The impact of Buddhism and Daoism on the development of Chinese Medicine

By Angie
At Affordable Acupuncture, we are inspired by the Buddhist tradition, and infuse their principles of compassion and kindness into our practice. For those interested in history, here is an article written in my University days about the contribution of Buddhism and Daoism to the development of Chinese Medicine. Its fairly long, but I think it is fascinating how developments were made in healthcare over thousands of years based on the idea that the physical and spiritual aspects of our selves are inseparable.

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Buddhism and Daoism are two important religious philosophies that have had a tremendous impact on the development of Traditional Chinese Medicine in similar yet diverse ways. The Buddhist movement is guided by feelings of ultimate love and compassion, and the desire to transcend the suffering of this world to reach a place of perfect bliss. The Daoist movement is motivated by the quest for immortality and a desire to achieve harmony with the incomprehensible yet wonderful mystery of the Dao. Both are spiritual movements that recognise the importance of a strong, healthy body in order to achieve higher levels of consciousness, thus both have developed various methods of nourishing, healing and prolonging life. Adepts of both religions studied healing as a means of benefiting themselves, their fellow devotees, and the public at large, both out of feelings of compassionate service as well as for missionary purposes. Consequently, the evolution of their powerful medical skills and knowledge has benefited the advancement of Traditional Chinese Medicine in a multitude of ways, from pragmatic pharmacotherapy, to medical ethics, lifestyle techniques and medical practices. The influence of these significant spiritual movements is still very much evident today.

Buddhism arrived in China in the first century A.D., with the earliest evidence of a Buddhist community in China dating to A.D. 65. The Buddhist doctrine proved popular, and was quickly assimilated into all strata of the population, irrevocably influencing the development of religious, ideological and therapeutic systems in China. Although there are various sects and movements, the unifying themes of Buddhism include belief in karma and reincarnation, recognition of the inevitability of suffering, and the possibility of achieving salvation by following the middle way. The Buddhist journey to liberation is based on cultivating the right thought, actions and speech in order to transcend the world of suffering and achieve ultimate peace and bliss in nirvana. This fundamental philosophy provided the framework for the myriad developments that ensued in many different aspects of life.

Buddhist monks intent on achieving enlightenment required the knowledge to prevent and treat disease, as illness and weakness were seen to dull the mind and thus prevent the devotee from achieving nirvana. The ancient texts of the Pali Canon state that medicine is one of the four necessities of life, reflecting the profound significance that healing practices held for the early Buddhist monks. This philosophy included eating a proper diet, including foods that had medicinal value, and restraining from overeating as a form of preventative medicine. It additionally initiated a fledgling materia medica, which began with just five standard medicines approved by the Buddha, and soon expanded to include many different healing agents. The Pali Canon also discussed the spiritual causes and cures of disease, indicating that physical illness was seen as a direct consequence of improper thinking, which could be cured by following prescriptive meditations. Thus contributions towards a holistic understanding of a balanced lifestyle and the importance of both the emotions and herbs as healing agents were already present in those early days.

Monks were not only motivated to look after themselves, but also to care for those among their ranks who fell ill, and additionally to laypeople outside of the monasteries as a form of compassionate service. Their therapeutic skills were also used as a way of spreading the teachings of the Buddha, and thus their healing abilities, as well as their collective body of knowledge, grew extensively as their practice flourished. Their benevolent service contributed not only to an increasing medicinal repertoire, but also to the general state of public health, as Buddhist communities established hospitals, health centers, havens, refuges and orphanages in early China. In fact, the eminent Tang physician, Sun Su-miao, recommended that in order to be a great healer, one must read the Buddhist works to understand the virtues of compassion, love and the medical ethics of selflessly serving others, which is an example that the Buddhist monks of early China clearly set from the very beginning. The aspirations of the Medicine Buddha include the desire that all sentient beings be free from illness, and the reverence that Buddhist practitioners have for all life is surely an inspiration for all healers everywhere.

This principle of universal love and compassion also provided guidelines for the ideal behaviour of both practitioner and patient in the therapeutic encounter. According to one of the Buddhist sutras, there are five qualities that identify incompetent monastic healing, which are: “first, ignorance of effective remedies; second, signs of unwillingness and a lack of dedication; third, indulgence in expressions of disgust and insensitivity; fourth, attendance of the patient solely with the intention of being compensated for the care; and fifth, failure to preach to the patient or converse with him”. It naturally follows that the superior practitioner in fact does the opposite of these unholy behaviours, and therefore ensures they are: well versed on therapeutic remedies; willing and dedicated to their cause; sensitive and kind in their manner; motivated by feelings of love and not greed; and finally competent in their communication and counselling skills. The sutra in question also outlines five kinds of improper behaviour in a patient that would interfere with the healing process, which include: unregulated consumption or food and drink; non-compliance with medication, and excessive emotional states. Traditional Chinese Medicine can be seen to incorporate this attitude of motivating responsibility on the part of the patient in terms of encouraging a positive and balanced lifestyle. Thus, the religious dogma of Buddhism lays down an appropriate framework for both practitioner and patient in order to facilitate the most effective healing encounter, a framework that is still relevant today and evident in the clinics of the most respected and eminent Traditional Chinese Medicine practitioners.

On a more tangible level, with medicine being such an essential life resource and point of focus for the Buddhist monks, the evolution of a pragmatic pharmacopoeia was inevitable. As formally mentioned, it began with just five basic medicines: oil, honey, molasses, clarified butter and fresh butter. These substances were said to help alleviate conditions such as wind, bile, phlegm and poor digestion, among other things. This demonstrates the incipient understanding of using foods as medicines, which soon expanded to incorporate medicinal foods in the form of fruits, gums, resins, fats, roots, extracts and salts. The classification of medicinal foods took into account their specific tastes (e.g. sweet, salty, bitter, astringent), specific categories (e.g. the type of food and the most therapeutic part of it), methods of preparation (e.g. using a grindstone or creating a decoction), proper times for consumption (e.g. time of day or year), storage times and the therapeutic relevance (e.g. what illnesses they could be used for). Thus the Buddhist monastic tradition accumulated a vast body of theoretical and practical knowledge of the pharmaceutical application of foods. This knowledge, in combination with the importation of exotic Indian medicinal foods such as ginger, cardamom, tumeric and cloves into China, made an impressive contribution to the development of the Chinese material medica. For example, cardomom is now known in China as Bou Dou Kou and its warm and pungent properties are commonly used for stomach pain due to Cold-Damp in the Middle Jiao.

Pragmatic pharmacotherapy was also practiced and developed by the Daoists, who made significant contributions to the development of Traditional Chinese Medicine in many different areas, including breathing and meditation techniques, Daoyin (therapeutic exercises), diet therapy and of course, the materia medica. Daoism, like Buddhism, is a diverse philosophical and religious movement with many different intellectual currents, however its unifying principle is a belief in the Dao, or the “unfathomable law of nature” and a desire to live in complete harmony with it. Daoists are inspired by tales of immortality, and devote their lives to the practice of longevity techniques designed to extend their lives indefinitely, or at least as long as possible with the greatest levels of vitality. Like the Buddhists, the Daoists understand exceptional physical health as being a necessary prerequisite for attaining higher stages of spiritual consciousness, and thus the development of healthful lifestyle practices and effective healing techniques became their legacy. The practice of healing was also a successful method of attracting more followers to join the early Daoist movements, which provided further stimulation of its growth.

In terms of their influence on the advancement of Traditional Chinese Medicine, perhaps the Daoist’s greatest contribution was in the field of herbal medicine. The quest for immortality provided a fervent drive to explore the life-enhancing effects of various drugs and the potential discovery of the elixir of life. It was the Daoist scholar Taohong Jing who wrote the extant classic, the Shen Nong Ben Cao Jing in 500 A.D, which was the first serious effort in Chinese history to present a systemized compendium of herbal substances. This work classified drugs into three categories: superior, medium, and inferior; each pertaining to the ability of the substance to either lead to immortality, enrich one’s life, or cure diseases respectively. Such was the scope and detail contained within this text, it remained the eminent reference for herbal medicine for over one thousand years.

Ge Heng was another significant Daoist seeker of immortality who contributed much to the development of pharmaceutical knowledge in China. He discussed the nature and effects of various drugs in his works, the Shenxian zhuan and Baopuzi, in terms of striving to achieve longevity or even immortality. His approach differed from the standard medical use of drugs in that he concerned himself most with miraculous herbs with alchemical formulations that only Daoist initiates could find and prepare. In describing some fifty-six elixirs for long life in the superior category of drugs, he refers to particular procedures for preparing the elixirs that made considerable contributions to Chinese chemistry, pharmacology and metallurgical techniques.

Sun Si Miao, the eminent physician who was so inspired by Buddhism, was actually a Daoist eremite and known as the “King of Pharmacology” for his contributions to Chinese Herbal Medicine. He personally collected, analysed, processed, applied and formulated hundreds of different kinds of drugs in his lifetime, and his work was the most detailed of his time in his field. He also made fantastic advancements in the areas of disease classification, dietary therapy, paediatrics, gynaecology, hygiene, acupuncture, moxibustion, sexual techniques, therapeutic exercises and of course medical ethics. He was among the first to recognise the importance of clean food and water for the prevention of disease, scientifically breaking with the religious superstition of ‘evil spirits’ in his day. He also made outstanding progress in the field of malnutritional diseases, and his work regarding the diagnosis, prevention and remedy for beriberi was the earliest recorded in the world. For all these reasons and more, the work of Sun Si Miao made a tremendous impact on the evolution of medicine in China.

Expanding on the work of such exemplary Daoist eremites Ge Hong and Sun Si Miao, many other Daoist scholars continued the tradition of developing techniques for longevity and radiant health in many fields. One such field is that of therapeutic exercises, or daoyin, which has an ancient history and is an integral part of daily life in contemporary China. Daoyin are universally recognised as beneficial for the maintenance of health, prevention of old age and disease, and the treatment of various illnesses. They are not unique to the Daoist tradition, but the development and transmission of the use of daoyin have been largely due to Daoist texts and practitioners. The Daoist Canon includes many texts that discuss physical exercises beneficial for nourishing life, including the Taiqing daoyin yangsheng jing, which deals almost exclusively with this topic. Another early text, the Zhubing yuanhou lun in 610 expanded exceptionally the collective knowledge at that time by providing a comprehensive description of various pathological conditions and the relevant gymnastic exercises to be applied for treatment, providing practitioners with a practical encyclopedia for therapeutic purposes. The integration of daoyin into the Daoist tradition ensured their practice among the literati and the upper classes, and the transmission of the wisdom through the ages. One of the earliest extant classics of Chinese Medicine, the Huangdi neijing suwen, mentions daoyin in several places and recommends it as a suitable therapy for many conditions and even for particular climates.

Hand-in-hand with therapeutic exercises are the specific breathing and meditation techniques pioneered by the Daoists. Regulated breathing was believed to achieve a range of therapeutic outcomes, including improving qi circulation, eliminating pain, harmonising the body, nourishing the vital principle and curing disease. The harmonised breath brought the practicing adepts in tune with the Dao, aligning their breath to the Primordial Breath, channeling and circulating it through the body in order to heal and nourish. Similarly, meditation techniques were practiced with the aim of identifying the Dao, dissolving to become one with the Dao, and achieving immortality. The body was seen as a dwelling place for gods who only reside in places of serenity, and thus meditation was seen as crucial for achieving divinity in this mortal realm. Daoist texts and practitioners have hence contributed to a rich tradition of harmonious spiritual practices with a strong emphasis on cultivating peace and balance within oneself. This is an important aspect of Chinese Medicine today, as the interaction between mind and body is firmly established and a superior practitioner in this field should always discuss exercise, breathing and relaxation as important lifestyle factors for the benefit of any medical condition.

Therefore, it is evident that the contributions of both Buddhism and Daoism to the development of Traditional Chinese Medicine over the last two thousand years have been of an impressive magnitude. Both religious groups, motivated by feelings of love, share the belief that a sound body is a necessary requirement for spiritual enlightenment and liberation. Hence, they have both developed means to restore and maintain radiant physical health in a variety of ways. Both have made significant advancements in the field of pragmatic pharmacotherapy, amassing a wealth of information about the various ways that herbal medicine can be utilised to nourish, heal and enhance human life. Both provide sensible guidance for advantageous lifestyle choices, in terms of observing a healthy diet and maintaining a peaceful mind. Buddhist healers also provided a unique framework for public health care and inspired values in medical ethics, reminding practitioners to display honourable and compassionate behaviour in their practice. Daoist healers have left a lasting legacy of breathing, meditation and daoyin techniques, all of which play an integral role in the journey to lasting health and happiness. Thus both movements have clearly provided wide-ranging inspiration for the progression of this therapeutic tradition, and demonstrate that the religious dimensions of healing are very much alive and present in the syncretic evolution of Traditional Chinese Medicine.