What is Disease according to Buddhism?
An Yang-gyu | Prof. of Division of Buddhism, Dongguk University at Gyeongju
King of Healing and Medicine of Dharma
Buddhism gives deep insight into and teachings about the suffering of life. Of all the human suffering that inevitably accompanies life, the most prominent one is sickness; some form of ailment is unavoidable. Buddhism says there are four forms of suffering that humanity experiences: birth, aging, sickness and death.
Sakyamuni Buddha has been revered as both the king of healing and king of medicine. In the Four Noble Truths which embrace all teachings of the Buddha, one can see the Buddha’s role as a physician. The “truth of suffering” equates to recognizing the disease. The “truth of the cause of suffering” equates to finding the cause of the disease. The “truth of the cessation of suffering” equates to recognizing that the disease can be removed and health restored. The “truth of the path to the cessation of suffering” equates to a prescription that cures the disease. In the same way a doctor precisely diagnoses a disease and gives you a prescription to heal it, the Buddha taught the path to become free from suffering.
And just as a doctor gives each patient a different type of medicine according to the nature of the illness, so the Buddha taught appropriate teachings to people with different mental and spiritual ailments. The faith and practice devoted to the Medicine Buddha (or Healing Buddha) in Mahayana Buddhism may be understood the same way. As the Buddha who heals the suffering of sentient beings, the Medicine Buddha was widely revered and worshiped. If medicine heals physical illnesses and prolongs life, the Buddhadharma is medicine that heals both mental and physical illnesses. Thus, the Buddha’s teachings are called “the medicine of Dharma” and the Buddha “the king of medicine.”
Types of Disease
Numerous types of disease exist, but they can be largely divided into physical and mental. “Some people can be free from physical disease years and years, perhaps their whole life, but no one is ever free from some form of mental disease, not even for a moment. The only exceptions are those who have completely removed their defilements.” [Defilements (Skt. kleśa; Pali. kilesa) are mental states that cloud the mind and manifest in unwholesome actions. Buddhism sees the three poisons of greed, hatred and delusion as the root of all defilements.] One who takes good care of their physical health may live without a major illness for a long time. However, no living being can escape psychological suffering even for a moment, say the Buddhist scriptures.
The apex of health is nirvana, a state of the complete absence of defilements, which are the pathogens of greed, hatred and delusion. True health is restored when all defilements are removed.
Buddhas and arhats who have completely eradicated their defilements are free from mental disease, but all others have some form of defilement that is a continual source of suffering.
Buddhism pays more attention to the healing of mental disease than physical disease. To the elderly householder Nakula the Buddha said, “The physical body holds lots of fear and suffering. This body has nothing substantial, but is just covered with thin skin. Relying on this body may give you fleeting joy, but that is an act of foolishness that the wise don’t cherish. Your physical body may be ill, but your mind must be free from illness.” This advice exhorts us to become free from mental suffering because although we cannot escape physical illness, we can keep our minds free from disease.
Diverse Causes of Disease
First, bad karma can be one cause of illness. The basic law of karmic retribution is: a good deed produces good fruit; an evil deed evil fruit. One who is prone to many illnesses from birth is likely to have created much bad karma in previous lives, including harassing or harming other living beings.
“Here is a man or woman whose nature is to harm others with their hands, a lump of dirt, stick or knife. Having committed these acts, they die and their body disintegrates; then they are born into unfavorable circumstances, into a place of suffering or in Niraya Hell. If they are neither reborn into unfavorable circumstances, nor into a place of suffering, nor in Niraya Hell after death, they are reborn as human beings. These people are prone to many diseases wherever they are.”
The above scripture teaches that one whose nature is to harasses or harm other living beings will be born into hell in severe cases or as humans in less severe cases. Once reborn a human, they are likely to suffer many illnesses due to bad karma from previous lives. The Buddha warns that the bad karma from killing is the primary cause of disease. Before domestic animals were killed for consumption, there were few diseases, but once they began to be butchered, “98 kinds of disease occurred.”
Second, unhealthy diet is mentioned as another cause of disease. The Buddha personally experienced the benefits of eating little and recommended his disciples to follow it. “I eat one meal a day. Since I began to eat one meal a day, I know neither struggle nor strife. My body is free from disease, my energy is firm and stable, and thus, I am comfortable and at peace. I advise you too to eat little.” Research on very old and healthy people reveals that eating little is an important factor in longevity. The Buddha also advised to avoid eating late at night. “Bhikkhus! I don’t eat at night. Because I don’t eat food at night, I am in good health and free from disease. I have vibrant energy, physical strength, and live a comfortable life.”
Third, Buddhist literature generally explains that an imbalance of the four great elements that constitute the physical body is another cause of diseases. Our physical body is formed by the integration of the four great elements. “People have four great elements that are earth, water, fire and wind, and a single one of these elements potentially causes 101 kinds of disease. When all four elements merge under certain conditions, 404 kinds of disease can occur at once. Such a person is extremely cold, extremely hot; experiences extreme hunger and extreme fullness; drinks excessively and feels extreme thirst. They have these diseases because they have lost the sense of proper time and place, and they have no discipline in sleeping and arising.” Thus, the scriptures reveal that an imbalance of the four great elements is usually caused by gluttony or bad life habits.
Fourth, the scriptures also say that defilements or afflictions cause disease. Greed, hatred, and delusion are widely known as the three poisons. Buddha says that the poisons of greed, hatred and delusion make humans sick. People suffer because they are taking in one or all of these three poisons. Thus, they can be the cause of the mental disease called unhappiness. These three poisons cause people to do all kinds of bad things. Greed, hatred, and delusion are the source of all bad karma; they do not arise from outside you but from inside the mind. Therefore, one’s state of mind decides whether one is happy or not.
Fifth, some early scriptures say that yakkhas or other evil beings enter human bodies and make them sick. Stories about evil beings like ghosts causing physical sickness are connected to the “Ritual of Feeding Ghosts to Heal Disease.” One who has strong attachments or holds an extreme grudge while alive may enter another human body to experience life again after death. This ritual offers food to these angry spirits and reads scriptures to them so they are released from their resentment to be reborn into a better world.
Positive Functions of Disease
Diseases are not unconditionally bad. If one doesn’t feel pain even though they are sick in body, it will be difficult for them to preserve their physical body safely. Because disease accompanies suffering, we can find its cause and get rid of it or avoid it. In this respect, a disease can be a kind of wake-up call to take care of your physical health. Disease may also lead one to enter monastic life. In the Buddha’s case, he went to the southern gate of the palace and saw a sick person, and seeing the suffering caused by disease firsthand motivated him to consider the path of a wandering ascetic. A true monastic might consider the following if they become seriously ill: “I am severely ill and may meet with death soon. Thus, I should practice sitting and walking meditation joyously. In that way I can earn what has not been earned, reap what has not been reaped, and awaken to what has not been awakened.” With a sense of urgency knowing that their life can end any minute, they practice even when they are ill. And after they are healed, they practice diligently thinking their practice might suffer if they have a relapse or are stricken with another disease. Thus, disease can motivate one to enter monastic life or to practice more vigilantly. When experiencing or even witnessing the suffering caused by disease, one can feel more urgently the need for practice.
Buddhism teaches that one can lessen such defilements as arrogance by reflecting on the inevitability of disease more often. “Living beings are conceited about their health when healthy, and this excessive pride in their health leads them to behave badly in thought, word, and deed. However, for those who reflect on the inevitability of disease, pride in one’s health decreases or is completely removed. For these reasons one should ponder the inevitability of disease from time to time.” “Do not desire to have no illness. Without physical illness, one is prone to become greedy and/or arrogant. Thus, the Buddha said, ‘Take the suffering of disease as good medicine.’” Greed easily arises when one has no physical illness because, with a healthy body, one wants to enjoy the five kinds of desire that arise from our attachment to things we see, hear, smell, taste and touch. A sick person can hardly think of enjoying such things. In this respect, a disease can be “good medicine” because it can help to purify the mind.
As long as we have the physical body consisting of the four great elements, we cannot fully avoid or remove physical disease. That doesn’t mean that we should neglect or not treat a physical illness. We should neither harm our health nor arouse disease through bad life patterns, including overeating. Mental illness is also caused by greed, hatred and delusion, and Buddhism teaches us to remove defilements to remain disease-free in our mind. When the cause of a disease is eradicated, health is restored. The apex of health is nirvana, a state of the complete absence of defilements, which are the pathogens of greed, hatred and delusion. True health is restored when all defilements are removed.
An Yang-gyu received his master’s degree from Dept. of Buddhist Studies, Dongguk University, and PhD from Oxford University, U.K. Having researched at Tokyo University, Japan, he is currently a professor in the Division of Buddhist Studies, Dongguk University at Gyeongju.