According to Chinese medicine, diseases are caused by seven internal and six external elements. The internal elements are extreme levels of happiness, anger, anxiety, a ruminating mind, sadness, fear, and shock. The external elements are coldness, summer-heat, dryness, heat, dampness, and wind. The seven internal elements, also referred to as emotions, are believed to cause illness because they directly impair the healthy functioning of the five main organs of human beings. Extreme levels of either happiness or fear damage the heart, anger harms the liver, anxiety harms the lungs, a ruminating mind affects the spleen, and shock hurts the kidneys. According to Chinese medicine, a healthy and balanced emotional life is essential in maintaining oneÂ’s physical health.
Various Buddhist sutras describe the causes of disease in a similar manner. For example, The Sutra of Buddha’s Diagnosismentions that there are ten causes and conditions of sickness. These reasons are: 1) sitting for too long a period without moving, 2) eating too much, 3) sadness, 4) fatigue, 5) excessive sexual desire, 6) anger, 7) postponing excrement, 8) postponing urination, 9) holding the breath, and 10) suppressing gas. Approaching the causes of disease from a slightly different angle, The Discourse of Great Equanimity and Insightful Meditation points out six origins for disease. They are described as: 1) an imbalance of the four elements (earth, water, fire, and wind), 2) irregular dietary habits, 3) incorrect meditation methods, 4) disturbances by spirits, 5) demon possession, and 6) the force of bad karma. Illness that originates from most of these origins can be cured if people improve their diet, become more aware of their bodies’ natural processes, and get plenty of rest. However, the last three causes 4) – 6) are related to karma, and one must work on improving his/her character and purifying his/her mind in order to be cured. A person afflicted for the last three reasons needs to spend time in spiritual practice, repentance, and doing good deeds. Only then will his/her illness begin to go away. The Mahaprajnaparamita Sastra states that illness is caused either by internal or external causes and conditions. Still, Visuddhimagga mentions additional causes of disease, but they are too numerous to list here. All of the theories on the various causes of illness can be grouped into two main categories: A) the imbalance of the four elements and B) the presence of three poisons of greed, anger, and ignorance. The following is a detailed discussion of these two classifications.
A. The Imbalance of the Four Elements
According to Buddhism, the body is composed of four impermanent elements – earth, water, fire, and wind. Only consciousness is reborn in one of the six realms. This theory is the foundation of Indian Buddhist medical science. Chinese medicine believes the body to be comprised of a unique system of subsidiary channels that transmits vital energy (chi), blood, nutrients, and other substances through the five organs and six internal regions in one’s body. When this intricate circulation system is flowing properly, the four elements stay in balance, the major organs can perform their essential functions, and the body remains healthy.
The Discourse of Condensed Equanimity and Insightful Meditation states that each of the four elements is able to cause one hundred and one diseases, with a total of four hundred and four diseases possible. Each element is connected to certain types of diseases. For instance, the earth element is related to diseases that make the body become heavy, stiff, and painful, such as arthritis; the water element afflicts the body with diarrhea, stomach aches, and difficult digestion; the fire element causes fever, constipation, and problems urinating; lastly, the wind element is related to breathing difficulties and vomiting.
The third volume of Nanhai Ji Gui Neifa Zhuan states that, “If diseases are related to the four elements, they are usually caused by overeating or overexertion.” An imbalance of the four elements and the resulting illness can also occur due to a diet that is not in tune with the four seasons. When the seasons change and the temperature varies from cool to cold to warm to hot, it is important to adjust our diet in a manner that enables the body to function at its best. In The Suvarnaprabhasottama Sutra, a young man asked his father who was a doctor, “How do we cure the suffering of human beings and cure diseases that arise from the imbalance of the four elements?” The doctor responded to his son by saying, “We live our lives through four seasons of three months, or six seasons of two months in some parts of the world. Whether four or six, we must live according to the seasons, eating food that corresponds with hot and cold, warm and cool. In this way, our bodies will benefit. A good doctor is well learned in prescribing the right food and medicine to adjust the four elements and nourish a patient’s body during a particular season. When the season and the food are in balance, so too will the body be in balance.”
Eating a reasonable amount and adjusting what we eat according to seasonal changes are two important factors in maintaining balance among the four elements and allowing chi to circulate unimpeded through our bodies. We automatically dress differently when the seasons change in order to comfort and protect ourselves during a particular temperature change or weather conditions. If we adopt this practice and adjust our diet with the weather and seasons, we help our bodies to stay balanced and guard against disease.
B. Greed, Anger, and Ignorance
Greed, anger, and ignorance, sometimes referred to as “the three poisons,” are also reasons why people are afflicted with sickness. When one is stuck in any one of these destructive mental states, one opens the door and invites disease. TheVimalakirti Sutra states, “All the diseases I have right now are derived from illusory thoughts I have had in the past … because human beings are attached to a “self”, affliction and diseases have the chance to be born their bodies.” When one allows oneself to be ruled by the three poisons, the psychological and physical health hazards are numerous and can be quite debilitating. The following descriptions provide insight into how greed, anger, and ignorance cause illness:
1. Greed
Greed is defined as an improper and excessive desire for something. For example, one is more likely to overeat when one is having a favorite meal. Such greed can then lead to an overly full stomach and the food will not be well digested. Or, one may like food so much that he/she eats much too frequently. This type of desire which cannot be satisfied can cause obesity, fatigue, and heart problems. Greed is never without consequences.
People can also have excessive desires for sensory experience. In The Discourse of Interpretation Great Equanimity and Insightful Meditation, it is stated that too much attachment to what we perceive through sound, smell, sight, taste, and touch can cause both psychological and physical illness. A person may cling to the experience of these five sensations, which can cause an imbalance in our rational thoughts and disturb our ability to make moral choices. Physical health problems can also arise. In the Buddhist health theory, those who are too attached to physical appearance will suffer from diseases of the liver. Those who are too attached to sounds will suffer from kidney diseases. Those who are too attached to aromas will suffer from lung diseases. Those who are too attached to taste will suffer from heart diseases; and those who are too attached to the sensation of touch will suffer from spleen diseases. Thus, when we encounter the multitude of sensations that are a natural part of daily life, it is best to maintain a balanced attitude and practice the Middle Path. In order to maintain optimum physical and mental health, the Middle Path is also the best way to approach sleeping, eating, and exercising. When one sleeps too much, one will not have a clear mind. When one eats too much food that is high in cholesterol and sugar, one is gradually increasing the risk of poor health and could ultimately face chronic disease, such as diabetes or heart disease. In todayÂ’s fast-paced society that promotes working excessively and watching hours of television, people do not exercise enough, and eventually, this has an adverse affect on their bodies. Additionally, nowadays people are constantly exposed to a noisy and stressful environment, which can cause people to become sick more easily. If one decreases oneÂ’s greed and desire and approaches life with the attitude of the Middle Path, one can lead a healthier life.
2. Anger
The fourteenth volume of The Mahaprajnaparamita Sastra states that, “Anger is the most toxic emotion compared to the other two poisons; its harm far exceeds all of the other afflictions as well. Of the ninety-eight torments, anger is the hardest one to subdue; among all psychological problems, anger is the most difficult to cure.” Although anger is a psychological problem, it can also lead to severe physical consequences. For example, when aversion and anger arise in a person, the blood vessels become constricted, causing a rise in blood pressure and thus increasing the risk of heart attack.
In writing about anger, Venerable Punengsong from the Qing Dynasty tells us,
A good doctor always finds out
The cause of a sickness first.
Anger is quite harmful
To someone who is sick.
The relationship between a patientÂ’s pulse
And his illness is delicate.
With the correct prescription,
We can heal ourselves of our illness.
