that can be used to turn an unhealthy mind into a healthy one.  In the spirit of Master Wuchih, I created my own recipe for health:  

      One strand of compassionate heart,

                   One slice of morality

           And original nature,

                   A pinch of cherishing good fortune,

Three portions of

        Gratitude and appreciation,

A complete package of

        Sincere words and actions,

One piece of observation of

        Precepts and upholding the Dharma,

      One piece of humility,

                   Ten portions of diligence and frugality,

      Combine all cause and effect,

                   And unlimited skillful means,

      Establishing affinities,

        The more the better!

Topped off with all your faith,

        Vows, and practice.

      Use the pot called magnanimity,

                   Use the heart called open-mindedness,

      Don’t burn it!      

        Don’t let it dry out!

      Lower your hot temper by three degrees,

                   (Mellow out and lose in a little gentleness.)

      Put into a bowl and grind into small pieces.

(Like people entering each other’s hearts and cooperating with each other.)

                 Think everything over three times,

                         Give encouragement as a pill,

                 Each day take this medicine three times,

        Drink it down with the soup of

Love and compassion,

                   Remember when you take the medicine,

You cannot have clarity in speaking

        But a muddled being.

      Or benefit yourself at the expense of others.

                   Ambushing others from behind,

                 And harboring malice within,

        Using a smile to masquerade the desire

 To strike,

                   Or speaking from both sides  of your mouth,

      Creating disharmony just for the heck of it,

                   Refrain from engaging in the seven above,

                      Along with no jealousy or suspicion,

                   Use self-discipline,

                 And Truth to calm the troubled heart,

                   If you can do this, all ills will disappear.

VI. The Contribution of Monastics to Medicine

In India, most monastics are well educated in the five sciences, especially in medicine, which they are required to study.  Because knowledge of medicine is mandatory for monastics, throughout Buddhist history there are many well-known monastic physicians, medical scholars, and medical texts.  For example, in the Buddhist sutras, we find countless references to and discussions about medicine.  Evidence also demonstrates that Buddhism has made a significant contribution to the world of medicine not only through the development of respectable health theories and principles but also through actual practice.  While by no means an exhaustive list, the following are brief accounts of Buddhist masters who have stood out in the history of Buddhist medicine. 

In China, Master Buddhasimha was dedicated as the Honorable National Master of the East Gin Dynasty by Emperors Shile and Shihu.  He was exceptionally skillful in reciting curative prayers and administering medicine.  He tended to many patients who were paralyzed, in great pain, and were hopeless about finding a cure for their ailment.  Master Buddhasimha never gave up on them, faithfully devoting his heart to caring for them as they suffered, prescribing the proper medication, and finding a lasting cure for their diseases.

Master Zhu fatiao came to China from India, and stayed in Changshan Temple most of the time.  He was quite famous for his ability to cure people, and patients journeyed hundreds of miles to seek his help.  After skillfully diagnosing the problem and prescribing the appropriate treatment, nearly all of his patients were restored to good health.

Master Faxi lived during the Tang Dynasty.  When he resided in the capital, he assumed full responsibility for all of his patients’ needs and cared for them personally, including cleaning up their excrement.  He never complained about this task or considered it filthy or difficult.  On the contrary, he was always enthusiastic and joyful as he tended to his patients.  Both the patients and fellow monastics praised his compassionate conduct.  Master Faxi not only cured patients’ physical diseases, he also patiently brought them the knowledge of the Dharma to comfort them when they were feeling hopeless or in pain. 

Buddhists have also been credited for contributing to the cure of leprosy, a dangerous and contagious illness that often drove people away.  However, many Buddhists chose not to avoid victims of leprosy but instead worked among them to help ease their suffering and cure their debilitating illness.  Many monks put forth great effort to help leprosy patients, caring for them, encouraging them, changing their bandages, draining their infected sores, and doing their laundry.  These people risked their lives by performing services that most people avoided.  Their tenderness touched many people.

VII. Conclusion

As we have discussed, numerous physical and mental diseases afflict us and cause great suffering.  While Buddhist medical theories acknowledge and treat the devastating effects of physical diseases, they regard diseases of the mind as the most destructive to health and happiness.  According to Buddhism, people suffer from disease when they:


Settle into peace of mind

Control anger

Resolve hatred

Calm a fearful heart

Dissolve sadness and worry


Cease arguing

Stop competing

Practice humility and offer tolerance to others

Recognize when quietude is appropriate

Maintain a healthy balance of chi


Endure life’s difficulties

Lead a simple lifestyle

Practice proper etiquette

Cease their fear of death

Reorient erroneous perceptions

All of these diseases are caused by our rigid attachment – to an idea, belief, person, appearance, possession, emotion, status, or experience – to anything at all.  If we can understand the true meaning of detachment and the true nature of emptiness and treat all illness with this awareness, we will then have the perfect, miracle medicine to remove the roots of disease.  Both the body and the mind need to be taken care of, and the medicine of Buddhism is the ideal remedy.  Use the Dharma to heal your mind, and the path of true health will open up for you.  I wish you health and happiness!


(1) The Tripitaka is the canon of Buddhist teachings, including Sutras (sermons of the Buddha), the Vinaya (precepts and rules of Buddhist discipline), and the Abhidharma (commentary on the Buddha’s teachings).

(2) Medicine is one of the five sciences whose study is mandatory for monastics. The other four are language, arts and mathematics, logic, and the philosophy of Buddhism. 

(3) According to Chinese medicine, chi is the energy or life force that circulates throughout the body; this vital power is believed to flow throughout the entire universe.

(4) In practicing the Middle Path, one avoids both extremes of indulgence and asceticism.

(5) Sometimes referred to as “temptations” or “afflictions,” these mind-torments, e.g. greed, anger, sloth, jealousy, and many others, inhibit one from residing in true, original, pure mind.

(6) System of glands that secrete hormones directly into the lymph or bloodstream.

(7) Powerful spiritual practice of reciting a word, sound, or verse, used to cultivate wisdom, deepen concentration, and effect a change in consciousness.

(8) Literally meaning “crossing over to the other shore,” paramitas are the core virtues of the bodhisattva path.


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