The Hindu Tradition Religious Beliefs and Healthcare Decisions By Arvind Sharma he Hindu tradition is one of the oldest living reli- Tgious traditions of the world. Identifiably Hindu practices and objects have been traced to what used to be called the Indus Valley culture but is now referred to increasingly as Harappan culture, after its best-known archeological site. This culture was con- temporaneous with the earliest indications of civiliza- Contents tion in Egypt, Mesopotamia, and China. The Individual and the 5 The relationship of this culture to the Vedas, the Patient-Caregiver Relationship foundational texts of Hinduism, remains obscure. The earliest of these Vedic texts, called the RgVeda. , had Family, Sexuality, and Procreation 6 been compiled by 1200 B.C.E., according to most Genetics 8 scholars. Its appearance commences the age of Vedic Organ and Tissue Transplantation 9 culture, which lasted until around the fourth century B.C.E. By the sixth century B.C.E., religious life in Mental Health 10 India was already in ferment as a result of the gradual Medical Experimentation 11 dissolution of the Vedic sacrificial worldview, and out and Research of this ferment emerged the other two great religious Death and Dying 11 traditions of ancient India: Buddhism and Jainism. The interaction of the Vedic tradition with these tradi- Special Concerns 13 tions gave rise to what is usually referred to as classi- cal Hinduism. The classical Hindu tradition, while it underwent numerous transformations and remained in continu- ous interaction with both Buddhism and Jainism, was the main religion of the Indian sub-continent until the arrival of Islam in a decisive way around 1200 C.E. The succeeding six hundred years saw the progres- Part of the “Religious Traditions and Healthcare Decisions” handbook series published by the Park Ridge Center Arvind Sharma, Ph.D., is Birks Professor of Comparative Religion in for the Study of Health, Faith, and Ethics the Faculty of Religious Studies at McGill University, Montreal, Canada. THE PARK RIDGE CENTER sive establishment of Muslim rule over virtually engaging in a dialogue with him or her on this the whole of the Indian sub-continent and is point. therefore referred to as the Muslim period of Most Hindus believe in reincarnation (punar- Indian history. This period is characterized by janma). From this belief follows a corollary various modes of interaction between Hinduism belief in multiple lifetimes of existence in the and Islam. past and the future (sams ˙ ara ¯ ), lifetimes in which By 1800 the British were well on their way to the quality of one’s present life is determined by achieving political control of the subcontinent. the quality of one’s past life (especially moral When they relinquished control in 1947, India life) as led in previous lifetimes (karma). It is and Pakistan emerged as independent states. For thus possible to improve the quality of one’s life the most part, Pakistan was carved out of those over several lives and attain a better rebirth, but parts of India that had Muslim majorities. the ultimate Hindu religious ideal aims at tran- Hinduism continues as the primary religion scending the process of the cycle of rebirths of India, over 80% of whose citizens count as itself. The successful attainment of this goal is Hindus. There are over a million Hindus in the called mok.sa or mukti (liberation). U.S.A., primarily as a result of Indian immigra- Several ways of attaining mok.sa are identified tion. The Indian diaspora, as the spread of peo- within the tradition. These methods are collec- ple of Indian origin through different parts of tively called yoga. The word is formed from a the world is called, includes about 20 million root which means “to join”; hence any system of Hindus. belief and practice which unites the seeker with the ultimate reality (brahman) can be called yoga. Such a union, when successfully effected, BELIEFS RELATING TO HEALTH CARE involves liberation from sams ˙ ara ¯ and thus leads to mok.sa. An important point to consider at the very out- The importance of health in the context of set, before specific beliefs of Hinduism which the practice of yoga is widely recognized, and a may relate to health care are taken into account, famous maxim attributed to one of classical is the nature of Hinduism itself as a belief sys- India’s most famous poets states that the body tem. Hinduism is a broad-based and doctrinally should be viewed as the primary instrument for tolerant religion with hardly any single and attaining mok.sa. This maxim is put into practice exclusive test of orthodoxy, with the result that in Hatha. Yoga, which takes the physical body as diverse and even contradictory beliefs can be the starting point of yoga (as distinguished from found co-existing within it. This diversity also the more usual practice of using the mind as the encompasses the reality that “folk religion” and point of such departure, as in R¯aja Yoga). In the the “religion of women folk” flourish freely West the term yoga has been almost exclusively within Hinduism, without the doctrinal con- identified with the physical form of yoga, straints that these expressions of religion might because of its popular appeal as a way of secur- face in the Abrahamic religions, which attempt ing and maintaining physical and even mental to “rationalize”1 these dimensions of religion. By health. The Hindu religious tradition, however, the same token, one must not presume to know associates the word yoga with the control of what the beliefs and practices of a patient might the body as well as the mind, and R¯aja Yoga be from the mere fact of his or her being a arguably associates it more with the mind than Hindu. Because Hinduism lacks a standard defi- the body. nition, and practice tends to take precedence Some of these yogic techniques go back to over theory, it is best to elicit the specific the Vedic period and may even have been part “Hindu” religious life-pattern of the patient by of Harappan culture. In due course, however, a 2 THE HINDU TRADITION: RELIGIOUS BELIEFS AND HEALTHCARE DECISIONS distinct branch of knowledge devoted to the cul- varies from individual to individual and is tivation of health and the treatment of diseases affected by lifestyle and food, Hindu medicine emerged. It was even accorded the status of a has always been patient-oriented, with a strong subsidiary Veda and is called A¯yur-Veda or the interest in diet, in which even the popular clas- “science” of longevity. The main textbooks of sical scripture of Hinduism, the Bhagavadgit¯¯ a, such medical lore in India are the Compendia evinces some interest. attributed to Caraka (c. 1st and 2nd century Some forms of Hinduism take the concept of C.E.) and Su´sruta (c. 4th century C.E.), the for- pollution very seriously. Although this concern mer focusing more on surgery and the latter on could easily represent a survival of early reli- physiology. Late Compendia, such as the gious beliefs, scholars have proposed that the As..t¯angahrdaya. of V¯agbha.ta (c. 8th century) concept may also imply an anticipation of the emphasize diagnosis and the use of pulse to this germ theory of disease and the need for quaran- end. M¯adhava (c.1370), an authority on diagno- tine in an age given to pandemics, although the sis, lived during the period of the Vijayanagar point has also been vigorously disputed.3 empire (14th-17th century). The important point to note here is that, Central to Hindu views of health and morbid- because of such notions, the Hindu has a ity is the concept of humors or dosa. These are greater aversion in general to contact with three, as with the Greeks: v¯ata (wind); pitta blood, urine, dead bodies, fecal matter, and the (bile); and kapha (phlegm). Physical well-being like than the average Westerner. Similarly, since consists in maintaining a balance between the by its nature Hinduism allows for the persist- three. ence of beliefs, the idea that illnesses may be This doctrine of the three humors is a part of caused by extra-medical or even magical sources tacit knowledge among Hindus and therefore such as the evil eye, curses, etc. is often found bears elaboration, as a Hindu patient may use among Hindus, along with a comparable confi- such phrases as “my pitta is acting up.” The fol- dence in mantras, yogas, or divine or saintly lowing table may be helpful in this respect: intervention to cure ailments that far exceeds their clinically demonstrable results. Age of Associated Humor Dominance Personality Type V¯ata Advanced age Artistic type OVERVIEW OF RELIGIOUS MORALITY Pitta Middle age Executive type AND ETHICS Kapha Childhood Mental type The fabric of religious morality and ethics in The three dosas. are also linked to an even Hinduism exhibits a particularistic as well as a more popular and pervasive trichotomy of the universalistic strand. Hindu social thought three gunas. or qualities, called sattva (lightness, emphasizes the first, Hindu spirituality the lat- sublimity), rajas (energy), and tamas (darkness, ter: Hinduism recognizes both. inertia). In this scheme, pitta is related to sattva; Hindu social thought in general is heavily v¯ata to rajas; and kapha to tamas. indebted to four overarching concepts: the ideas Equally significant is a less pedantic and more of the four classes (c¯aturvarnya. ), the four stages popular classification of foods, diseases, and of life (catura´ ¯srama), the four ends of human drugs into hot (us.na. ) and cold (´sita¯ ).