Back in 2001, I spent a summer-long “rains retreat” at a Thai forest monastery in the far northeastern territory of the country. The muggy days were long and filled with manual labor, and one of the jobs we were required to do daily was to sweep the monastery’s paths clear of leaves. Foliage was constantly falling upon the maze of dirt walkways that crisscrossed the grounds, so keeping them clear was a never-ending task. But it was also an important job, for in the rainforest you never know what may be silently lurking underneath a layer of new-fallen leaves.
One evening we had the misfortune of learning one answer to that question. It was around dusk, and several of the lay residents who were staying for the summer were relaxing in the main hall before the evening bell. One of us, a Singaporean guy in his early twenties, called it a night and set off toward his hut alone. Just a few minutes later, he came limping back to the group and breathlessly told us he had stepped on a dtakab, a red 8-inch centipede greatly feared for its venomous bite. The centipede had run up his pant leg and had gotten him right in the groin.
As the words came out of the young man’s mouth, he collapsed onto the floor, moaning in pain. We were all rainforest rookies, so we had no idea what it meant to be bitten by a dtakab or how to help. But someone grabbed a high-powered flashlight and bravely set out into the gathering darkness. Shortly after, they returned with one of the senior monastics—the temple’s “doctor monk.” He briefly examined the patient—whose pain was becoming worse by the minute—and swiftly prepared an infusion using a forest herb that he said had antitoxin and antifebrile qualities. We were in the middle of nowhere, hours from a hospital, but the monk assured us that the patient would pull through if we remained with him and periodically administered a dose of the medicinal brew. He also stressed that we should help our friend chant in homage to the Buddha continuously until his symptoms had passed.
Namo tassa bhagavato arahato samma sambuddhassa. All that night we chanted this line while our fellow resident struggled through the pain, his abdomen rigid, his breathing labored, his body contorted in pain. Every hour or so we got him to drink a dose of the medicine. At one point, he was in such pain that it looked like he might be having seizures, but the pain slowly began to subside as the night passed. Gradually his chanting got stronger and eventually, just before dawn, he sat up and declared that he was better.
That chant—“Honor to the Blessed One, the Worthy One, the Fully Perfectly Enlightened One”—is a standard gatha, or sacred verse, familiar to any Theravada Buddhist. My assumption was that the doctor monk had recommended it because he believed it had magical healing powers. Indeed, by this point in my travels I had already seen that same phrase used in countless other rituals taking place all over Thailand, from temple blessings to protective sak yant tattoos to exorcisms.
No doubt the gatha was intended to invoke the magical protection of the Buddha, which is an integral part of any Thai folk remedy. Maybe the doctor monk also intended it as a kind of placebo to instill faith in the patient that he would be OK. However, I also came to understand that the healing powers of chanting the gatha through that long night were much more tangible than I initially supposed. It gave the patient a way to concentrate his mind, allowing him to focus on something other than his pain and anxiety. Doing this with his friends also reassured him that he was not alone. It offered him a concrete sign that we were sticking around, caring for him, and wishing him well. As I watched the young man’s progress that night, I also noticed that to chant the gatha out loud with the proper intonation, he had to regulate his breathing, to take deeper, longer, more rhythmic breaths. This allowed his body to relax, while the vibration of his voice resonated in his chest and abdomen.
The more I reflected on what had happened, the more I saw the many different facets of healing that one gatha could evoke. From one perspective, it qualified as a religious or magical remedy, but it was simultaneously affecting the patient on the energetic, emotional, social, physiological, and even anatomical levels. How much healing wisdom could be found in a practice I had initially discounted as mere superstition!
This episode was one of many encounters with Buddhist healing practices that I witnessed or participated in while I was living in Thailand in the late 1990s and early 2000s. Taken together, these experiences ultimately inspired me to become the scholar and historian that I am today. For the past twenty years, I have dedicated myself to studying and writing about the history and contemporary practice of Buddhist healing. I think one of the most important takeaways from this research is the encouragement it gives us to move beyond simplistic characterizations of the relationship between Buddhism and medicine (or between spirituality and health, more generally).
For example, take the debate that is prevalent these days about the health benefits of meditation. On the one hand, many proponents of mindfulness-based stress reduction and other meditation-based interventions dismiss practices like chanting gathas as “Asian cultural baggage” that should be omitted in favor of more secular approaches. On the other hand, we hear Buddhists criticize the use of meditation only for stress reduction or other therapeutic purposes as “McMindfulness” that debases or waters down the dharma.
However, based on my research of Buddhist scriptures and other historical writings, a productive and nuanced dialogue has taken place between Buddhism and medicine since the very beginning of the tradition. Comparing Pali, Sanskrit, Chinese, and Tibetan sources also shows unequivocally that there has never been one single Buddhist approach to questions of healing. Buddhists have understood the intersection of health care and the dharma in many diverse ways across cultures, and there has been much change and development over time.
In some times and places, Buddhist teachings have drawn a stark line between the “otherworldly” (lokottara) goal of enlightenment and “this-worldly” (laukika) aims such as health and well-being. This kind of discourse is commonly found in writings directed toward monastics, such as the various vinayas and other disciplinary texts. The Pali Vinaya, for example, calls healing a “worldly art” (tiracchana-vijja), off-limits to the sangha along with other distractions such as spell casting, interpretation of dreams and omens, and astrology. Even so, other Pali texts—and indeed other sections of the same Pali Vinaya—relate many examples of medical procedures, healing rituals, and miraculous interventions conducted by the Buddhist laity, monastics, and even the Buddha himself. Thus we can’t say that there was a definitive prohibition against this kind of activity.
With all this dialogue taking place between Buddhism and medicine, it doesn’t make sense to separate the two.
As the Buddhist tradition developed over time, healing became more central to the formal practice of the dharma. Indeed, in some of the most influential literature of the Mahayana (such as the Lotus Sutra, the Sutra of Golden Light, and the Flower Garland Sutra) medical learning and healing activities are celebrated as essential parts of the bodhisattva path. In Vajrayana, or esoteric Buddhism, mental and physical health are almost always enumerated among the explicit goals of tantric practice, and ritual texts such as the Mahavairocana Tantra, the Kalacakra Tantra, and others describe exactly how practitioners can achieve perfect health.
Looking beyond the scriptures, historical records from all over Asia show us that health care was a major part of Buddhist practice wherever the religion spread. Buddhist hospitals were founded in 7th-century China, 9th-century Sri Lanka, and 12th-century Indonesia, among other areas. Monastic medical schools were operational at Nalanda, the ancient university in India, at Dunhuang along the Silk Roads, at Lhasa in Tibet, and across northeastern China and Mongolia. Major Buddhist texts containing healing formulas and rituals—including the Sutra of Golden Light, the Medicine Buddha Sutra, and the Sutra of the Great Compassion Dharani of Avalokiteshvara—circulated widely throughout the region. Medical texts used by traditional doctors from Sri Lanka to Japan contained all kinds of remedies and interventions drawn from Buddhist sources.
This flow of Buddhist healing knowledge was facilitated by extensive networks of exchange by which texts, medicinal substances, and healer-monks traveled back and forth between Buddhist kingdoms across Asia. All this activity inspired the development of local forms of Buddhist-influenced traditional medicine that are still popular today in places like Thailand, Myanmar, Cambodia, and Laos. The practice of sowa rigpa, a form of Buddhist medicine that developed in Tibet, spread throughout the Himalayas, Mongolia, and neighboring parts of India, China, and Russia. In sum, it turns out that Buddhism was one of the most important catalysts in all of premodern world history for the cross-cultural transmission of medicine.
In the modern period, Buddhists around the world have continued to integrate dharma teachings with mental and physical health in myriad ways. Traditional Buddhist ideas about illness being caused by demons, energies, and elements, which were the main ways of understanding illness in all premodern Buddhist cultures, continue to be valued across the planet today. At the same time, many Buddhists at present are attempting to reconcile these ideas with modern scientific models and understandings, though how exactly these two worlds are brought together varies from culture to culture. In Thailand, for example, Buddhist practice is considered to be a legitimate part of the national healthcare system, complementing biomedicine. In Tibetan cultural areas, Buddhist healers use modern science to explain the healing efficacy of chanting mantras. In Japan, scientists have adapted Pure Land contemplative practices for the treatment of alcoholism in prisons and health clinics. And here in the West, meditation for stress reduction has become a routine part of mainstream health care.
The point is that there is no single correct Buddhist position on health and healing. There is a rich and complicated history around this issue with many divergent positions taken by faithful and committed Buddhists in different cultures, times, and places. With all this dialogue taking place between Buddhism and medicine, it doesn’t make sense to separate the two; indeed, to most Buddhists they are overlapping spheres.
Resituating our current understanding of the relationship between Buddhism and health care within the longer global history of Buddhist medicine opens us up to hear a wider range of diverse voices. Understanding this complex history helps us to move beyond the dualistic thinking that often characterizes these debates. When we consider perspectives beyond our Eurocentric views, we realize that aspects of the Buddhist tradition we might be quick to dismiss as “cultural baggage” or “superstition” may contain a great deal of practical healing wisdom.
For example, I learned that night in the Thai forest monastery that the advice to chant a gatha—which I assumed was simply an optional religious or spiritual add-on to the doctor’s herbal prescription—was in fact an integral part of the medicine. Bringing that insight into my textual research over the past few decades, I have come to see that many other Buddhist approaches to healing consist of sophisticated blends of herbal medicines, physical interventions, breathing exercises, energy work, magical therapeutics, and religious beliefs—all operating together to maximize the total healing effect on the human being.
A black-or-white approach that either focuses exclusively on the results of scientific study of meditation or is only interested in the transcendent goals of Buddhist practice misses these nuances entirely. In my view, it is precisely the integration of anatomical, physiological, energetic, emotional, social, and spiritual levels that defines Buddhism’s approach to well-being and gives Buddhist medicine its unique advantages. After twenty years of study, I have come to believe that this tradition is a treasure trove of healing interventions that remain to be fully appreciated—and that call out to be translated into English and clinically tested. I am hopeful that a more careful, sensitive, and inclusive investigation of what Buddhism has to offer may in the future lead to better health outcomes and to longer, happier lives for us all.