Buddhism and Health:
Healing the Ills of Body and Spirit
Modern medicine has worked great wonders for humanity over the past century. Many of the ancient scourges, polio and smallpox among them, have been largely eradicated or are at least no longer feared. Average life spans continue to lengthen worldwide, even if at a slower pace in the developing world than in the developed. And the coming century promises even more marvels, thanks to ceaseless advances and new technologies.
Yet medical science is not without its share of shortcomings. As the June 24, 1996, cover story of TIME magazine observed: "Western medicine is at its best in a crisis--battling acute infection, repairing the wounds of war, replacing a broken-down kidney or heart. But increasingly, what ails America and other prosperous societies are chronic illnesses, such as high blood pressure, backaches . . . and acute illnesses that become chronic, such as cancer and AIDS. In most of these, stress and life-style play a part."
In short, modern medicine, with its predominant focus on human physiology, is woefully unprepared to combat and cure a bevy of debilitating disorders that are either triggered or aggravated by mental, emotional and spiritual factors. This view of the comprehensive nature of human health is neither new nor unique. The preamble to the World Health Organization charter reads: "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity."
The Buddhist understanding of good health is similar, with its emphasis on the balanced interaction between the mind and body as well as between life and its environment. Illnesses tend to arise when this delicate equilibrium is upset, and Buddhist theory and practice aim to restore and strengthen this balance. In the treatment of illness, however, Buddhism in no way rejects modern medicine and the powerful array of diagnostic and therapeutic tools at its disposal. Rather, it states that these can be put to most effective use in combating illness when based on, and reinforced by, a deeper understanding of the inner, subjective processes of life.
Central to the Buddhist approach to health and healing is its emphasis on spiritual strength and an overriding sense of purpose, or mission, in life based on compassionate action for others. While the therapeutic efficacy of these attributes is still not widely recognized by the medical profession, Buddhism asserts that they make it possible for an individual not only to create value even in face of the severest adversity, including sickness, but to forge from them an opportunity for personal growth.
The Swiss philosopher Karl Hilti (1833 - 1909) may have described this process best when he wrote, "Just as the flooding of a river digs up the soil and nourishes the fields, illnesses serve to nourish our own hearts. A person who understands his illness correctly and perseveres through it will achieve a greater depth, strength and greatness in life." Buddhism holds that genuine good health is in fact to be found within this process of self-actualization.
From Herbs to Harmony
Since the emergence of the human species, health and disease have been primary concerns. Over time, people learned that some ailments could be treated with herbs and minerals found in nature; others, however, defied simple cures and were usually assigned supernatural causes. Hippocrates of Cos (c. 460 - c. 377 B.C.E.), best known today for the Hippocratic oath sworn by medical students the world over, believed that physical well-being was the result of the harmonious interaction of a variety of factors. Likewise, he was acutely aware of the body's innate healing powers.
At around the same time as Hippocrates, Shakyamuni, the founder of Buddhism, was advancing remarkably similar notions on health and healing. As the prince of a small Indian kingdom, Shakyamuni himself was traditionally said to have studied medicine and thus to have acquired knowledge about the medical techniques practiced in his day. Such roots may have helped consolidate the bonds tying Buddhist spirituality to healing: Buddhist texts, for instance, liken people's sufferings and delusions to illness, Shakyamuni to a great physician, and his teachings to good medicine.
Shakyamuni's view of the healing arts was eminently practical. Given the difficulty of maintaining sanitary conditions at the time, for instance, he preferred noninvasive dietary and ointment therapy to surgery--although he permitted it where there was no other alternative. Other examples of his pragmatic approach include the insistence on proper hygiene and the recognition of the value of physical exercise.
More importantly, Shakyamuni never resorted to what might be considered "faith healing," nor did he ever instruct the sick to perform magical rituals of any kind. Instead, he offered people rational, pragmatic instruction in dealing with their injuries and illnesses, based on his profound insight into the nature of life. Among the key principles he taught were the oneness of body and mind, value of altruistic compassion and of enhancing wisdom and the natural vital energies inherent in life.
While modern medicine tends to address the ailing part of the body in isolation from the rest, treating it alone as if fixing a malfunctioning part of a machine, the Buddhist understanding of health sees disease as a reflection of the total somatic system, or life itself, and seeks to cure it through a fundamental reorientation of a person's life-style and outlook.
There are a number of reasons why Buddhism takes this approach. A major factor, as noted earlier, is the inseparability of the physical aspects of life from the emotional, mental and spiritual--stress being the most commonly encountered negative example of this principle at work. The optimal condition of health, therefore, is one achieved when mind and body are functioning well and interacting together as one. Tapping the inexhaustible font of somatic energy that exists within all people is a principal purpose of Buddhist practice.
The Buddhist outlook, moreover, maintains that life force is further strengthened by such qualities as hope, courage and a strong sense of purpose in life. The last is especially critical. Just as an Olympic athlete is driven to ever greater performances by the ever more demanding goals he or she sets, the loftier one's lifelong mission, the more expansive a state of life one can enjoy. The most treasured of all missions, Buddhism asserts, is that of the bodhisattva, or a life of altruistic compassion devoted to the welfare and happiness of all people. An individual who is profoundly committed to such a mission is able to create enriching, life-affirming values out of any difficulty and can use all problems as an impetus for further development.
For a person possessing such unassailable inner strength, physical health alone is no longer the determining factor for personal happiness. Rather, the challenge of overcoming illness itself becomes an important bodhisattva practice because it encourages and inspires hope in others and, by doing so, helps relieve their suffering. Even death, which is as much a part of human life as illness and aging, provides an opportunity for inspiring for others through example.
The Buddhist view of health and modern medicine, therefore, are not mutually incompatible but can serve to complement one another. Further, a greater understanding of Buddhist perspectives on health and healing could broaden the horizons of Western medicine--not through advances in technology, but through the adoption of a new philosophy, or attitude, towards health and life that may serve as the underpinnings of a truly modern medicine. In the words of the late Norman Cousins, a renowned journalist and humanitarian: "A good physician is not only a scientist but a philosopher."
Perhaps the most systematic presentation of the Buddhist perspective on disease and its causes was classified by Chih-i, a Buddhist teacher in sixth-century China, in the treatise Great Concentration and Insight. The six categories are: disharmony among the so-called "four elements" (earth, wind, fire and water, each representing specific physiological systems or functions); immoderate eating or drinking; poor posture; the work of demons from without; attacks by devils from within; and karmic diseases.
While Chih-i noted that an imbalance between any one of the four elements and the environment invariably led to specific ailments, the essence of his analysis was that human health is very much contingent on environmental factors. This dynamic and interactive process, furthermore, is the reason why Buddhists believe the preservation of the world's ecosystem is an important means to protect the health of human beings. This is paralleled on a personal level by the sensible caveat against immoderate drinking and eating.
To understand what karmic diseases are, an explanation of karma is needed. Karma can be thought of as the deeply rooted potential or tendencies which we have implanted in the inner realms of life over time. Karma is the stored-up accumulation of causes which become manifest as specific effects when the proper conditions are present. Karmic illnesses are almost by definition beyond the power of the treatments of that era. As a cure for one such illness is found, another seems to arise to take its place, maintaining an almost constant balance of this form of human misery. Over the millennia, for example, leprosy was considered a karmic disease; today, new and incurable ailments such as the Ebola virus or AIDS would fit that classification.
More is meant by the admonition on "posture" than just the way the body is held; it represents the rhythm of daily living. Buddhist Great teacher Chih-i(or Tientai of China) warned that a disruption of this rhythm could upset the equilibrium of the four elements and thus trigger an array of ailments. References to demons and devils are likewise symbolic. The former are external factors, such as invasive pathogenic bacteria and viruses. The latter, in contrast, are internal influences such as spiritual malaise.
The ultimate such debilitating influence is what Buddhism describes as "the fundamental darkness of life, which can so deprive people of compassion and wisdom that they can commit without flinching the most depraved and destructive acts. This deluded nature drives the impulse to kill and destroy, or the equally primitive urge to dominate or control others for one's own benefit. Buddhism defines a life lived under the sway of these impulses as a form of mental illness.
This barbarism lurking in the depths of life is undoubtedly one of the most fertile spawning grounds of that bane of modern society: stress. Keenly aware of omnipresent toll of stress, the late Dr. Linus Pauling, recipient of the Nobel prizes for chemistry and peace, called for the development of economic and political systems that would reduce the amount of stress on the individual human being. As he noted in A Lifelong Quest for Peace, a dialogue with SGI President Daisaku Ikeda, "A good way to do this is to abolish war." Indeed, the innate potential for violence is why Buddhism places such a premium on robust spirituality and compassionate action for others--and the reason the Buddhist concept of health transcends the mere absence or presence of disease. For no human pathology cries more loudly for cure today than war.