THE AS THE GREATEST HEALER: THE COMPLEXITIES OF A COMPARISON

PAR

PHYLLIS GRANOFF*

I. THE BUDDHA AS SUPREME HEALER

It is well known that the Buddha was often compared to a physician; indeed in many texts he was called the greatest physician of all.1 This comparison was deeply embedded in Buddhist discussions of the nature of suffering; suffering is a disease, the cause of which must be under- stood and removed, just as the cause of ordinary physical ailments must be understood and countered. The fact that the same metaphor occurs with equal strength in medieval Christian Penitentials suggests its power as a description of the process of salvation.2 I would like to begin this

* Lex Hixon Professor of World Religions, Department of Religious Studies, Yale University. 1 The Jains could say the same of the Jina. See the Upamitibhavaprapañcakatha, ed. Peter Peterson, Calcutta: Baptist Mission, 1899, pp. 1211-1215. For references to Buddhist sources see Paul Demiéville, “Byo” in the Hobogirin, Troisième Fascicule, Paris: Adrien Maisonneuve, 1937, p. 224-265 and Kenneth Zysk, Asceticism and Healing in Ancient , New York: Oxford University Press 1991. Wilhelm Halbfass, Tradition and Reflec- tion: Explorations in Indian Thought, Buffalo: State University of New York Press, 1991, chapter 7, “The Therapeutic Paradigm and the Search for Identity in Indian Philosophy”, pp. 242-257, discusses the limits of the medical model in and other schools of Indian philosophy as well. See also the extensive discussion in Linda Covill, A Meta- phorical Study of the Saundarananda, : , 2009, pp. 99-184. I also thank Charles Malamoud for sharing with me his paper, “Doctors as Characters in Narrative Literature.” 2 Handling Sin: Confession in the Middle Ages, ed. Peter Biller and A.J. Minnis, York: York Medieval Press,1998, Introduction, p.8; Alexander Murray, “Counseling in Medieval Confession”, p. 66; 69-70; John Baldwin, “From the Ordeal to Confession”, pp. 202-203; J T McNeill, “Medicine for sin as prescribed in the Pentientials”, Church History 1, 1932 pp. 14-26.

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discussion with a passage from the Mulasarvastivadavinaya, in which the Buddha explains to his own celebrated doctor Jivaka just why the Buddha is called the best of physicians, the best of surgeons. The passage appears in a long section on the extraordinary abilities of the doctor Jivaka, who is an illegitimate son of the king Bimbisara. In this passage, Jivaka has performed so many brilliant diagnoses and cures that he begins to let his pride get the better of him. Here is the text3. Jivaka became proud and thought, “There is no doctor who is my equal. I am the best of those who cure the body and the Blessed One is the best of those who cure the mind.” Now one time he went to see the Blessed One. Being overcome by his pride, he could not see the truths. The Blessed One thought to himself, “This Jivaka has accumulated much . How is it that he does not see the truths? It is because of his pride. I must destroy his pride. “And so the Blessed One said to Jivaka, “Jivaka, have you seen the Himalaya, the king of the mountains?” “No, Blessed One”. “Then grab on to a corner of the Tathagata’s robe.” Jivaka grabbed the robe. And with that the Blessed One took Jivaka the King of Physi- cians to the Himalaya, King of Mountains. There numerous medicinal herbs glowed like so many lamps. The Blessed One said to Jivaka the King of Physicians, “Jivaka, gather all the herbs you want.” “Blessed One, I am afraid.”. And so the Blessed One said to the yakÒa Vajrapa∞i “Go, Vajrapa∞i, and protect Jivaka. “Jivaka went with him and gathered up all sorts of medicinal herbs. The Blessed One asked him, “Jivaka, do you know the name of this herb?” He answered, “Blessed One, it is such and such. With this, such and such a disease is cured. And this one is such and such. It cures such and such.” But he did not know the names of the others. The Blessed One told him about all the herbs that he did not know: this is such and such and used in this way it cures such and such. This is such and such and so on. Jivaka said, “The Blessed One also knows medicine!” The Blessed One then said to Jivaka, “A doctor, a surgeon, is worthy of the title of king, worthy to be a king, and gains fame in the court of the king, by knowing four things. By what four things is a doctor, a surgeon, worthy of the title of king, worthy to be a

3 Mulasarvastivadavinaya, edited Dr. S. Bagchi, Buddhist Sanskrit Texts no 16, Darb- hanga: Mithila Institute of Post-Graduate Studies and Research in Sanskrit, 1967, p. 193-4.

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king? He is skilled in the nature of diseases, in their causes, in the curing of diseases that have arisen, and in the prevention of their arising in the future. There follows a long description of various medical practices used to cure diseases and a definition of each of these four skills of the doctor, which I abbreviate.

Then the Blessed One says, “Similarly, with these very four things, the Tathagata, the , the perfectly enlightened one, is said to be the best of doctors, the best of surgeons. He knows the truth of suffering; he knows the cause of suffering, the removal of suffering, and he knows the path to avoid all future suffering. But, Jivaka, the ordinary doctor, the ordinary surgeon, does not know the medicine that cures the suffering that is caused by birth. The Tathagata does. Therefore the Tathagata, the Arhat, the per- fectly enlightened one, is said to be the best of all doctors, the best of all surgeons.”

In this passage, the Buddha is depicted as both an accomplished doctor of medicine in ordinary terms and a very special kind of healer whose skill transcends any skill that a medical doctor possesses. As an ordinary physician, he knows far more even than the great Jivaka, because he knows about medicaments that Jivaka has never even seen and indeed could not have seen without the assistance of the Buddha’s magical power that enabled him to transport Jivaka to the distant Himalaya. Jivaka is surprised by the Buddha’s knowledge of healing herbs, but the Buddha wants Jivaka and us to understand that even the greatest healers of the body are not as great as the Buddha, who heals the disease that is life itself, with all its woes of birth, sickness, ageing and death. The Buddha likens the to the four-fold knowledge that a doctor must have: the doctor must know that there are diseases and what they are, just as the Buddha knows that everything is duÌkha, suffering. The doctor must know the causes of diseases, whether a disease is caused by an abundance of wind, of bile or of phlegm, as the text elaborates, or by ignorance and craving as the four-fold path will teach. The doctor must know how to cure diseases, and here the text gives a list of treatments, including purgatives, emetics, sweating, fumigation, that must have rep- resented current medical practice. In the Four Noble Truths, the treatment is the removal of the causes of birth and suffering, for example ignorance

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and craving. The ordinary doctor must prevent the future occurrence of a disease and insure health; similarly the Buddha teaches a way to find a permanent from suffering, through the eight-fold path. In this vignette we see that the Buddha is both the transcendent healer and the consummate physician of the body. There are many stories in the which describe how the Buddha by his mere presence or by the touch of his hand was able to heal. One of the most famous of these stories was told in the Mahavastu, about the Buddha ridding the city Vaisali of the plague merely by stepping across the threshold of the city gate.4 In the Lalitavistara the Buddha heals from the womb. Throngs of the sick come to see the pregnant Maya, who stretches out her hand and by her touch heals them all. She even prepares healing herbs that she distributes to the sick.5 There are many such stories, but I will leave them for another occasion and return to the comparison that was so often made between the Buddha and a physician. The Buddhabaladhanapratiharyasutra, which is known from a manu- script discovered in Gilgit, opens with a similar long comparison between the Buddha and a doctor.6 The skilled physician masters the science of medicine with its eight-fold limbs and knows what is best for his patients who are suffering from various diseases. He knows what will heal them and he knows the various causes of their disorders. The means that he exploits to cure them are various, and the text lists many of them. For his part, the Buddha has mastered trance states, attained powers from his meditative practices, and has supernatural sight and hearing. These the text likens to the doctor’s mastery of the eight-limbed science of medicine. Like the doc- tor, the Buddha employs various means, which the text calls his “skill in means” to relieve the suffering of living beings. These living beings are all afflicted by the diseases of lust, hatred and delusion; they are enveloped in fear, anger and grief. The Buddha sets them on the path to health, which is perfect enlightenment and nirva∞a, through the eight-fold noble path.

4 Mahavastu, translated J.J. Jones, reprinted London: Text Society, 1973, vol. 1, pp. 208-218; text on GRETIL pp. 253-258. 5 Lalitavistara, text on GRETIL, p. 53 (from the edition of P.L. Vaidya, : Mithila Institute, 1958.) 6 Text on GRETIL, from the edition of N. Dutt, Gilgit Manuscripts, vol. V, 1984, pp. 173-183.

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The comparison between the doctor’s craft and the Buddha’s teaching is far reaching in this text. Both the doctor and the Buddha possess spe- cialized knowledge; both exploit multiple strategies to cure; both adjust their remedies to the nature of the individual sickness and the individual patient, and both aim for a lasting cure from sickness. In some texts in fact the ultimate Buddhist goal of nirva∞a is even called arogya, freedom from sickness.7 It is not only the Buddha who is likened to a doctor and to one par- ticular celebrated doctor, Jivaka. The also becomes likened to a doctor and to Jivaka. In chapter 8 of the SikÒasamuccaya, we find a somewhat risqué story about Jivaka that is taken from a text called the Tathagataguhyasutra8. In this story Jivaka collects all the medicinal herbs that exist and shapes them into a statue of a woman. This statue is animated; it can walk, sit, lie down, everything but talk. The sick come in droves, kings, princes, merchants. Jivaka has them fondle the statue (and perhaps more) and when they touch it they are cured of their ills. The text explains that this is the treatment for ordinary physical ail- ments. For his part, the bodhisattva by the great power of his vow is instructed to heal all the living beings, who are made ill with lust and delusion, by the mere touch of his body. The same theme is to be found in the Suraμgamasamadhisutra, where the Bodhisattva is compared to the great king of medicaments (MahabhaiÒajyaraja), and to the greatest medicinal trees (bhaiÒajyav®ÈÒa) every part of which can cure illness. Like the tree, the bodhisattva in every moment of his existence aids living beings9. Other texts enlarge the comparison of the Buddha with the physician. In the Bodhicaryavatara chapter 7, an aspiring bodhisattva becomes fear- ful that the path is too difficult and he cannot make it. His fear is aroused by the often told stories of how the Buddha gave life and limb to save another living being. He fears he will not be able to endure such pain.

7 For references see both Paul Demiéville, “Byo, p. 224-265 and Kenneth Zysk, cited in note 1. 8 ÇikÒasamuccaya: A Compendium of Buddhist Teaching, edited Cecil Bengall, ’S-Gravenhage: Mouton &Co, 1957, pp. 158-159. 9 Suraμgamasamadhisutra:The Concentration of Heroic Progress, translated by Étienne Lamotte, London: Curzon Press, 1998, pp.136-137.

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The text explains that even in teaching a path that is so arduous, the Buddha is simply behaving like the best of doctors. Like a master healer, the Buddha teaches a way that involves some pain, but in the end brings absolute relief. “All good doctors heal by first causing pain through their treatments. Therefore you must endure some minor pain in order to be rid of your much greater suffering.” 2310 The pain of practicing the bodhisattva path is likened to the pain of extracting an arrow from the body; in the end the bodhisattva path leads to enlightenment just as the removal of the arrow, though itself painful, in the end leads to a respite from the pain that the arrow had caused. The practice of medicine is not just a metaphor for the teaching of the Buddha. In Buddhist texts of all schools monks are instructed to care for their sick brethren. In texts like the Bodhisattvabhumi, learning the art of medicine is recommended as one way in which the bodhisattva can win people over to the Buddhist cause and serve his fellow human beings.11 To praise the Buddha as the best of physicians, to recommend to the Bodhisattva to study medicine, to liken the pain of the path to the pain encountered in a medical procedure implies, I think, a great respect for the medical profession and its practitioners. It assumes that doctors really do exemplify the wonderful qualities that the medical texts tell us the good doctor should have.12 Indeed many are the stories in the Buddhist texts, particularly of the Buddha’s doctor Jivaka whom we have already met, that reflect the community’s very trusting belief in the powers of the phy- sician to heal and in his honesty. In the rules about medicine, the Buddha works in conjunction with a doctor or vaidya to define the rules. Both in the Pali Mahavagga and the Sanskrit Mulasarvastivadavinaya, the occasion for setting a rule about what medicine is allowable is that a monk becomes sick and goes to a doctor. The doctor tells the monk to

10 Bodhicaryavatara, edited P.L. Vaidya, Buddhist Sanskrit Texts Series, no. 12, Darb- hanga: Mithila Institute of Post-Graduate Studies and Research in Sanskrit Learning, 1960, p. 122. 11 Bodhisattvabhumi, edited Nilakantha Dutta, : K.P. Jayaswal Institute, 1978, p. 74. 12 For a summary of these see Linda Covill, cited in note 1, pp. 144-146.

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take a certain medicine and the monk then goes to the Buddha to get the Buddha’s permission. The Buddha invariable replies, “If that is what the doctor told you to take, then you should take it.” Sometimes the monks return to the doctor for more specific instructions, and the doctor sum- marily and rudely dismisses them, saying, “Your teacher is Omniscient. Go ask him!13 In passages like these no doubt is expressed about the vaidya’s skills or his instructions or his motives, and the Buddha concurs with them. Our familiarity with these passages and with the image of the Buddha as doctor makes the comparison seem natural to us. But in the rest of this paper I would like to argue that there was another view of the healing art, a less optimistic and less positive one, and that it peeks through even in some of the laudatory stories the Buddhists told of the most famous of all healers of the body, Jivaka, who was more than once consecrated by King Bimbisara as the “King of Doctors”. I would also like to suggest that in their elevating the physician to the position of worldly counterpart to the Buddha himself, our Buddhist texts are distinc- tive. Others throughout Indian history did not look so favorably either on the skills of the doctors in their midst or on their ethics. We know, for example, that the Brahmanical law codes like Manu considered doctors among those who are ritually and thus socially unacceptable; if on a ritual occasion someone gives food to a doctor, in the next life he will himself have to eat pus and blood (3.180).14 In this verse the doctor is listed with the person who sells soma and the fallen priest who tends images in a temple. He is thus among the lowest of the low. Even earlier, the Taittiriya Saμhita, vi.4.9, proclaimed that the physician is “impure, unfit for the sacrifice.”15 If we look at some of this other material, I think we can see that the use of the doctor as the counterpart to the Buddha was not as natural or as simple as it might at first appear, and in its radical support for this controversial figure in society, might even have had some surprise value that we have entirely overlooked.

13 Mulasarvastivada, p. 3. 14 Manavadharmasastram with the Commentaries of Medatathi, Sarvajñanaraya∞a, Kulluka, Raghavananda, Nandana and Ramachandra, Bombay: Ganapat Krishnaji’s Press, 1886, pp.388-389. 15 The Veda of the Black Yajus School Entitled Taittiriya Samhita, Part 2: Ka∞∂as IV-VII, translated by Arthur Baerriedale Keith, Delhi: Motilal Banarsidass, second issue 1967, p. 535.

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II. THE INCOMPETENT DOCTOR

I would like to begin by looking at some of the stories of Jivaka told in the Civaravastu of the Mulasarvastivadavinaya.16 The birth of Jivaka is told at the beginning of this section of the vinaya; he is the illegitimate son of King Bimbisara, who is described as a womanizer, and a married woman, whose husband the king has sent away on an errand. The child is brought to the palace and raised with another illegitimate son of the king, Abhaya. Both decide that it is Ajatasatru who will succeed Bimbisara and that they need to have a trade and a way to earn a living. Abhaya decides to be a chariot maker, and Jivaka decides to be a doctor. Neither of these is a high-status occupations. Jivaka begins to study medicine and wants to learn the magic art of opening the skull, the kapalamocinividya. For this he must journey to TakÒasila, where he studies under the great physician Atreya. Jivaka accompanies the doctor when he goes to make house calls, which is very lucky for some of the patients. Once when Atreya tells a sick man to take a certain medicine, Jivaka thinks to himself, and I translate, “This teacher of mine is over the hill. If this patient were to take this medi- cine, he would die on the spot. The teacher has surely made a mistake. I must find some way out of this.” He left with Atreya but then went back. He told them, The teacher says, ‘Do not give the medicine he first told you to give. Give this instead.’ They did what Jivaka said and the patient was cured.” The story is clearly told in praise of Jivaka’s great skill. As the story concludes, Atreya realizes what has happened and knows that Jivaka is gifted. From that time on he takes him with him wherever he goes. But there is another side to the story, and that is Atreya’s incompetence. He is over the hill and would certainly have killed his patient but for Jivaka’s intervention. In another vignette, Jivaka watches surreptitiously while Atreya uses the Kapalamocanividya, the skull-opening spell, because he wants to learn how to open skulls and Atreya has not yet been willing to teach him. Atreya has a patient who has a headache because some kind of insect has lodged in his brain. Atreya opens the skull and tries to remove the insect with a tweezer. Jivaka realizes that he will kill the patient and

16 Mulasarvastivadavinaya, p. 184ff.

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jumps out of the hole in which he was hiding. He tells Atreya to heat the end of the tweezers and then touch the hot metal to the tail of the insect. The insect will curl up its feet and can be easily removed. Atreya again praises Jivaka’s skill and finally agrees to teach him the spell.17 Again, the highly revered doctor Atreya was about to kill his patient. The senile doctor appears in Jain stories as well and we can assume that it was a well-known theme. The Jain Puratanaprabandhasaμgraha, a much later text than the Mulasarvastivadavinaya, preserves some stories about the famous physician Vagbha†a. In one story the elder Vagbha†a is sum- moned to cure the king of his headache. The king has a creature in his head, much as did Atreya’s patient. The creature is called a darduri, which could mean a female frog, but is probably more like the centipede-like creature that was troubling Atreya’s patient. The elder Vagbha†a is accom- panied by the younger Vagbha†a, his son-in-law. The elder doctor cannot for the life of him remove the creature. When everything he tries fails, the younger doctor easily coaxes the creature out by it a dish with his own blood in it. The moral of the story is clear: even the greatest physi- cians fail in their powers and need to step aside for younger doctors18. This is not the only Jain parallel to a Jivaka story. There is a story told about a misstep on the part of Jivaka, or at least what seems on the sur- face to be a misdiagnosis19: A certain in Rajag®ha was suffering from a kind of boil. He had been turned away by all the doctors. He thought to himself, “I will go see Jivaka. If he can cure me, fine. If not I will kill myself.” He went to see Jivaka. “Jivaka, cure me!” Jivaka said, “Sir! The medicines to cure you are not so easily found.” He thought, “Jivaka too refuses to treat me. Maybe this is the time for me to kill myself.” And so he went to the cremation ground. There by a blazing cremation fire he saw a lizard and an ichneumon that had fallen into the flames, exhausted from their fight with each other. Starved, he ate them both. It began to rain. He drank the water that was flowing along the cremation ground. Not far from the cemetery was an encampment of cowherds. He went there and ate some coarse grain and buttermilk. His boil burst open. He was completely cured.

17 Mulasarvastivadavinaya, p. 188. 18 Puratanaprabandhasaμgraha, edited Jinavijaya Muni, Calcutta: Singhi Jaina Jñana Pi†ha, Singhi Jain Series, no. 46, 1936 p. 96-97. 19 Mulasarvastivadavinaya, p. 191.

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When it comes time to crown Jivaka as the king of doctors, the person to whom he had said, “The medicines to cure you are not easily found”, appeared on the scene and objected. “King! Are you installing Jivaka as king of the doctors out of love for him because he is your son, or because of his skill as a physician?” “Because of his skill as a physician.” “Well, if that is the case, let me tell you that he could not cure me.” Jivaka said, “Sir! I did not try to cure you. But I did say that the medicines to cure you are not easily found.” The man asked, “What are the medicines that could have cured me?” Jivaka said, “If on the fourteenth night of the dark half of the moon, a person of red complexion should die and as he is burning on the pyre a lizard and ichneumon should fall into the flames, you should eat them both. Then it rains. And you should drink the water that flows from the cemetery and then eat coarse grain and buttermilk. This will cure you. And that is why I told you, ‘The medicines to cure you are not so easily found’”. The man was pleased with this reply and said to the king, “King! Go ahead and make Jivaka king of the physicians.” Here is the Jain version from the Puratanaprabandhasaμgraha20: In order to help people King Bhoja maintained one hundred and seven doctors, providing them with food and a livelihood. He had a huge bell installed at the main crossroads of the city and said, “Whoever is sick should ring the bell so that the doctors can assemble and heal him.” And whoever is sick should help himself to the food and medicines that he needs from the bazaar.” After some time had passed, a person suffering from a swollen abdomen rang the bell. Summoned by the ringing, a doctor pro- nounced him incurable. The sick man went to see the king. The king, his compassion aroused, said, “Doctors, save this man.” The doctors replied, “King, he cannot be saved by us.” When he heard this, the king gave the sick man five hundred dinaras and sent him away. It was the hot season, and the sick man stopped at mid- day along a path where no caravan passed to rest in the shade of a tree. A snake, repelled by his stench, slithered quickly away. Depressed and determined to kill himself, the sick man ran after the snake. He ate some leaves of the arka plant on which a few drops of the snake’s venom had fallen. That cured him. Some woman then took him in and nursed him until he was completely well. He went back to the city and rang the bell. The doctors gathered at the sound of the bell. When they saw that he was not sick, they asked, “Why did you ring the bell?” He replied, “The king will know.” He was taken to the king by them. The king asked him, “What is wrong with you?” He replied, “I am the person whom the doctors gave up on when I was suffering from a swollen

20 Puratanaprabandhasaμgraha, p. 22.

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abdomen. Through your kindness I have been healed.” “How can that be?” One of the doctors replied, “It is that very one. His disease was able to be cured by only one medicine in the world and that medicine could only be procured through the force of his own karma; it could not be bought with money in the bazaar. What is that medicine? King! In the hot season, at midday, he had to eat leaves of the arka plant smeared with the poison of a cobra. If he lived without that medicine, then we are indeed at fault.” The king asked, “Is this the case?” He said, “It is exactly as he said. I ate the leaves of the arka plant smeared with the venom of the snake.” The king was pleased with both sides and gave them both a reward. In both these stories the reputation of the doctor who has failed to help a patient is saved by painting the doctor as omniscient. These stories also may be read as salvage efforts and suggest that there was a tacit acknowl- edgement that there were many such incidents in which a doctor was either outright wrong or did not know the cure, but was certainly skillful in covering up his inadequacy. That doctors could be less than honest is clear from another story in the Mulasarvastivadavinaya, BhaiÒajyavastu this time told not of Jivaka, but of another doctor, who from many indications was the Buddha in a past life21. The context for the story is that the Buddha has fallen ill with indigestion, mandagni. “The monks ask, ‘What deed did the Buddha do, as a result of which, even though he has achieved perfect enlightenment, he suffers from this illness?’ Here is the answer. “In the past, O monks, there was a doctor in a certain village. The son of a householder was taken ill. He summoned the doctor, who gave the child some medicine. The son recovered. The householder did not pay the doctor. The son of that householder became sick three times and the doctor cured him three times. And the householder did not pay the doctor all three times. The doctor was furious and thought to himself, ‘I cured that man’s son three times and he did not do anything for me in return. If the child should fall ill again, then I will give him a potion that will rip his entrails apart.’ And as fate would have it, the householder’s child fell ill again. Furious, the doctor gave him a potion that ripped his entrails apart.”

21 Mulasarvastivadavinaya, BhaiÒajyavastu, p. 133.

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The doctor in this story is hardly a paragon of virtue. Angry over not being given a payment for curing the patient, the next time he kills him. This story reappears in a very different context, in Pali and Sanskrit texts that describe the bad deeds that the Buddha did in his past life, as a result of which he suffered in his final , even after his Enlightenment. Thus the Avadanakalpalata of KÒemendra in the Dasakarmaplutyavadana tells of the Buddha as a wicked doctor, who furious at not being properly remuniated, retaliates by killing his patient. As a result of this he suffers from diarrhea22. It is clear that some doctors were very wicked indeed. The Pali Mahavagga, VI.22 depicts a doctor who is both arrogant and wrong. In this episode the Buddha has come to Rajag®ha. He finds a sick monk and a doctor about to operate on the monk. The monk has piles and the doctor asks the Buddha to take a look for himself at the monk’s back- side, which he offers looks like the face of a lizard. The Buddha is appalled and guesses that the doctor is trying to make fun of him. He retreats with- out a word but then promulgates the rule that surgery is not to be performed for this condition23. Here, it is clear, the Buddha’s knowledge of the rudi- ments of medicine and surgery greatly outstrips that of the incompetent doctor. It would seem, then, that even in these Buddhist texts, the doctor is not always a model to be emulated. In the commentary to the Pali Petavatthu we even meet with a doctor who can be bribed to perform abortions24. Jain commentaries likewise preserve stories of doctors who are downright incompetent and lazy, besides. In one vignette we are introduced to a doc- tor who has lost all his medical books and medicaments, either through addiction to gambling or sense pleasures. When the king summons him, the doctor simply lies and says his things have all been stolen by a thief25.

22 Avadanakalpalata, edited P L Vaidya, Darbhanga:Mithila Institute of Post-Graduate Studies and Research in Sanskrit Learning, 1959, Buddhist Sanskrit Texts no. 23, section 50, p.314. The Pali version is discussed by Jonathan Walters, “The Buddha’s Bad Karma: A Problem in the History of Buddhism”, Numen, 37.1, 1990, pp. 70-95. 23 Vinaya Pi†akam, edited Hermann Oldenberg, Pali Text Society, London: Luzac & Company Ltd., 1969, p. 216. 24 Elucidation of the Intrinsic Meaning so Named The Commentary on the Peta-Stories, translated U Ba Kyaw, Pali Text Society, 1980, story I.7, p. 40. 25 The story, from Malayagiri’s commentary to the Vyavahara BhaÒya, can be found in Willem Bollée, Tales of Atonement, page 54-55, http://www.indologica.it/volumi/doc_ XXXI/01_Bollee.pdf. The text is also published by Hindi Grantha Karyalaya.

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I would like to turn now to a non-Buddhist text, which is suspicious both of the doctor and his cures. Remember, the Buddhist simile implies that the doctor is as successful in removing sickness as the Buddha is in removing suffering. Here we see an objection to that very upbeat view of doctors. The Ma†harav®tti is a commentary to the Saμkhya Karika of Isvarak®Ò∞a.26 Scholars are not in agreement about its date; some date it very early, while others suggest either the 6th century or even the 9th century. The first verse of the Saμkhya Karika asserts that the knowledge the text imparts is required to remove human suffering. An objector in the commentary says that in fact this new knowledge is totally useless, since we already have the means to remove suffering. “For diseases of the body there are doctors, who can cure every ailment, from fever to diarrhea. These doctors know the eight-limbed Ayur Veda, the science of medicine, and are skilled in removing foreign bodies, in the wiel- ding of the scalpel, in antidotes to poisons, remedies for insanity, diseases of old age and childhood.” The Siddhantin replies that this is not the same. The doctrine of the Saμkhya brings about a complete and permanent cure from suffering and works in every instance. Such is not the case with doctors, “For we see that some patients live, while others die, even when they are all treated by doctors who apply their remedies with the greatest vigor. And we see that even in a doctor’s own family a beloved wife, son, brother, father, and so on still cannot escape the clutches of death. And so we see that the doctor’s remedies do not always work. The doctor’s remedies are also not permanent, for we see patients who have been cured by some médicine some days later spike a fever again. And so it is clear that no remedy for ills of the body is permanent. Even diseases like smallpox, seemingly cured, can return. On this there is this verse: Again I burn up, again my body shivers, Again hiccups torment me, again the fever has come back. And this one:

26 Saμkhya-karika of Srimad Isvarak®Ò∞a with Ma†harav®tti of Ma†haracarya, edited by Sahityacarya Pt. ViÒ∞u Prasad Sarma, : Chowkhamba Sanskrit Series Office, 1970, pp. 3-4.

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The doctor has blood-shot eyes, his bones ache and his skin is mottled with leprosy. They ask the pediatrician, and how did your own children all die?27 Furthermore, cures do not come from merely knowing well a person’s constitution: You can take all kinds of medicaments and pound them with whatever other ingredients, give it to this one or that one, but even so, who knows what the result will be. And another thing. Doctors are known to make an illness even worse than it was in order to gobble up the wealth of their patients or spread their own fame. And in some cases they go too far and can’t cure what they have caused. As it is said, Doctors, O doctors! Praise be to you, who have killed every living being. The Lord of Death, turning over his job to you, spends his time in happy idleness.” Doctors, for this writer, are dishonest quacks, out to make money. At best their cures are only temporary. Unlike the Buddhist texts, the commentators to the Samkhya Karika agree that even in their own sphere of operation, physicians are no good. While he is less humorous than his predecessor, Vacaspati Misra in the Tattvakaumudi says much the same about medical procedures: many times they do not work or they work for a while and then the disease returns.28 The doctor as incompetent, unethical, out for money, is a familiar figure in Sanskrit literature. In what may be the earliest depiction of a healer, ˛gveda X.97, the doctor is described as eager to make a killing.29

27 Compare the words of Vimalakirti in the Vimalakirtisutra when he upbraids Ananda for saying the Buddha is sick. He fears that the heretics will say, “If their teacher cannot even cure his own illness, how can he be expected to cure the illness of other living beings?” yadyeÒaμ sasta svaturatra∞asyapyasamarthaÌ, sattvatura∞aμ tra∞amiva (datuμ) kutaÌ sakroti’ (GRETIL, based on the edition by L.M. Joshi and Bhiksu Pasadika: Vimalakirtinirdesasutram, : Central Institute of Higher Tibetan Studies, 1981). 28 The Tattva-Kaumudi, text and translation into English by Mahamahopadhyaya Ganganath Jha, Poona: Oriental Book Agency, 1965, p. 5. 29 Yadi ima vajayann aham oÒadhir hasta adadhe 11. Saya∞a glosses vajayan with rug∞aμ balinaμ kurvan, “making the sick strong”, but surely Geldner is closer to the meaning, “Wenn ich nach dem Siegerpreis (Gewinn) verlangend die Kraüter in die Hand nehme”, Karl Friederich Geldner, Der Rig-Veda, Cambridge: Harvard University Press, 1951, vol. 3 p. 307. See also Leopold von Schroeder, Mysterium und Mimus im Rigveda, Leipzig: H. Haessel Verlag, 1908, p. 373, “Wenn ich, ein Beutellustiger, / Die Krauter

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In the drama, the Bhagavadajjuka, which may be the earliest Sanskrit farce that has come down to us, the doctor is a figure of comic scorn. He is so ignorant that he cannot even recite the simplest stanza from a medical text. The courtesan he has been summoned to treat knows more than he does about snakebite and its symptoms.30 In the tenth century Tilakamañjari of Dhanapala, a god, soon to fall from heaven offers a king a valuable necklace of pearls. He worries that the king will refuse, thinking, “How can I be like the doctor who sees a patient is about to die and knows he cannot cure him, yet robs him of his wealth?”31 Later texts are even more bitingly sarcastic in their treatment of the physician. The Kalivi∂ambana of the 17th century Nilaka∞†hadikÒita depicts doctors as money-grubbing and dishonest32. The doctor has no use for the healthy or the incurably ill. It is the chronically ill and feeble who are the sources of the doctor’s good fortune. 23 The doctor should not be overly optimistic to a patient, nor should he terrify him. The first will give him nothing, because he is not worried about his health, while the latter will give him nothing because he enter- tains no hope of living. 24 A doctor should be careful to describe any medicine he gives as having side effects. If the patient is cured, they will praise the great skill of the doctor. If he dies, they will blame the medicine. 25 Doctors, O doctors! Praise be to you who have killed every living being…. The contrast could not be more striking. On the one hand there are the Buddha and the as doctors who save every living being, even at the cost of their own lives. The Buddha is the doctor who cures illness for once and for all with his many treatments and his special

hier nehm’ in die Hand”, in chaper XIV, “Der Mimus des Medizinmannes RV 10.97”, pp. 369-395. 30 Bhagavadajjuka, Die Heiligen-Hetäre: Eine indische Yoga-Komödie, tr. Ulrike Roesler, Jayandra Soni, Luitgard Soni, Roland Steiner and Martin Straube, München: P. Kirchheim Verlag, 2006. The date of the text is uncertain, but it must have been com- posed before the 7th century according to Steiner’s afterword, p. 76. 31 Tilakamañjari, Bo†ada Saurahstra: Srivijayalava∞yasurisvarajñanamandira, 1951, p. 123: vipatpratikarasamarthaÌ kÒi∞ayuÒo ‘sya bhiÒag iva kathaμ riktham aharami. 32 Text on GRETIL.

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knowledge… The Buddha establishes all beings in nirva∞a, the total absence of suffering and disease…. And then there is the doctor who can’t possibly cure any illness for good and in fact kills every living being.

III. CONCLUSIONS

The Buddhists, in choosing the image of the Buddha as doctor, were clearly wading into very problematic territory. They were not the only reli- gious group to use the image of the teacher as a doctor. We have seen the Jains use it as well. The PañcarthabhaÒya of Kau∞∂inya, which is dated anywhere from 400-600 AD, also described the teacher as a physician and the pupil as the “patient.”33 They may well have borrowed the image from the Buddhists. The Bhagavatapura∞a compares the saving power of the god K®Ò∞a to the medicament known as the king of medicines, agadaraja: both can save even the ignorant who do not know their true essence.34 But the Buddhists seem to have used the image of the doctor most thor- oughly and enthusiastically. I have tried to show here that this view of the doctor as a compassionate healer was not universally shared. The doctor was at best an ambivalent figure in early and medieval India, and at worst, typified all that was false and dishonest. Why did the early Buddhists choose the figure of the doctor as their example of all that was good and altruistic? And why did they never show any ambivalence themselves about the comparison between the Buddha and the doctor? Or did they? Koichi Shinohara suggested to me that it was the power of the image of saμsara as illness that led to the description of the Buddha as the greatest healer, and with that would have come the idealistic image of the worldly physician, so at variance with stories told of him even in Buddhist litera- ture and elsewhere in the tradition. I close with another story. This story suggests that although the image of the Buddha as healer would remain intact throughout the many changes in Buddhist doctrine and practice, the role of the worldly physician might well have changed as ritual healing

33 1.1.40, text on GRETIL. 34 Bhagavatapura∞a, 10.47.60, Delhi: Nag Publishers 1987, volume 3.

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supplanted other technologies of healing, perhaps contributing to the negative image of the worldly physician. The Mulasarvastivada, BhaiÒajyavastu contains another story which describes the origins of the Mahamayuri spell.35 The monk Svati is bitten by a snake; the other monks all say to themselves that if Svati were a layman, his family would take care of him. The Buddha tells the monks to call a doctor. The doctor tells them to give him “vik®tabhojana”, something perverse to eat. They ask him what in the world that is, and the doctor rudely replies, “Go ask your teacher. He is supposed to be Omniscient.” The Buddha explains that it is substances like feces and urine. The monks feed this stuff to poor Svati, who as we might have expected, does not get well. The Buddha then recites the Mahamayuri spell and cures him. He then tells the story of the past, in which he was the king of peacocks, who used the spell to break free of the ropes tying him up.

This is an odd story, to say the least. It is clear in the story that the doctor is at worst a rogue, at best incompetent. The power of the spell has obviated the need for any doctor. The development of ritual techniques of healing will be rapid in the medieval period, and many are the miracle stories told about how a patient had been abandoned by the doctors only to be cured by the power of a sacred spell. Here, the worldly doctor recedes entirely from the arena, replaced by the words of the Buddha or other sacred words. Left far behind, perhaps in practice as well as in literature, the doctor is here just a comic figure, the brunt of a coarse joke. But there are reminders that the doctor could and should be more than this. A Jain medical text of the 8th century, the Kalya∞akaraka, reverses the comparison that I have been exploring in this paper.36 In its description of the virtues of the good doctor, the text tells us that a great physician can bring great happiness to his patient, as the religious teacher can to his pupil. The text thus reminds us of the potential nobility of the doctor’s mission, likening it to the salvific mission of the Jina himself. Seeing the

35 Mulasarvastivada, Bhaisajyavastu, p. 171. 36 Sri Ugradityacarya Kalya∞akaraka, edited Pt V.P. Shastri, Sholapur: Seth Govindji Raoji Doshi, 1940 Sakharam Nemchand Granthamala no 129, p. 116 verse 43.

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best of human nature and the importance of the doctor’s commitment to heal, this text along with the Buddhist texts examined here, offers an inspiring vision of what the practice of medicine could be. We would do well to remember it today, when Nilaka∞†ha’s and Dhanapala’s biting sarcasm seems too often sadly on the mark.

SUMMARY One of the most common images used to describe the Buddha is that he is the supreme physician, the great healer who cures the ultimate disease, which is trans- migratory existence. The image of a great religious leader as a healer was not uniquely Buddhist. But it is also not unproblematic. Attitudes towards doctors varied greatly in early India and were often strikingly negative. This paper explores the range of attitudes towards physicians in story literature and philosophical texts. Keywords: Doctors, quacks, Buddhism, , story literature.

RÉSUMÉ L’une des images les plus couramment employées pour décrire le Buddha est celle du médecin suprême, du grand thérapeute qui guérit de la principale maladie, la transmigration existentielle. La représentation du meneur religieux comme étant un thérapeute ne fut pas exclusivement bouddhique. Elle ne va pas non plus sans problème. Les attitudes envers les médecins étaient d’une grande variété dans l’Inde ancienne; elle furent souvent singulièrement négatives. Cet article explore une partie de l’éventail des sentiments envers les médecins dans la littérature narrative et les ouvrages philosophiques. Mots-clés: Médecins, charlatans, bouddhisme, jaïnisme, littérature narrative.

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