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Encyclopedia of India–China Cultural Contacts v1.c6.s2: B. Medical Sciences

Encyclopedia of India–China Cultural Contacts v1.c6.s2

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English

Contents

B. Medical Sciences

Cikitsāvidyā

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Concerned with suffering and illness as well as healing and deliverance of humankind, Buddhism had a special place for *Cikitsāvidyā*, or *Bhaiṣajyaśāstra* (medicine), since its inception. The Pundit-monks were well acquainted with medicine because of their formal training in *Pañcavidyā*. They practiced various medical specialties including surgery and provided treatment to the residents of monasteries as well as to the lay people in need. They were the first transmitters of ancient Indian medicine to China.

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The monks used *cikitsāvidyā* in three ways. First, the scientific medical terminology for ridding the body of an illness was used as a metaphor to explain the doctrine of deliverance from worldly existence. Second, psychosomatic diseases were treated by magico-religious remedies like prayers or invocations to Buddha, Nagarjuna or Jivaka or charms to be carried to drive away evil spirits. Lastly, medicine and surgery were practiced to relieve the human body of physical suffering. Thus, medicine developed as an integral part of Buddhist culture in China.

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The *cikitsāvidyā* entered China through translation of Buddhist sutras from texts like *Samyuktāgama*. For example, a *sutra* translated in Chinese at the beginning of the fourth century CE invokes Buddha and explains that the great king of physicians is the one 'who is able to realise the following principles; first, to understand the illness well which means to be able to differentiate between the various illnesses; second, to understand the origin of illness whether it be caused by wind, phlegm, saliva or various types of colds, whether the illness is acute or due to the season; third, to understand the antidotes eg there are salves, cough remedies or emetics, laxatives, nose drops or aromatic medication; fourth, to be skilled in treating illnesses without fear of a relapse.' Analysing methods for classification of disease and investigation of its causes, it states the basic *tridoṣa* principle of ancient Indian medicine *kapha* – tan 痰 (phlegm), *vāta* – feng 風 (wind) and *pitta* – danzhi 胆汁 (bile) and general methods of treatment.

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Medical specialties that were prominent in ancient Indian medicine, *Kāyācikitsā*, *Kaumārabhṛtya*, *Śālākya* and *Viṣagārapraśamana* received great fillip with the transmission of the science of medicine. Indian ophthalmology eg was acknowledged for its sophistication. Wang Tao王 焘 (CE 670-755), in his famous medical compilation Waitai miyao 外台秘要 (Medical secrets of an official) included a work on ophthalmology that claimed an Indian origin, viz, Tianzhu jing lunyan 天竺經論眼 (Indian classic of discussion on eyes). Two more Chinese ophthalmic works with Indian connections namely Longshu (pusa) yanlun龍樹菩薩眼論 [Discourse of (Bodhisattva) Nāgārjuna on Eyes] of 9^th^ century CE and Longmu zong lun 龍木總論 [*Nāgārjuna's Comprehensive Treatise*] in late 11^th^ century or early 12^th^ century appeared soon after.

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Primary elements and their role in the formation and working of the human body were transmitted through translation of Buddhist texts like *Viśuddhimagga* of the 5^th^ century CE. These texts informed that: “In this body what is stiffness and harshness is the *Pṛthvī* or earth element. What is fluidity or cohesion is *Āpa* or water element, what is maturing or heat is *Teja* or fire element, and what is distension or movement is *Vāyu* or wind element.”

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Pharmaceutical ideas and medicines were introduced too. One Indian monk named Bao si wei jing 寶思惟靜 or Ratnacintā translated Bodhisattva Avalokiteśvara's *Cintāmaṇidharaṇi* classic in the Tang Dynasty. Indian medicines like Hu jiao 胡椒 or pepper, Niu huang 牛黃 or dried gallstone of domestic cattle etc to treat eye diseases are mentioned in this text. Moreover, it includes treatment for diseases like juvenile glaucoma, pterygium using ointments made from the drugs Long nao xiang 龍腦香 and She xiang 麝香. A Buddhist sutra *Suraṅgamasūtra* explains how the Buddhists identified a drug by its physical properties such as taste, its physiological effect (like poisonous or non-poisonous) or its so-called intrinsic nature ie hot/ cold. *Suraṅgamasūtra* was translated by Pāramita around 705 CE and is part of the Chinese Buddhist canon. Earlier, *Suraṅgamasamādhisūtra* was translated by Kumārajiva around CE 350.

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Buddhism can thus be credited for introducing ancient Indian medicine with its concepts, techniques and drugs into Chinese culture thus contributing to the overall evolution of medicine in medieval China.

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(*Vijaya J. Deshpande & Kamal Sheel*)

Indian Medical Science and its Transmission to China

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Science and technology display a phenomenon of universality in their development. They tend to quickly expand and facilitate connections in the world. Diffusion of ideas and techniques from one culture to another through intentional or unintentional transmission had been observed since ancient times. It spreads over a long period of time, even a few centuries. One such significant transmission occurred between India and China during the early medieval period when Sino-Indian Buddhist contacts were followed by scientific/ medical contacts.

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Ancient Indian Medicine – Roots and Development

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The Indian medicine followed a developmental pattern that was no different from other ancient cultures. It started off with demonology and magical medicine. This is observed in Atharvaveda, which is considered to be the first recognised scientific text composed during the 7th-8th centuries BCE. Cures suggested were both magic spells and plant remedies. Yet *Atharvaveda* and other Vedic literature also reveal roots of various medical disciplines like

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*Fragments containing records of Indian medicine unearthed on the Silk Route*

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anatomy, embryology and ophthalmology. The first rational approach to medicine is seen in the composition of *Carakasaṃhitā* and *Suśṛtasaṃhitā* when the indigenous medical philosophy that provided a theoretical foundation for etiology and treatment of diseases viz, the *Tridoṣa* theory evolved.¹ Along with the *Pañcamahābhūta*² theory, it reflected contemporary ideas of cosmology, elemental theory and its relation to the human

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*Cover of Liao Yu Chun's book, Ayurveda: India's traditional medicine*

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body and health. Among the post-Sushruta works, *Aṣṭāṅgahṛdayasaṃhitā*, by Vāgabhata, is of foremost importance, for its scope and popularity. Several prominent medical works and their commentaries came about the following centuries eg *Mādhavanidānan* (6/ 7ᵗʰ century CE), *Kalyāṇakāraka* (9ᵗʰ century CE), *Śāraṅgdharasaṃhitā* (13ᵗʰ century CE), *Bhāvaprakāśa* (16ᵗʰ century CE) etc.

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By the time Buddhism established itself in India and began its outward transmission to Central and East Asia particularly to China, Korea and Japan, the Indian medical system, its prominent theories and disciplines were already defined. It has remained a controversial point whether the Buddhists borrowed medical concepts from Indian medicine and gave them the philosophical overtures or vice versa. Some scholars are of the opinion that significant growth of Indian medicine took place in early Buddhist monastic establishments followed by its later Hinduisation.³ Buddhist canonical literature is full of cursory references to medicine and surgery, but they do not reflect deeper medical insights. It ought to have been the case if the Buddhists were to be credited with significant development in medicine. Therefore, for all we know, it was the Buddhists who borrowed the concepts of Ayurveda that reached China with Buddhism in the 2nd/ 3rd centuries CE.

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Buddhism and Medicine

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Buddhists were deeply concerned with human suffering and illness. *Nirvāna* being considered as the state of the deliverance from all sufferings, the one who leads men to it ie Buddha was equated to a physician. Therefore, the name Bhaiṣajyaguru or藥師Yao shi, ‘The medicine-teacher’ or Bhaiṣajyarāja 藥王Yao wang, ‘The king of medicine’ was given to him. A healthy body was considered as a pre-requisite for the peaceful pursuit of knowledge and enlightenment. To assist the layman and monks alike in its achievement was the prime duty of Buddha and Bodhisattvas. After recognising “suffering” as a “noble truth” ie inevitable part of life, the subsequent truths were recognised as “cause of the suffering, the path to overcome it, and its final stopping”. These four truths correspond to diagnosis, etiology, therapeutics and recovery in medical terminology.⁴

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Buddhists’ commitment to medicine paved the way for entry of ancient Indian medicine or Ayurveda into China and its eventual absorption in Chinese body scientific.

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Travels of the Buddhist Monks

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Buddhism reached China in the 2nd century CE via Silk Route. Soon there was a regular flow of Buddhist monks between India and China. Chinese monks visited India for pilgrimage and also to collect canonical works. Buddhism thrived in China during the Tang Dynasty and the number of Buddhist monasteries and temples increased rapidly. The early Tang emperor Taizong (627-650 CE) developed contacts with several Indian kingdoms including Magadha that was ruled by the powerful king, Harṣavardhana. Nalanda University, therein, was a famous seat of learning at that time and Chinese Buddhist monks visited it in large numbers. Since interests in Indian medicine and other sciences were growing, these monk-travellers wrote about the distinctive nature of Indian medicine in their travelogues.⁵ By and large, under the directive of Tang emperors, Chinese monks and visitors searched for famous Indian doctors and drugs. Practice of medicine in Chinese monasteries also grew rapidly and it is reflected in literature, cave inscriptions and carvings of the time.

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Xuanzang, 玄奘 during CE 629-645 and Yijing , 義淨 between CE 671-695 visited India. During their stay, they made Indians aware of the Chinese techniques of accupunture and pulse examination. On their return journey, they carried with them Buddhist works with their innumerable medical references. Also, valuable information on medicinal plants, methods of treatment, organisation of free hospitals and dispensaries.

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Indian monks visited China often to participate in the translation of Indian-Buddhist texts into Chinese. Because of Buddhists’ interest in medicine, their scriptures often referred to it. Among the medicine-related essays some mentioned medicine in general⁶ and others to some specific discipline of medicine like pediatrics, ophthalmology, women’s diseases etc.⁷ Standard Ayurvedic treatments of internal medicine and surgery are also mentioned. Furthermore, they often cite “Tridoṣa” theory that forms the basis of diagnosis and treatment in Ayurveda.

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With Buddhism, concepts of hot and cold food came into Chinese medicine. Also, healing of mental suffering was advocated and thus arose the art of meditation, *Dhyāna* from which evolved the Zen sect of Buddhism in Japan. A Buddhist monk Ta Mo or Bodhidharma, in CE 527 taught martial arts to the Chinese Buddhist monks at Shao Lin monastery and his method finally evolved into what is known as Shao Lin School of martial arts.

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Chinese Absorption of Indian Medicine

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Medical knowledge which permeated in this early period through the translated Buddhist texts was effective in introducing new ideas of composition of human body and evolution of diseases into China. Chinese medical theories were so far based on the theories of Yin and Yang symbolism – the male and female. This classified all the objects in the universe into these two categories depending on their nature, based on the five elements – wood, fire, earth, metal and water, the vital energy *qi* and the blood. Writings of Tao Hongjing (5th century CE) depicted influence of Buddhist four element theory for the first time.

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Gradually, Ayurvedic concepts, methods and medicines took root in China. It was manifest in diverse ways like Buddhist Canonical works, medical treatment provided by monks, Legends of Buddha and Bodhisattva as Bhaiṣajyaguru, medical manuscripts like Qiposhu or *Jīvakapustaka* found in Dunhuang caves and pictures of medical treatment and engravings of medicinal formulae as in ‘Cave of prescriptions’ in Longmen (Dragon gate) caves at Loyang in north China. Finally, Chinese historical, popular as well as medical literature, also depicted Ayurvedic influence.

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Before long, standard medical works began referring to Indian medicine and surgery as seen in Sun Simiao’s 孫思邈writings.⁸ He was a famous medical personality who lived in 7th century CE. He had studied Buddhism and Taoism too. His work also lists several medicinal formulae attributed to Jīvaka,⁹ a great medical personality of ancient India.

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Transliterated Sanskrit terms pointing at Ayurvedic connections are numerous in Sun Simiao’s works eg “Agatuo” 阿迦陀 for “Agada” meaning disease-free, “Ka mo lo” 迦摩羅for “Kāmalā” or jaundice and translated term “Zuo dao yao” 座導藥 for “Bastinetra” both meaning sitting-directing medicine ie a suppository. Although suppositories were used in China earlier as seen in “Sengshenfang” (profound medicinal formulae of the Buddhists), a 5th century work but they were not under this name.¹⁰ Sun Simiao also introduced concepts of healing of mental sufferings by means of “Chan” 禪 for *Dhyāna*, and a method of Indian massage “An mo fa” 按 摩 法 and called it a Brahmin’s method.

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Sun Simiao was interested in Taoism as well as Buddhism so he was called “a new Vimalakirti”. Demieville¹¹ comments on Sun’s Buddhist connections as follows:

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“Sun Simiao, was an eclectic author, conversant with the philosophies of the diverse Chinese schools – chiefly with Taoism but he was interested in Buddhism as well; a contemporary even nicknamed him "a new Vimalakirti",” (Jiu Tang Shu 舊唐書, 卷: 4a-b). To be a good physician, he says in the introduction (Taoist Canon 道藏1: 1b-2b), “It will not suffice to be versed in Confucian and Taoist literature: no one who has not read Buddhist books will experience love, compassion and the joy of renunciation. One will not know when approaching patients vow to convey succour to all animate beings in all their sufferings, without distinction of rank, fortune, age, beauty, friendship or intimacy, nationality (Chinese or Barbarian) or intelligence. One will not succeed in considering all patients, with even mindedness, as one’s most dear friends.” This quote reflects Buddhist medical ethics beautifully.

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Cover of Chen Ming's book, *Medieval Medicine and foreign culture*

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Ophthalmology

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When Buddhists wrote their philosophical literature they compared “removing ignorance by means of wisdom” to “taking away cataract, using a golden needle”. Even a symbolic operation of cataract with a probe was part of initiation ritual for monks, is described in a work which was translated into Chinese sometime in 4/ 5th centuries CE.

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“Tathagata” surpasses mundane physicians in ophthalmology because he understood how to cut off the cataract (timira) of ignorance with the iron of wisdom.¹²

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“Also, the Buddha, the king of physicians or Vaidya-Rāja clears away the membrane or Paṭala, of ignorance with a golden needle.”¹³

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These and the other similar ideas expressed in Buddhist canonical literature, which became abundant in China by 4/ 5ᵗʰ centuries CE, turned out to be an eye-opener to the Chinese, both figuratively and literally. Influence of Indian medicine is most apparent in the case of ophthalmology. The very first mention of ophthalmic surgery in Chinese medical works is found in Sun Simiao’s work. He refers to cutting a white growth in the eye in the case of disease “pterygium” in his work “Prescriptions Worth a Thousand Pieces of Gold”.¹⁴

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There are several references in Chinese historical documents which refer to Indians performing successful eye surgeries. Even popular literature was no exception. Famous Chinese poet Bo Juyi (772-846 CE) in one of his poems, refers to a classic of Nagarjuna – the Doctor and a medicine called “Drug of Bright Eyesight”¹⁵. Yet another poet Liu Yuxi (772-842 CE) wrote in his poem, entitled “The Brahmin Priest Physician Who Bestowed Eyes”, how an Indian monk, who also happened to be a physician, removed cataract opacity from his eyes and enabled him to see clearly once again. These poems suggest that Nagarjuna was considered as an authority on eye diseases at that time. His book was well-known and specially the method of golden needle for the removal of cataract was famous as an effective surgical treatment introduced by the Indians.

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Since ophthalmology and surgery were not developed in China at that time, these ideas aroused the curiosity of Chinese Buddhists who were the elites of that society interested in various scholarly pursuits including medicine.

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Surgery in Chinese Medicine

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Ancient Indian medicine freely prescribed both medical and surgical treatments. The situation was different in the case of ancient Chinese medicine where surgery, together with anatomy, was still the most primitive branch of medicine. The reason is two-fold. One being the Confucian doctrine which regarded human body as a sacred gift from one’s parents, not to be mutilated in any way, came in the way of any development in the field of anatomical knowledge and surgery. The second was the prevalent medical philosophy which was based on the idea that imbalance of Yin and Yang gives rise to an illness. As a result, to counter this imbalance, pharmaceutical drugs were prescribed and usual treatment for any malady was administration of drugs. Before the introduction of Indian surgical ideas Chinese medicine had not developed surgery to any noticeable extent. This is perhaps the reason why Indian ophthalmic surgery sent waves in the then Chinese medical circle and it was willingly absorbed in their traditional system.

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Indian Ophthalmology and its Special Features

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Sushruta in his work, *Suśṛtasamhitā*, introduced various topics related to the eye, its morphology, and relation of its parts ie the muscles, blood, white and black parts and empty channels, to five principal elements viz *bhu, agni, jala, vayu* and *akasa* meaning earth, fire, water, wind and aether, respectively.¹⁶ Then came the eye diseases and their etiologies. Susruta classified the eye diseases in a number of different ways eg they were based on 1. morphology of the eye, 2. curability of eye diseases, 3. etiology of eye diseases and lastly 4. the treatment. This was a novel approach for that period. Classification of diseases in other ancient cultures used to be chiefly based on the symptoms only. Susruta discussed altogether 76 eye diseases which included diseases of junctional areas, eye-lids, conjunctiva, then those of cornea and also those of the inner parts of the eye like various kinds of cataracts, glaucoma and night blindness.

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Treatment suggested by Susruta is of three types: 1. general 2. local and 3. surgical. General treatment includes purification of the body. The local treatment includes spray, fomentation, application of fine powders in the eye and chemotherapy. Surgical methods include scraping, cutting, needling, puncturing or trephining.

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Ancient Indian medical men tried to diagnose the eye diseases on the basis of the lesion location, symptoms and pathogenesis. Functioning of the inner parts of the eye eg the optic nerve or the relation of the flow of aqueous humour to intra ocular pressure, all this was unknown at that time. Yet they recognised diseases like optic atrophy and glaucoma to be different from cataract. They could recognise this from their experience. Incurability of optic atrophy and also that of the final stages of glaucoma was known to them. Temporary relief of elevated ocular pressure was achieved by bloodletting, sometimes using leeches.

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Ideas like classification based on anatomy of the eye involving basic principles of surgical interventions, eg removal of cataract opacities, polypus-like growths, cautery to stop the unwanted growth, epilation and tearing of the eyelid in the case of entropion and bloodletting to relieve the intra-ocular pressure in the case of glaucoma, as well as pharmaceutical prescriptions which are miotic/ mydriatic or germicidal in their application, agree basically with the modern understanding of the diseases and their treatment.

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Nagarjuna in Chinese Ophthalmological Works

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From the 6^th century CE onwards there appeared several Chinese texts which mentioned Indian medicine, and especially Nagarjuna's ophthalmology. Also three prominent works on ophthalmology which appeared in China over a period of some four-five centuries were related to Indian medicine. Firstly, during Tang Dynasty there appeared *Indian Classic of Ophthalmology* compiled in 752 CE. A little later, there was another text by Bodhisattva Nagarjuna entitled 'Treatise on Ophthalmology' which must have been written around the mid-8th century CE.¹⁷ This is the one which was mentioned in the poems mentioned earlier. Then yet another work appeared early in 12th century CE by the name 'Nagarjuna's complete treatise'¹⁸.

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There were many new trends in Chinese ophthalmology as a result of the Indian influence. The classification of eye diseases was now based on anatomy, and treatments suggested were combination of Indian surgical methods and traditional Chinese methods of internal medicine. Ophthalmic surgery in all its aspects was introduced into Chinese medicine at this time. Inclusion of certain drugs in the prescriptions eg “Amalika” which was called A mo qin 阿黎勒 “Haritaki” or 訶黎勒He li qin in “Triphalā” translated as 三果, “Chakshus” or Jue ming zi决 明子and “Jaṭāmańsi” or Ma xi and黄連 Huang lian in Chinese, further suggest a useful integration of the two medical systems.¹⁹

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Entry of Indian knowledge provided foundation for the establishment of ophthalmology as a separate discipline in Chinese medicine and remained a dominant element in its development for over a millennium, in its various aspects such as medical philosophy, etiology, nosology, diagnosis, treatment, medical writings and education. As to ophthalmic surgery the Indian imports remained the sole dominant factor till perhaps the entry of western surgery.

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Other Medical Disciplines - Gynecology

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With ideas and techniques, technical terms traversed too eg Nao sha for *Navasāra* ie Ammonium chloride and Totamu for *Tutthanāga* ie zinc (frequently used in alchemy and metallurgy) and Zuo dao yao for *Bastinetra* which was employed in gynecology. Medical personalities like Jīvaka or Qi po 耆婆, Kaśyapa or Ka ye fo 迦葉佛 and ‘Rāvaṇa’ or Lu fu na 囉哺拏 are mentioned in the context of gynecology, obstetrics and pediatrics respectively.²⁰ Both Jīvaka's and Kaśyapa's names are closely related to ancient Indian female pathology and pediatrics.²¹ Likewise Rāvaṇa’s name is associated with pediatrics in ancient Indian medicine.

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As monastic medicine flourished, gradually some monasteries became famous for their medical treatment. The Monastery of Benevolent Aid or惠濟寺 Huijisi is located at the Xiaoshan county in Zhejiang province of China. It is locally called 竹林寺 Zhulinsi or the Bamboo Grove Monastery. It has been famous for its practice of medicine till the 19th century. Monks of the Bamboo Grove Monastery were regarded as experts in the treatment of women’s diseases. ²² Yixinfang also quotes a Sanskrit *Dhāraṇī* or Mantra from a canonical work大集陀羅尼經 Da ji tuo lo ni jing (*Mahādhāraṇī* classic). It is to be uttered to ease difficult childbirth.²³

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Pharmaceutics

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The Bibliography of Sui Dynasty (581-618 CE) enlists Indian books on scientific topics like mathematics, pharmaceutics and astronomy. They were attributed to Bodhisattva Nagarjuna and Brahmin sages. As the use of Indian drugs increased, they found entry in Chinese pharmacopoeia eg 本草拾遺 Bencao shiyi (a supplement for the pharmaceutical natural histories) of 725 CE by Chen Zangchi. He added 368 new entries including阿勒勃 A-le-bo or *Āragvadha* (Cassia Fistula L). He also wrote about波羅門皂莢 Bolomen zaojia (Brahmin Soap Bean Tree, Glenditsia Sinensis). 段成式 Duan Chengshi has also described it in his work 酉陽雜俎 Yu yang za zu (Miscellany of Yuyang Mountains) of 860 CE. Again, Buddhist cave engravings viz Longmen caves and others included pharmaceutical formulae.

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The Silk Road not only carried Chinese porcelain, gun powder and paper but also the art of accupuncture and pulse examination to the West. Similar was the case when Indian spices, precious stones traversed to foreign lands, Buddhist philosophy and the pragmatic knowledge went along. Just as medicine came in handy to the Christian missionaries, it became bait for the sympathetic reception of Buddhist faith in China. Silk Route, which linked China to India, Arabia and further west, was thus a bridge between the eastern and Western civilisations where along with exchange of goods it promoted scientific exchanges and mutual cooperation in their development.

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Vijaya J. Deshpande & Kamal Sheel

Personalities

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Ge Hong

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Ge Hong (282-364 or 343? CE) was a Taoist and medical scientist in the Eastern Jin Dynasty (317-420), styled as Zhi Chuan, also known by his literary name Bao Puzi. He was born in Jurong, Danyang (present-day Jurong County, Zhenjiang City, Jiangsu province) and was widely referred to as “Taoist Immortal Ge”.

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Ge Hong was an expert in alchemy and medical science. He was also a master in Taoism and Confucianism and wrote a number of books in his life, including *The Master of Preserving Simplicity*, *The Tales of Immortals*, *Handbook of Prescriptions for Emergencies* and *Yuhan Prescriptions*. It is said that the famous Chinese literary sketches, *A Miscellany of the Western Capital*, is also one of his works. There are a total of 13 books by him collected in the *Orthodox Collected Taoist Scriptures* and *Supplement of Taoist Scriptures in the Period of Wanli*. In his later years, he lived in seclusion in the Luofu Mountain, Guangdong province, to study alchemy, and his study made a far-reaching influence on medical

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Ge Hong

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science to later generations. According to *Study on Five Internal Organs* by Zhang Zhongjing, Dunhuang manuscript collected by the French National Library, the alchemy of Huainan Gehong was very effective and mysterious and had remained a secret recipe for later generations and the prescriptions of *Ji Yan* were widely used by people. It shows that Geng Hong’s alchemy or way of becoming immortal is highly valued by later generations. After his death, his *Handbook of Prescriptions for Emergencies* was further supplemented by Tao Hongjing, a famous medical scientist in the Liang Dynasty of the Northern and Southern Dynasty, and the new book, totalling 101 chapters, was renamed as the *Supplement of Handbook of Prescriptions for Emergencies for One Hundred and One Diseases* by Huayang Hermit. The “One Hundred and One Diseases” in the title is based on a theory in Buddhist texts that, a man’s body is made up of four major elements namely “earth”, “water”, “fire” and “wind”, and the discordance and imbalance of one of them will cause one hundred and one kinds of diseases. It demonstrates that traditional Chinese medicine scientists in the Northern and Southern Dynasty had acquired preliminary understanding of the Indian medical theory of Buddhism and took it down in their own writings.

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(Chen Ming)

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Tao Hongjing

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Tao Hongjing (456-536 CE) was a very famous Taoism thinker, medical scientist, spagirist and litterateur in the Southern Dynasties (including four dynasties of Song, Qi, Liang and Chen). He was born in Moling, Danyang (present-day Nanjing, Jiangsu Province) and styled Tong Ming, also well-known by his literary name Huayang Hermit. His posthumous title was 'Zhen Bai'. Many of his books widely cited the terms of Indian Buddhist medicine.

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Tao Hongjing lived in three dynasties of Song, Qi and Liang and was an expert in both Buddhism and Taoism, thus being widely recognised as the “Prime Minister in the Mountain”. Most of his life stories are recorded in *Book of Liang*, Volume 51, *History of Southern Dynasties*, Volume 76, *Recording of Huayang Hermit* and *Biography of Huayang Hermit Tao*, etc. He was very fond of reading *The Tales of Immortals* by Ge Hong in his childhood and then in his adulthood, he became an official but later he unexpectedly chose to live in seclusion in the prime of his life by retreating to Maoshan to explore Taoism for years during which he created the Maoshan Fraction, and eventually grew into a leading authority in the development of Shangqing Taoism. Tao was also very interested in Buddhism and maintained a very close personal relationship with Emperor Wu of Liang Dynasty, a firm believer in Buddhism. As a very excellent thinker proficient in medical science, Tao Hongjing made the 86-chapter *Handbook of Prescriptions for Emergencies* by Ge Hong (living in the Eastern Jin Dynasty) into a great medical book totalling 101 chapters which he renamed as *Supplement of Handbook of Prescriptions for Emergencies for One Hundred and One Diseases*. And in the foreword, he quoted one saying from Buddhist texts that a man’s body is made up of four greatest elements, “earth”, “water”, “fire” and “wind” and the disharmony and imbalance of one of them will cause 101 kinds of diseases. It is based on the theory of 404 kinds of diseases in *Sutra of Medicine*. We can recognise how deeply Tao was influenced by the Buddhist theories of medicine by the book’s name in which he added *One Hundred and One*.

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Tao Hongjing

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Meanwhile, Tao Hongjing, on the basis of reviewing and revising *Chinese Ephedra from Shen Nong’s Chinese Materia Medica*, added some new knowledge on medicine found at his time into his book *Collective Notes to the Canon of Materia medica*, another classic for the development of the Chinese traditional medicine and herbalism. The book is available in the three volume or seven volume version, collecting 730 kinds of drugs which are first categorised in accordance with the property of a medicine and include such seven categories as “Jade and Stone”, “Herb”, “Insect and Beast”, “Fruit”, “Vegetable”, “Food” and “Disused”. Now, there are two editions of *Collective Notes to the Canon of Materia Medica* available in the world, one is collected in the library of Ryukoku University in Japan, a manuscript of Buddhist texts from Dunhuang Caves Temple discovered by Otani Expedition during their third exploration. The front of the original volume (the serial number is Dragon 530) is *Collective Notes to the Canon of Materia medica* and *Mahaprajnaparamita Upadesha* while the back is *Dharmagupta-vinaya Buddhist Monk Pratimoksa*. This is the foreword of Volume I of the book and its contents were basically completely preserved. The other edition is collected in the National Library of Germany, the fragmented pieces of *Collective Notes to the Canon of Materia Medica* unearthed in Turpan, codenamed as ch. 1036v. This is the Volume III of the book, transcribed at the beginning of the Tang Dynasty (the start of seventh century). The other books written by Tao Hongjing include *Essentials of Nature Cultivation and Longevity*, *Zhen Gao* and *Supplementary Records of Famous Physicians* and so on. About more studies on Tao Hongjing, please refer to *Collected Essays on Tao Hongjing* (Qilu Publishing House, 2003).

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(*Chen Ming*)

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Sun Simiao

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Sun Simiao (?-682 CE) is the greatest physician of the traditional Chinese medicine. He was born in Jingzhao Huayuan (present-day Yao County, Shaanxi Province) and lived for more than 100 years, whose life story and achievements can be found in *Old Book of Tang*. He is widely known as one of the Three Medical Sages in China along with Zhang Zhongjing and Li Shizhen, one of the “Three Greatest Taoist Medical Scientists” with Ge Hong and Tao Hongjing as well as the King of Medicine with temples built all over the country for people to worship his contributions. His works absorbed a large scale of the essentials of ancient Indian medical and Buddhist knowledge, a vivid embodiment of influence of Indian medical science on traditional Chinese medicine.

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Sun Simiao showed his intelligence when he was a little child and he was able to recite 1,000 words a day. As a quite knowledgeable person, he was very fond of discussing Taoism and dissecting various Schools of Thought and was an absolute expert in medical science and as a gentleman of noble nature and unsullied character, he never sought fame and wealth but lived in seclusion, practised medicine and tried his best to help the poor. He wrote a large number of books in his life among which *Essential Recipes for Emergency Use* (finished in 652 CE with 5,300 prescriptions in total) and *Supplement to* *Invaluable Prescriptions for Ready Reference* (finished in 682 CE, collecting 2,571 prescriptions), each totalling 30 volumes, are the most important classic literature in the history of Chinese traditional medicine. The two books systematically summarised the medical achievements before the Tang Dynasty and the author’s practical experience, and can be rated as the earliest encyclopaedia on clinical medicine.

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Sun Simiao’s works have been dramatically influenced by foreign culture with great absorption of Buddhism and Indian medical knowledge. Among them, *Essential Recipes for Emergency Use-Volume One* adopted the theory of the “404 Diseases” from Buddhist texts, but changes the idea of the “disorder of ‘earth’, ‘water’, ‘fire’ and ‘wind’, the cause of diseases” into the “irregularity of Qi, the cause of diseases”. Sun Simiao also copied the theory of *General Treatise on the Cause and Symptoms of Diseases* (by Chao Yuanfang) in his book. In *Essential Recipes for Emergency Use-Volume 27*, he said, “Various diseases can deteriorate the functions of the five internal organs; each of the organs corresponds to 81 kinds of illnesses; coldness, heat, wind and Qi altogether can lead to 404 kinds of illnesses in total”.

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His saying applies the five-internal-organ theory of traditional Chinese medicine to the theory of 404

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Sun Simiao

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diseases in Indian Buddhism medicine, and changes the “earth, fire, water and wind” into “coldness, heat, wind and Qi”, which demonstrated that Sun Simiao’s medical ideas have both absorbed and revised something of the Indian medical science. In *Essential Recipes for Emergency Use*, there are also Jivaka Pill for Various Diseases and Indian massages etc and the latter can also be found in *Taiqing Daolin Health Conservation Theory* and this is the first time that this essential Yoga practice method in India was translated into the classic of traditional Chinese medicine.

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*Supplement to Invaluable Prescriptions for Ready Reference* is based on the theory that almost every material on earth is the panacea to a specific kind of disease. Volume 21 of the book lists some of

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Picture of Sun Simiao feeling the pulse

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the foreign prescriptions such as Agada Pill and Jivaka’s Recipe for Malignant Diseases. The Rhizoma Atractylodis Pill includes various aromatic drugs like fructus chebulae, *pistacia lentiscus*, radix curcumae, styrax and *aconitum napellus* etc all from India and Persia. Agada Pill makes good use of such five herbs as pterocarpus indicus, barberry, madder root, radix curcumae and pepper similar to the *Mahà-gandha-hasti-agada* in *Caraka-saühità*, another classic of Indian Ayurveda. There are also “Jivaka Decoction”, “Beisang Decoction” (from Persia and Ta Chin, the latter referred to as Eastern Rome in ancient China), “Drug Infusing Method in Wine” in *Jivaka’s Prescription-Study on the Diagnosis and Treatment of Diseases Caused by Wind*, “Jivaka’s Prescription for Various Diseases of Internal Organs and Replenishing Life Extension Recipe” and *Bans for Family Harmony*, and so on, all pertained to foreign medical science. The Acorus Calamus Prescription in *Supplement to Invaluable Prescriptions for Ready Reference* is typically a foreign prescription which was brought to China by the envoy sent by Tripitaka Dharma Master Bamo Midi from the kingdom of Magadha in ancient India and Tujue in the eighth year of Daye Period (612 CE) and then translated by Master Zhuju in Pureland Monastery on July, 23, the sixth year of Wude (623 CE) Sun Simiao learnt a large amount of foreign medical knowledge by the eminent monks of Middle Earth, which were collected in his own works and even appropriately revised in accordance with the theory of traditional Chinese medicine. His works further strengthened and enlarged the influence of Indian medical knowledge and Buddhism thought on traditional Chinese medicine.

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Wang Tao

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Wang Tao (670-775 CE or 690-756 CE), born in Mei County, Shaanxi Province (present-day Mei County, Shaanxi Province), is a renowned medical scientist of the prosperous period of Tang dynasty. He is the author of Arcane Essentials from the Imperial Library, a well-known medical book which recorded lots of medical knowledge of India and was widely

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*Wang Tao*

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acclaimed as the most essential collection of historical materials on the history of the India-China Medical Communication.

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Wang Tao’s life story and experience is attached after Biography of Wang Gui in the New Book of Tang. Wang Gui (571-639) is the great-grandfather of Wang Tao, once assumed several important posts such as Privy Counsellor and Director of the Board of Rites after engaging in politics. The epitaphs of Wao Tao’s grandson, Wang Shizheng and great-grandson, Wang Tan have both been unearthed, which offer a short introduction to his official positions. Wang Tao was in poor health when he was a little child but he was very kind and obedient and treated his parents very well, and in order to treat his mother’s disease, he pushed himself very hard to explore medical science and even travelled with some famous doctors at his time across the whole country, in the process of which, he almost acquired all of the skills and knowledge of that doctor. Though the medical achievements he made are not as influential and far-reaching as those of some medical giants such as Sun Simiao, his skill and experience is undoubtedly profound and deep.

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He was once appointed as supervising secretary, managing numerous volumes of literature and books in Hong Wen Library for more than 20 years and during this process, he read a wide range of books and managed to acquire their essentials and main

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*Tang Dynasty physician-scholar Wang Tao’s ‘Wai Tai Miyao Fang Shu’*

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ideas. However, he was demoted due to the marital upheaval, and then dismissed to Fangling (present-day Fang County, Hubei Province) and later he took the office of prefecture chief of Daning (Xi County, Shanxi Province). Wang Tao travelled a lot of places around the country and made good use of his medical knowledge and some classical prescriptions to save ordinary people’s lives. He devoted himself into medical science and eventually through years of painstaking efforts, completed the compilation of *Arcane Essentials from the Imperial Library* in the 11^th year of Tianbao period (752 CE), an immortal book focussing on the discussion and exploration of medical science and an invaluable asset through generations. His works also include *Summary of Arcane Essentials from the Imperial Library* (10 volumes in total), *On Recipe for Lacteal Calculus in Essentials of Arcane Essentials from the Imperial Library* (two volumes), *Bright Hall Moxibustion Therapy* (or *Bright Hall Acupuncture and Moxibustion Chart*), *Prescription for Typhoid fever in Arcane Essentials from the Imperial Library Volume One and Two* or *Medical Secrets from the Royal Library* and so on. *Arcane Essentials from the Imperial Library*, which is 40 volumes in total, collecting a total of 10 classic books from the Han to Tang Dynasty, absorbed the advantages and essence of each book, and it is no wonder that medical scientists in later generations all believed that a person cannot be a good doctor if he’s never studied the prescriptions in *Arcane Essentials from the Imperial Library* and explored the discourse on prescription in *Essential Recipes For Emergent Use*. *Arcane Essentials from the Imperial Library* extracted a great amount of foreign medical knowledge and was therefore one of the most valuable resources to study the medical communication from six dynasties of Sui and Tang Dynasty.

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(*Chen Ming*)

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LI Shizhen

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Li Shizhen (1518-1893 CE) was an expert of traditional Chinese medicine in the Ming Dynasty, and wrote *Compendium of Materia Medica* which was the great work of Chinese pharmaceutical science. He absorbed the achievements of pharmaceutical science development in past dynasties, recorded knowledge of multiple foreign medicines and wrote *Compendium of Materia Medica* which became an important historical book to study ancient Sino-foreign (especially India-China) medical exchanges.

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Li Shizhen, whose courtesy name was Dongbi, was also known as Binhu. He came from Qizhou, Hubei (Qichun, Hubei). He was born in a well-known family of traditional Chinese medicine. Being edified by what he saw, he visited famous doctors and accumulated many medicine books while especially being fond of conducting site investigations on herbal medicines, and finally compiled *Compendium*

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*Li Shizhen*

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*of Materia Medica* in 1578 after nearly 30 years of great effort. This was considered to be the ultimate work in the history of ancient traditional Chinese medicine. It had 52 volumes, divided into 16 parts and 56 categories and collected 1,892 medicines including 374 new medicines. The book collected widely from medical books and Buddhist explanation classics and added annotations of transliteration forms for Sanskrit medicine names from India and Central Asia. In terms of collected Indian medicines, the main original versions of *Compendium of Materia Medica* were *Supplement to Materia Medica* of Chen Cangqi in the Tang Dynasty and *Classified Materia Medica* was finished by Tang Shenwei in 1082, who was the folk doctor in the Northern Song Dynasty. Particularly the latter had many revised versions. It had 30 volumes, collected 1,746 medicines and was claimed as a great achievement integrating herbalism of previous generations and the Tang and Song Dynasty. *Compendium of Materia Medica* recorded multiple medicines related to India such as black pepper, nutmeg, asafetida, rhizoma picrorrhiza, aragbadha, emblic leafflower fruit, terminalia belerica, haritaki, long pepper, dutchmanspipe root and benzoin etc as well as rhizoma curculiginis offered by Brahmin monks to Emperor Xuanzong of Tang in the first year of Kaiyuan of the Tang Dynasty (713). It was named Asvagandha in Sanskrit and could dispel wind-evil, warm waist and feet, nourish

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*Compendium of Medical Herbs* compiled by Li Shizhen

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five viscera, strengthen muscles and bones and help in digestion. It could reduce weight and was good for facial appearance after having been taken for a long time. So it was called as salsify. Common people obtained it after the spread from the palace and Tantric Master Amoghavajra presented it to court officials and further extended the scope of its use in China. Li Shizhen absorbed the achievements of previous literature as well as corrected previous errors, supplemented new recognition and methods of medicines, and made some Indian medicines (such as haritaki and chavica roxburghii) which became common drugs of traditional Chinese medicine and gradually lost the characteristics of foreign culture and completed the process of thorough localisation.

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(*Chen Ming*)

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George Hatem

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George Hatem (1910-1988 CE) was a modern Chinese expert on venereal diseases and leprosy. He was an Arab American and his family origin was Lebanon. He was born in Buffalo, New York in the United States of America on September 26, 1910. He died on October 3, 1988 in Beijing. He was a famous international communist fighter and won the Gandhi International Leprosy Award granted by India because of his outstanding medical achievements.

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George Hatem began to learn medicine in 1927 in America, received a medical doctor degree from University of Geneva Switzerland in 1933 and came to Shanghai to investigate the conditions of tropical disease in the same year. In the spring of 1936, with the help of Song Qingling, George Hatem and Edgar Snow arrived in North Shaanxi and engaged in disease prevention, treatment and scientific research for decades in China since then. During the period working in hospitals of Yan’an, George Hatem received Indian doctors including M. Atal, D. S. Kotnis and B. K. Basu who came to support the Anti-Japanese War, and they exchanged ideas mutually and worked together. After the founding of the People’s Republic of China, George Hatem became the first foreigner who was approved to join Chinese nationality. As one of the pioneers of the health service of New China, he helped establish Central Institute of Dermatology and Venereology, committed himself to prevention and research of venereal diseases and leprosy and found effective methods to treat syphilis which was suitable for China’s conditions. He set up comprehensive

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*Tang Youzhi teaching ophthalmology students*

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Beijing Guang’anmen Hospital and China Academy of Chinese Medical Sciences and engaged in clinical, research and teaching related to ophthalmology.

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The gold needle couching originated from ancient India, and was recorded in *Medical Secrets from the Royal Library* written by Wang Tao in the Tang Dynasty but it had been lost in China and India for a long time. Since 1960, Tang Youzhi restored to use the gold needle couching successfully and solved the problem of the early complication such as glaucoma after operative incision on pars plana and couching clinically. In 1966, the couching was recognised by Ministry of Health and was promoted as the first scientific research achievement of traditional Chinese medicine which was verified by Chinese and western medical experts scientifically. Tang Youzhi conducted the golden needle couching for important domestic and foreign political members such as Mao Zedong, Prince Penm Nouth of Cambodia, Kim II Sung of North Korea, Wahid of Indonesia etc and made them recover their eyesight.

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In 1981, Tang Youzhi, the then deputy director of China Academy of Chinese Medical Sciences, led the delegation of traditional Chinese medicine visited India. They visited six Indian cities and widely discussed traditional medical theories

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*George Hatem*

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research bases to prevent leprosy in Hai’an County of Jiangsu province and Chao’an County of Guangdong province and made great contributions to eliminate venereal disease and leprosy in China. George Hatem developed cooperation and exchange in Chinese and foreign medical circles actively and as the advisor of China Ministry of Health, he led a delegation of 10 people to participate in the 12ᵗʰ International Conference on Leprosy in India. In 1985, he held the first International Exchange Conference on Leprosy in China. In his later years, he visited different areas with poor health and made his due contribution to prevention of leprosy on an international level. George Hatem’s medical achievements were recognised by the world and he was granted with the American Damien-Dutton Leprosy Award in 1982. He received the Gandhi International Leprosy Award granted by India in 1988 which was of great importance in the modern India-China medical exchange history.

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(*Chen Ming*)

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*Tang Youzhi performing operations*

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Tang Youzhi

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Tang Youzhi (1926) is an ophthalmology expert of traditional Chinese medicine. His style name was Kunwu, he came from Hangzhou City, Zhejiang Province and his main achievements are restoration and innovation of ancient Chinese “gold needle couching” originated from India.

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He began to learn ophthalmology from his teachers since 1942. He studied in medical department of Beijing Medical College from 1952 to 1957. After graduation, he successively worked at and technologies of both countries with peers in India’s medical circle. At Varanasi, the delegation got together with several hundred of experts of Traditional Indian Medicine Institute and watched the documentary film of Chinese doctors including Tang Youzhi doing “the gold needle couching”. Indian experts felt surprised and pleased to see the revival of this unique ancient skill. This was a much told story in the modern India-China medical exchange history.

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Nagarjuna - the Physician

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Nagarjuna is a name common to several famous scholars in ancient and medieval India linked with correlated areas like Buddhist philosophy, tantrism, medicine as well as alchemy, all of whom lived in the period ranging from 2nd to 9th centuries CE. He connected with the revision of *Suṣṛtasamhītā*, an ancient Indian work on medicine, especially surgery. He is traditionally considered to be the author of its last chapter that includes ophthalmology.

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In Chinese history, Nagarjuna’s name (recorded in Chinese as Long Shu龍樹, Long Shan龍勝or Long iMeng龍猛, literally, Dragon tree, Dragon conqueror and Dragon the brave or transliterated as 那伽闕刺樹那) appears in two contexts. The first as a “Second Buddha” – the founder of Madhyamak philosophy of Mahayana Buddhism who contributed 24 philosophical works to the Chinese Tripitaka. The second as a great doctor with specialisation as an ophthalmologist producing several works on medicine on topics ranging from pharmaceutics, compounding of perfumes and incense, nourishing the vital essence and ophthalmology.

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The bibliography of the “History of the Sui Dynasty” (581-618 CE) mentions 12 titles on medicine authored by Indians out of which three are attributed to Nagarjuna viz Pharmaceutics of Bodhisattva Nagarjuna (Longshu pusa yaofang龍樹菩薩藥方), Bodhisattva Nagarjuna’s Methods for Compounding Perfumes and Incense (Longshu pusa hexiang fa 龍樹菩薩和香法) and Bodhisattva Nagarjuna’s method for nourishing the vital essence (Longshu pusa yangxing fang 龍樹菩薩養性方). Unfortunately, none are available now.

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Further, in the 9th century CE, Nagarjuna’s name appears in a poem entitled Mu-bing目病 (eye disease) of Bo Juyi白居易 (772 - 846 CE), the famous poet of the Tang dynasty (CE 618-907). It was about ophthalmology. Bo Juyi had a serious eye-disease in his old age. He subsequently refers to his problem in many poems referring to “Nagarjuna’s classics” and “a drug for clear eyesight”.

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