Jivaka, the Buddha’s physician. British Library
There is a natural association between Buddhism and medicine. Buddhist doctrine recognizes the phenomenon of suffering, unravels its causes, understands the state of elimination of suffering and prescribes the right method for elimination of suffering seen and heard.
The Pali texts describe the Buddha as the physician (bhishak) and as the surgeon (salla–katta).Ashvagosha the poet (80-150 BCE) called Buddha Maha –Bhishak (the great physician). At a later stage in Buddhism, the Buddha worship in the Bhaishajya Guru (The Guru of all physicians) form came into practice.
Interestingly, the life of one of the celebrated physicians and surgeons of the ancient India was closely associated with that of the Buddha. Jivaka came to the Buddha as a young man in the prime of his youth and stayed faithful to the Buddha until the later years of the Master, as his disciple, friend and as his physician.
He gained a great reputation as a surgeon who successfully conducted operations like craniotomy ( surgical incision into the skull) and laparotomy (surgical incision into the abdominal wall). He was known for curing jaundice, fistula and other ailments. Jivaka’s fame as a healer and a child specialist was widely known and tales about his life and medical feats are in almost all versions of Buddhist scriptures.
The Jivaka’s story is elaborated in four versions -the Pali, the Sanskrit, the Chinese and the Tibetan. We will follow the Pali version because some important discourses addressed to Jivaka are in that version.
The Buddha-Jivaka story is a very human story. Their relationship was not cast in the usual mould that one comes across in religious texts. In a way, it de-mystifies the Buddha imagery. The Buddha you meet here is not the ethereal philosopher with his head in the clouds nor is he The God himself. You will find, he not always resembled the serene, ever smiling young Apollo – Greco Roman God like images that sit on our coffee tables or that decorate our bookcases. He was a real man, a wise, compassionate, mellow, independent and a mature person who walked and lived on this land. He did encounter many problems, but more importantly, he got over them with reason and dignity. He suffered from injuries, illness, constipation, diarroehea and other problems related to old age. Whenever he needed help, he did ask for help. But, you never see him losing his composure. Here you see him put forth some unusual but rational views on the day-to-day concerns of the monks and the lay. That brings us closer to the Buddha.
Once when Prince Abhaya son of Bimbisara the king of Rajagriha, was riding through the city, he noticed a flock of crows circling and cawing round a winnowing basket, thrown on a rubbish heap. As he got closer to the basket, he saw, to his amazement, a lovely looking baby boy wrapped in clothes placed in the basket. He took the baby home and decided to raise him as his son. The baby was given the name Jivaka, the live one, since he survived his abandonment on the rubbish heap. Because the prince raised him, he also acquired the pet name Kumarabhacca (nourished by prince).
Jivaka enjoyed a happy princely childhood. As his birth-situation later dawned on him, Jivaka reasoned that it was unfair and dishonourable to be dependent on the generosity of the prince, forever. He determined to earn his livelihood by pursuing a career, independently. He aspired to be a physician. He then left home, without informing the prince, and traveled all the way to Taxasila, in the distant West; to study medicine under the well-known teacher Disapamok Achariya. There, he studied medicine diligently for seven years.
Towards the end of his seven-year study, he took a practical examination that tested his medical skills and his knowledge of medical herbs. He passed the test with merit. With a little financial help and blessings of his mentor, Jivaka set out into the world in search of a carrier, fame and fortune.
On his way back home to Rajagriha, he stopped at Saketha where he came to know that the wife of the richest merchant (setthi) in the town was suffering from a chronic head ache for the past seven years and the local physicians failed to find a cure for her ailment. Jivaka succeed in convincing the rich lady that though young as he was, he would surely rid her of the ailment. He procured some herbs and cooked them in pure ghee obtained from the lady’s household. He made the patient lie on her back on a couch and injected the medicine, he prepared, through her nose. When the injected medicine was flowing out of her mouth, the patient gestured to her servant to mop up that fluid (ghee/medicine) with a piece of cotton and store it a vessel. The bemused physician Jivaka wondered, “That ghee ought to be thrown away, but this stingy woman ordered it to be taken with cotton. I do not know whether I will get my fee. This thrift is rather too much”. After she recovered, the Settani watching the puzzled expression on Jivaka’s face smiled and explained, “That is a good ghee mixed with medicine and can be used for rubbing on sore feet. Don’t be alarmed. I am not so stingy .I will pay you your fee.” She was highly pleased with the miracle cure and paid the young physician four thousand kappanas (silver coins). Her son added an equal amount to his purse.
On his return to Rajagriha, flushed with success, Jivaka set up his own establishment. He had a great start to his medical careeer. He performed the operation of trepanning (to pierce with a surgical crown saw) on a setthi of Rājagaha and followed it up with an operation on the son of the setthi of Varanasi who suffered from chronic intestinal trouble due to misplacement.
A son of a merchant while playing at somersaults suffered a twist in the bowels (an entanglement of his intestines). He could not digest properly whatever he ate and drank; and looked discolored with the veins standing out upon his skin. Jivaka cut the skin of the stomach, drew out the twisted bowel, and sewed the skin of the stomach. On applying an ointment given by Jivaka, the boy in due course became well.
Jivaka was also a well-known pediatrician. His name Kaumarabhtya (in Sanskrit) was some times interpreted to mean ‘expert in children’s diseases’. A part of the Bower MSS discovered during1880 in Kuchar of Chinese Turkistan quotes Jivaka’s formulae as the “Navan_taka” (meaning ‘butter’). This medical compilation of the 4th century AD attributes two formulae dealing with children’s disease to Jivaka, saying ‘Iti hovaca Jivakah” i.e. thus spoke Jivaka. One formula is: Bhargi, long pepper, Paha, payasya, together with honey, may be used against emeses ( act of vomiting ) due to deranged phlegma. Some of the cures attributed to Jivaka may be exaggerations, but they indicate the importance attached to accurate observation and deduction in ancient times. (http://www.vigyanprasar.gov.in/dream/may2000/article1.htm)
[His teachings travelled to Thailand along with Buddhism, around the 2nd and 3rd century BC. Learners and practitioners of the traditional Thai massage art respect his methods, even today.
As his fame spread, the king’s men invited Jivaka to cure the king Bimbisara of his fistula. The successful physician was paid a huge fee and appointed the physician to the king.
Jivaka, the successful young physician, enjoying fame and fortune went to meet his benefactor and adopted father Prince Abhaya and laid at his feet all the wealth he earned. .Jivaka thanked the Prince for his love, compassion and caring. Prince Abhaya appreciated the gesture and said that the gifts were undoubtedly very valuable indeed; but it was not the gift he was waiting for, he said. ”You are my true gift” he exclaimed. Prince Abhaya explained that during Jivaka’s absence he enquired into the circumstances of his birth. His mother, Salawathi, was the sought-after courtesan of the kings and nobility. Wanting to retain her freedom, she discarded her baby who she feared might burden her. Prince Abhaya had unknowingly adopted his own child.
Prince Abhaya built a palace to serve as his son Jivaka’s residence and provided him with riches and many servants
The turning point in Jivaka’s life came when Ananda came to fetch him to treat the Buddha who suffered from “blocked intestines” (constipation?).When Jivaka saw the condition of the patient, it occurred to him he might not survive a strong purgative. He then had fat rubbed into the Buddha’s body and gave him a handful of lotuses to inhale the essence emanating from the flowers. Jīvaka was away when the mild purgative was later administered to the patient, and he suddenly remembered that he had omitted to ask him to bathe in warm water to complete the cure process. The Buddha, it is said, read his thoughts and bathed as required.( Vin.i.279f; DhA. ii.164f).
On another occasion when the Buddha’s was injured in his foot by a splinter from a rock hurled by Devadutta (Buddha’s cousin), the Buddha had to be carried from Maddakucchi (a park near Rajagriha) to Jīvaka’s Ambavana residence. There, Jīvaka applied an astringent, and having bandaged the wound, left the city expecting to return in time to remove it. However, by the time he did return, the city gates were shut. He was greatly worried because if the bandage remained on all night the Buddha would suffer intense pain. The Buddha, it is said, read his thoughts and removed the bandage. (J.v.333.).
There is a mention of a meal hosted by Jīvaka, wherein the Buddha refused to be served until one Cūlapanthaka (denied entry by the host Jivaka) was served food. Cula_panthaka was the son of a rich merchant’s daughter who eloped with her slave. She, in dire circumstances, gave birth to a baby boy on the roadside. That baby was promptly named panthaka, who later turned out to be a dullard. He was however very fond of listening to Buddha and spent most of his time in the Vihara, though he was driven out each time. He later gained knowledge and became an Arhant, by grace of the Buddha’s compassion.
Jivaka became an ardent admirer and disciple of the Buddha. He tried to meet the Buddha at least two times a day. Since the Veluvana, where the Buddha stayed at that time, was far away, he built a monastery with all its adjuncts in his own Ambavana in Rājagaha and dedicated it to the Buddha and his monks (DA.i.133; MA.ii.590).
With foresight, love and compassion Jivaka took care of the physical health of the Buddha and His Sangha.The Buddha at the suggestion of Jivaka introduced a number of measures to regulate the day-to-day activities of the monks. Those included the following:
-. When Jīvaka went to Vesali (capital of Licchavi) on business, he noticed the monks there had gone pale and were unhealthy looking (Vin.ii.119). At Jīvaka’s request, the Buddha instructed the monks to exercise regularly.
-.As an extension of this routine the Buddha instructed the monks to sweep the compound of the monastery and attend to other duties to exercise their bodies, to ensure good health and to keep the premises clean.
-. Those monks who were ill were advised to use medicines and whenever needed to apply ointment to their sore feet.
-.The monks were in the habit of walking bare foot and many of them sustained injuries and suffered from sore feet. The Buddha advised them to wear foot coverings.
-.The Buddha advised the monks to use modest clothing and not wander about naked. He also asked them not to indulge in excessive austerities.
-.A discipline was introduced which required the monks to take care of each other. The famous advice of the Buddha to the monks, in this context, was,”Ye, O Bhikkhus, have no mother and father to wait upon you. If you wait not one upon the other, who is there, indeed, who will wait upon you? Whosoever, O Bhikkhus, would wait upon me, he should wait upon the sick.”
-.With the introduction of better health care measures in the Sangha , more and more lay persons entered the Order. Many people, afflicted with disease and unable to pay for treatment, joined the Order in order to avail free medical facilities. This influx naturally rendered Jivaka’s task more difficult. He was unable to cope with the increased workload. Further, he thought, the Order was misused. At his suggestion, the Buddha laid down a rule that men afflicted with certain diseases be refused entry into the Order. The diseases prevalent in Maghada of those times included: leprosy, boils, dry leprosy, consumption, and fits (Vin.i.71ff). Later cripples and homosexual were also kept out of the order. (Vinaya, Vol. 4, pp. 141-142.).
Once Jivaka offered to the Buddha, an exquisite shawl earlier presented to him (Jivaka) by a king. The Buddha accepted the celestial shawl, as requested by Jivaka. The Buddha, however, felt that keeping such a valuable shawl in the monastery would attract thieves and endanger His monks. He asked Ananda to cut the shawl into strips and sew it again, so that it would be of little value to thieves. In addition, it would inculcate in the monks a sense of non- attachment to objects. This was how the custom of wearing patched garments came into practice in the Sangha.
The Blessed One accepted the suit,
and after having delivered a religious discourse,
he addressed the bhikkhus thus:
“Henceforth ye shall be at liberty to wear either cast-off rags or lay robes.
Whether ye are pleased with the one or with the other, I will approve of it.”
When the people at Rajagraha heard :“The Blessed One has allowed the bhikkhus to wear lay robes” .
Jivaka gained fame as the first layman to offer robes to the monks. Thereafter, others who were willing to bestow gifts became glad. The term kathina denotes a cotton cloth offered by lay people to bhikkhus (monks) annually, after the end of the vassa rainy retreat, for the purpose of making robes. And in that one day, many thousands of robes were presented at Rajagaha to the bhikkhus. Then , offering robes to the monks and nuns in the Sangha came to be regarded as one of the meritorious deeds .
The above instance illustrates the process in which the rules governing the conduct of the monks evolved in the early Buddhism. This was in sharp contrast to the practices in a few other religions where the Rule was initially pronounced or written down and later imposed on the followers. The Buddhist practices, especially those concerning the conduct of the monks, emerged out of the incidents in the Buddha’s life or out of his discourses. It was a gradual process; and a Rule developed in response to a challenge or to fulfill the needs of the growing Order.
This tradition, incidentally, helped the Buddhist teaching methods in explaining the significance or the concept behind a certain conduct or a practice recommended for the monks. It helped the learner to appreciate how the rule fitted into a coherent whole.
Vegetarianism in Buddhism :
Once while he visited the Buddha who was then staying in his Mango grove, Jīvaka asked, if it was true that animals were slain expressly for the Buddha’s use. The Buddha replied— he forbids the eating of meat only when there is evidence of one’s eyes or ears as grounds for suspicion that the animal was slain for one’s express use. Anyone who slays an animal for the use of a monk and gives it to him commits a great evil”. Jīvaka was pleased with the reply and declared himself a follower of the Buddha. (Jīvaka Sutta – M.i.368f.)
Jivaka sutta :
This is the much-discussed Jivaka Sutta that puts forth the Buddhist views on meat eating and vegetarianism. The sutra and the discussions that follow are elaborate. Some of that can be explored by following the links at the bottom of this paragraph.
– a monk or nun should accept, without any discrimination, whatever food is offered in alms , offered with good will; this could include meat. However, the Buddha declared the meat trade as wrong livelihood. (Vanijja Sutta, AN 5:177)
-Taking life, beating, cutting, binding, stealing, lying, fraud, deceit, pretence at knowledge, adultery; this is un-cleanliness and not the eating of meat.
-When men are rough and harsh, backbiting, treacherous, without compassion, haughty, ungenerous and do not give anything to anybody; this is un-cleanliness and not the eating of meat.
-Anger, pride, obstinacy, antagonism, hypocrisy, envy, ostentation, pride of opinion, interacting with the unrighteous; this is un-cleanliness and not the eating of meat.
-When men are of bad morals, refuse to pay their debts, are slanderers, deceitful in their dealings, pretenders, when the vilest of men commit foul deeds; this is un-cleanliness and not the eating of meat.
-When men attack living beings because of either greed or hostility and are always bent upon evil, they go to darkness after death and fall headlong into hell; this is un-cleanliness and not the eating of meat.
-.Abstaining from fish and meat, nakedness, shaving of the head, matted hair, smearing ashes, wearing rough deerskins, attending the sacrificial fire; none of the various penances in the world performed for unhealthy ends, neither incantations, oblations, sacrifices nor seasonal observances, purify a person who has not overcome his doubts.
-.He who lives with his senses guarded, conquered, and is established in the Dhamma delights in uprightness and gentleness; who has gone beyond attachments and has overcome all sorrows; that wise man does not cling to what is seen and heard.(Amagandha Sutta)
-meat should not be eaten under three circumstances: when it is seen or heard or suspected to have been killed on purpose for a monk. (When a living being is purposely slaughtered for the eater).
-meat can be eaten in three circumstances: when it is not seen, heard, or suspected (when a living being is not purposely slaughtered for the eater). (Jivaka Sutta, MN 55)
He permitted His monks to be vegetarians if they so wished; He did not prescribe that as a rule (to avoid hardship to His monks).
The Buddha declared that kamma is intention. One should not therefore condemn a person merely because he is eating meat to sustain himself. This sets him apart from one who eats meat out of greed for meat or for enjoyment in killing.
None should discourage those who opt not to eat meat. A balanced diet could be achieved without meat, if one so desires. Many Buddhists have opted to become vegetarians because it helps them to practice “loving-kindness”.
The Buddha’s last message to his disciples was:
“Behold now, bhikkhus, I exhort you: All compounded things are subject to vanish. Strive with earnestness”
“My years are now full ripe; the life span left is short.
Departing, I go hence from you, relying on myself alone.
Be earnest, then, O bhikkhus, be mindful and of
With firm resolve, guard your own mind,
Whoso untiringly pursues the Dhamma and the Discipline
Shall go beyond the round of births and make an end of suffering.”
(DN 16 Maha-parinibbana Sutta)
Jivaka’s story is fascinating by itself; in addition, it provides an insight into evolution of values and attitudes in the early Sangha.
Sources and References
http://aimwell.org/assets/Amagandha%20Sutta.pdf (Amagandha Sutta)