Symptoms
Illness can be addressed via three different but related aspects namely, its symptoms (byadalaksana), its causes(byadahetu) or its cure.
For most of us the symptoms of an illness constitute the actual illness itself. Due to this we often see its cure as being the blotting out, or putting away, of its symptoms.
We thus endeavour to suppress such symptoms by all means at our disposal. With such suppression, illness and its resultant pains and discomforts, become 'manageable'.
If we cannot succeed in such endeavours we usually go and see our Doctor who, more often than not, does the same thing using more powerful medicines than we can obtain ourselves. His motivation for doing so lies in his or her sworn duty to relieve a patients suffering.

Symptoms are not difficult to recognise but causes often are.
The art of healing itself must always revolve around the development of skill in the art of diagnosis for such diagnosis determines what and how all subsequent treatments will be.
The method employed for diagnosis usually determines just what art or aspect of healing we are involved in.

Skill in the art of knowing how to suppress symptoms, however noble it may seem, does not constitute a skill in healing nor are they (skill in healing methods and healing itself) necessarily found together. To suppress the symptoms of disharmony and regard this act as being a cure for illness is a very limited approach for any doctor orhealer to adopt as it can only ever achieve exactly what it sets out to do, namely the usually temporary eradication of symptoms.

Another danger of such an approach lies in the methods used as a result of such a view. The development of new and more devastating forms of illnesses has brought ever more terrible sufferings in its wake and their symptoms require even more powerful drugs to be developed, manufactured and administered. All too often a patient suffers more from the results of a 'therapeutic' chemical process than the illness it is held to cure.

What we experience as the symptoms of an illness are simply the apparent effects of a more general state of ill health manifesting in a particular manner, or in a particular place within the body. What we regard as its cause (if at all known) is usually the antecedents of the symptoms themselves rather than anything else.
Orthodox preventative medicine encourages us how to understand and avoid such causes in the future. but of course if see these causes as simply being the symptoms alone illness will always arise anew.

That such a state of affairs is commonly understood to exist by the orthodox healing professions can be seen in the fact that there is no general view amongst them that such causes could ever be made to cease for ever, nor is it considered a real possibility that a person could ever attain a state in which they never develop or 'catch' an illness.
Such concepts or situations within people would obviate the need and reason for the art of medicine to exist.

We can see here that the danger of developing an inherently pessimistic orientation for the art of medicine is great and one based upon what are considered to be the experiential inevitabilities existing within a continual state of struggle to be free from illness. Insurance companies and the commercial manufacturers of medicines grow wealthy from such ideas and views.

Ancient traditions
That the state of illness has been with us a long time is known by the very ancient accounts of healing and medicine in all the civilised nations of the world. Some of them however did consider illness with a more positive outlook particularly in the case of Buddhism and Hinduism. Both these systems had very advanced concepts and therapies about illness and its causes. What is especially interesting is how they viewed the nature of illness itself.
Their views resulted in very different forms of diagnosis and from this the very therapies they practiced.

In general both these great traditions of healing regarded many more factors than mere external symptoms in their evaluation of the nature and treatment of illness.
They also regarded understanding the nature and interaction of the mind/body complex as fundamental in evaluating both sickness and health.

Long before people such as Freud, Harvey, Pasteur, or arts such as psychiatry and chemotherapy, they had evolved sophisticated ways of determining the nature of both mental and physical illness as well as what are now called infections. Treatments arising from these ideas consisted of a wide variety of therapeutic endeavours and practices many of which would not nowadays be connected to the art of medicine at all.
The types of treatment applied by the ancient Buddhist and Hindu doctors often involved practices which are still regarded as very new or forward looking in modern times. The phototherapy of G.G Luce and its related S.A.D. syndrome were all well known, as were (safe) radiation treatment, osteopathy, phytotherapy, chromotherapy, hydrotherapy, inoculation, vaccination, and a very advanced form of clinical surgery, the like of which was not equalled for 2000 years in the western hemisphere. Some of these healing practices still await discovery by modern medicine.

The practitioners themselves were also different in that, in common with the ancient Greeks and Egyptians, the art of healing was regarded as religious practice and an exalted profession fit only to be studied and performed by priests or renunciates.
We can see from such features that the healing art itself was considered to require a special type of person, one not involved or attached to the materialistic aspects of life. Such a requirement guaranteed patients that they could trust their doctor to be impartial, honest and confidential in his treatment of them. Echoes of such a bond between patient and doctor can be found in the wording of the ancient oath of Hippocrates, the father of the ancient Greek forms of healing.
One section especially, namely that relating to the acceptance of money in return for treatment, has long been ignored in modern medicine although a shortened form of this very oath is required of every practicing doctor. The ancient Hindu equivalents of Hippocrates, namely Susruta and Caraka. formulated similar ethical guidelines.

The healing of bodies and the healing of minds go naturally together and for a person who is involved in studying and applying both of these aspects an inner balance of each is essential. Such balance is achieved through spiritual practices and both Hinduism and Buddhism fully recognise this fundamental fact.
What constitutes the make up of a human being determines how and what they become, their distinctive temperament and habit. It is within these that illness strikes. If we live a healthy, peaceful and 'good' life we expect not to be ill. If we live in the opposite manner illness does not surprise us, it seems to be the results of our own excesses.
Although there may not always be agreement as to what is and what is not an 'excess', a broad range of activities is agreed by most of us to be acceptable and anything beyond that is regarded as asking for trouble.
Whilst some forms of illness and disease may have quite rational and determinable causes, at least from the materialists point of view, others do not. The ancient healers were very familiar with genetically caused disorders, they also were far more aware than modern doctors concerning natural poisons and pollutants.

Despite this knowledge illnesses still arises. It often strikes when we haven't done anything to justify it and in order to explain such occurrences the ancient teachers quite wisely sought answers in both the physical and spiritual realms.
Unlike their later western counterparts 'answers' were forthcoming for it was in the understanding of what actually constituted the human being that one 'key' to understanding the nature of illness was found.

If one took the materialist view that humankind was all and only physical being then one had to accept the sheer injustice of disease and sickness. Therapeutic endeavour was thus strictly limited to what could be experientially evident. Every new disease began a flurry of research and experimentation until some solution to it was unearthed.
In the meantime the poor patient simply had to bear his lot and trust that someday this cycle of subsequent and retrospective discovery would eventually come to an end. Such a day has not arrived and, due to its retroactive basis, never could.

Diagnosis

If our system of diagnosis is faulty, incomplete or both, any and every treatment we apply will not be totally successful in the long term. In some cases it could be that bearing the symptoms will be healthier for us than taking the treatment suggested for it. The symptom we repress will be replaced by yet other symptoms until the patient's body is no longer able to bear either the treatment suppressing those symptoms or the symptoms themselves.
We can perhaps understand these principles by means of an analogy.

Suppose we work hard all our lives, save our money and buy our dream cottage in the country. It is a beautiful place with woods, fields and a lovely pond in which fish and frogs abound. Soon we make friends with our neighbours who are all simple and spiritual folks like ourselves. all seems well and we are very happy, content and looking forwards to enjoying the fruits of our well deserved labours.
One day our closest neighbour, whom we get on with very well, and who is the poorest and simplest of all those who live in the locale, begins to create a small workshop. In this he hopes to produce a few goods which he can sell in order to raise some sorely needed money for himself and his family. We feel very glad for him and make a note to publicise his efforts to others in the neighbourhood.

After a few months however we begin to notice that the fish in our pond are not so abundant. Later on we find some of them floating dead on the surface of the pond. Being concerned with this we try to find out what has happened and ask around and take advice about this situation. Eventually we discover that all the oxygen in the water of our pond has gone and along with it all the fish and other pond life.
Even the frogs etc have died. Because there are no fish left, the insect population, which the fish usually eat, increases in leaps and bounds. The water clogs up with the weeds normally eaten by the fish. In a short time our previously beautiful pond has become a choked up, swamp like, dip in the ground, filled with parasites such as mosquitoes along with their eggs etc.
Such a situation would concern us but we may ignore it by suppressing our concern and hope that it will go away. Of course it doesn't, so we then try replacing our concern with another i.e. we go on an extended holiday somewhere. This means we do not see the pond or experience the sadness it brings us. This isn't of course a proper solution for eventually we have to return and face it all anew.
Such a response is like ignoring an illness we suspect we are developing or being told by our doctor that what we think we have will pass naturally and doesn't require any significant treatment.

If decide to change this situation in the style of modern medicine by removing its immediate symptoms we could introduce oxygenating pond plants and perhaps new fish into the pond. These would work for a time but sooner or later the same situation would arise anew and we would be back where we started and the degeneration would continue to increase. No matter how many times we applied this remedy the same situation would reassert itself because it isn't the real problem, it is only its symptom.

At this point we would need to positively decide what more we could do, so we initiate an investigation into its possible causes. With a little detective work we discover that our industrious neighbour has been tipping waste products form his workshop into or close to the pond and these have seeped into the water and killed the fish.
We now have decide on a further course of action to alleviate this situation. We could approach our neighbour and explain what has happened. He may for instance say he did not intend this to occur and is very sorry that it has, but that the materials involved, or the way he uses and disposes of them in his work are essential, and he needs the money. He likes what he does and no amount of persuasion or pressure can change his way of working as his work depends upon this and he cannot afford to do anything else.
We then reach a stalemate situation. There is nothing further we can usefully do by stating our case. We know what it is that we wish to achieve but we do not have the means or power to do it.

If we decide to again use medicines' technique of suppression we could secretly go around to our neighbours workshop late one night and quite illegally burn it down. This would halt his activities for a while and give our pond a chance to recover its natural life, but by using such a method there arises the possibility that he could rebuild it later, perhaps on an even larger scale, to make up for his lost trade.

Then we would be faced with the possibility of even greater acts of sabotage and a greater chance of being discovered and caught in the act. To do more along these lines would mean initiating a cycle of events that we would have no way of knowing where or how would end.
Such an approach is rather like medicines idea of surgically removing an infected organ or body part in the hope that this will end the illness and symptom.
Another course of action could be to remove the actual environment which makes the situation possible, by filling in the pond and cultivating the regained land. However this would materially alter the value, nature and aspect of the environment, which was a main reason we chose to live there in the first place, and our neighbour may still have to dispose of his waste upon the land around him which may in turn cause other forms of pollution.

Such a remedy would be rather like encouraging a patient who is difficult to treat to die quickly and his relatives to produce a new baby to replace him.
A more wise solution would be to recognise the real causes of the situation, namely the financial hardship which prompted our neighbour to engage in the business in the first place and it is that very financial need that we should really address first and foremost.

This could start by suggesting, helping or even creating for him, other means of income or more amenable premises and places of work.
We could even offer to pay for his waste disposal as an interim encouragement. By giving some time to trying to understand how our neighbour sees this situation, how and what he thinks about it, enables us to develop an individual approach that we can present to him in terms he finds both understandable and acceptable.

Attitudes

It seems clear that it is the therapists view of patients in general which is a key factor in the formulation of both diagnosis and treatment. If one is limited so will be the other. If a doctor has a limited conception as to the potentialities inherent in general humanity he or she will only address those factors. It is doctors themselves alone who restrict their diagnostic basis and it is the range and basis of his or her own mental and physical being which limit the efficacy of their diagnosis and treatment.

The recognition of this feature was one reason as to why the art of medicine originally developed only within spiritual contexts for it was only within them that we find a range of vision wide enough to embrace all those aspects of life and death relevant to the art of healing and medicine. It seems to me significant that none of the traditional founders of the middle eastern semetic religions (Christianity, Judaism and Islam) ever spoke directly of or gave teachings in, the art of medicine even though in some cases they seemed able to perform acts of healing (which they attributed to their God).
Although their 'power' to heal obviously derived from sources other, or additional to, the purely outward and physical disciplines common to modern institutional medicine, they were never recorded as having taught their students to consider such things in any systematic manner. When the disciples of these prophets fell ill they sought out Doctors the same as everyone else. Such a defecit of consideration is noticeably absent in the Buddhist outlook.

The Buddha healing a sick monk

The Buddha
In the Buddhist scriptures the Buddha himself often spoke of healing methods and approaches. He permitted his monks to prepare medicines and even tended sick people himself as an example to them. He also outlined many different forms of diagnostic interrogation but these were never simply restricted to observable or reported physical symptoms. Buddhism itself sprang directly as a response to the ultimate diagnostic query, namely 'what is the cause of the sufferings we experience in life?'. The Buddha expressed his cure by formulating the course of therapeutic endeavour entitled the '4 Noble Truths'.
He, and many of his later disciples, outlined different, and surprisingly modern sounding themes concerning the causal factors involved in both the formation and development of physical illness. These included various types of foodstuffs (ahara), their colour, texture, substance and preparation, as well as the time and environment in which they are consumed. How the seasons of the year affect one's temperament (which is literally what the word really indicates) and the body's homogenous interactive responses (prasada) to them. In the Ceylonese version of the text entitled 'Visuddhi Magga' X1.14-26 ('The Path of Purification') we find all these described in depth. Another early text, the 'Chie to tao Lun', was taken to China and seems to have been much used as a 'vade mecum' by missionaries. In Pali this was entitled the 'Vimutti Magga'(The Path of Liberation) authorship of which is ascribed to the Arahant Upatissa. Its Chapters describe and explain organic & skeletal anatomy, respiration, death states and causes of infections.

Despite the extensive knowledge of the working of the body,the Buddha always addressed equally the significance of the role of mental as well as physical factors. He determined clearly for instance the differences between mental and physical 'foods'.
The Buddhist system proved a worthy basis for the exploration of human and superhuman potential and we find even within the earliest forms of Buddhism the tools necessary for the formulation of both psychological and physiological medicines and intricately structured healing systems. Although the Buddha was borne into a time and tradition in which healing was already a very sophisticated practice, his teachings extended its range and methods considerably. So significant was his contribution that within a short time Hindu physicians and healers adopted many of his ideas concerning disease and illness wholesale. The basic textbooks of the aforementioned Caraka and Susruta contain many excerpts of Buddhist scriptures and commentaries concerning both the practical art of healing as well ethical and philosophical attitudes it assumed.
The texts of Caraka and Susruta were much later carried into medieval Europe by Arab traders and many sections of their teachings came to be included in the medical references created by Christian monks.

The study and practice of medicine continued unceasingly after the death of the Buddha and we find famous teachers of both Indian and Chinese Buddhist schools, such as Kasyapa, Jivaka, Nagarjuna and Vasubandhu writing commentaries concerning both directly and indirectly the art of healing, In China, the 1st century CE, An Shi Kuo translated many such texts which elevated and revolutionised the existing Chinese traditions.

Modern systems of medicine lacks a central universalist basis, It has no proper definition of good health other than a negative one of 'lack of disease'. This is consonant with its inherently pessimistic view of illness itself as was outlined earlier. The Buddhist system however has always had a central and positive goal, namely that of human Enlightenment (Nirvana). Such a goal is seen as the ultimate and transcendental overcoming of all mental and physical sufferings and is the noblest target a healer can aim for.
In such a quest the separation of mental and physical illness is recognised as foolish, so also is the concept that one can attain wisdom through specific and specialised knowledge of any one method or practice. This fact is of course completely contrary to the general understanding and view of the intellectual capabilities of a medical specialist or 'consultant'.
Understanding and expertise of the art of healing only arises through a balanced understanding of the various spiritual, natural, environmental and psychologial contexts and interactions available to one's patients and which may affect them not simply from any departmentalised 'specialised' information or outlook.
To understand a great deal about any single thing but not know or care what its significance will be, both in general vis a vis the world and within the life of those subject to its results, is really a method of evading personal responsibility, not as wisdom.
It does not qualify one as a balanced human being, let alone a healer.

The burden upon the Buddhist healer is then to try and understand, diagnose and apply therapies which are balanced and conducive to the best wordly and suprawordly conditions and interests of the patient. The uncovering of what these consist of is the great adventure of healing.

Shifu Nagaboshi

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