Buddhism and the Pastoral Aspects of the Treatment of Infectious Disease

The manuscript for the 21th International Conference "The Pastoral Aspects of the Treatment of Infectious Disease" on 23-24-25 November 2006 at Vatican City New Synod Hall.

First, I'd like to thank the Pontifical Council for inviting me to join this conference. I would like to talk about Buddhism and the treatment of infectious diseases.

The history of infectious disease is intimately linked to the history of Buddhism because Buddha's mother, Maya, passed away one week after his delivery. The most probable cause of her death would be childbed fever - a bacterial infection that occurs after delivery. From that time until the 19th century the treatment of bacterial diseases made essentially no progress.

In 1847, Ignaz Philipp Semmelweis, an obstetrician from Hungary, discovered that childbed fever could be prevented by washing hands before delivery. Until those days, the production of pus was believed to be a necessary part of the heeling process rather than a problem to be prevented.

In 1865, Louis Pasteur, the great bacteriologist from France, suggested that what we now know as bacterial disease was caused by living organisms.

In 1867, Joseph Lister, a surgeon from England, connected Pasteur's idea with wound sepsis and began to clean wounds and dress them using a solution of phenol. Disinfecting proved that wounds heal up without the production of pus.

In 1874, the hypothesis that bacteria caused infectious disease was proven conclusively by the experiments of Robert Koch from Germany.

The antibiotic penicillin was discovered by Alexander Fleming from Scotland in 1928. Penicillin was actually produced as a drug for human use as a result of subsequent research and resulted in life expectancy going abruptly up. And, maternal deaths, like that of Buddha's mother, are now less than one in 10 thousand in advanced nations.

Buddhism and medicine have always been closely linked. Historically Buddhist priests had to study five subjects; linguistics, logic, engineering, Buddhism and medicine. One reason why Buddhism blossomed in Asia was that Buddhist priests, with their medical knowledge, traveled throughout the region saving people with physical diseases through herbal medicine and from spiritual suffering through Buddha's teaching. The situation regarding infectious diseases and Buddhism today echoes this history. Infectious diseases are treated as scientific matters. And, spiritual problems or medical ethics are addressed by Buddhism. In Japan, medicine and Buddhism have historically functioned side by side. The first national hospital in Japan found its home on the grounds of a Buddhist temple. In the 6th century when Japan's first national temple appeared, it included both a hospital and a pharmacy.

However, before scientific treatments for infectious diseases were found, Buddhism was limited in what it could do to help people with things like smallpox. What people feared most in those days was an epidemic. There wasn't really any effective treatment. So, people tried to escape an epidemic by praying. Hoping to escape a smallpox epidemic, people in Japan prayed to a special God. It took the form of a deity with a bull's head. This Bull-headed God was thought to be the guardian of an ancient Buddhist temple called 'Gion' and was considered to be a Medical Buddha's incarnation.

Since 869, more than 4 thousand 'Gion' shrines were built all over Japan, and 'Gion' summer festivals came to be performed everywhere. The festivals continue to be held everywhere in Japan to this day.

It is unknown why a bull head deity is used for the ritual, but it is said that it might be related to cowpox. Immunization was actually practiced in ancient Asia since the first century B.C. using pus or scab from smallpox victims to immunize people against that disease. The technique eventually arrived in Japan. This was also introduced to Europe in 1721 by Mary Wortley Montagu from England. But it was still dangerous, with a mortality rate around 1%. Jenner heard a legend about cowpox and smallpox from a woman who was milking cows. She said that a person who'd had cowpox could not contract smallpox. Jenner went on to verify this legend through human experiments and saved the world from smallpox. Pasteur made the word 'vaccine' from the Latin word 'vaca' which means bull.

When Jenner's vaccine came to Japan, the advertisement for it had a warrior on a bull destroying the smallpox virus. In the end it seems that the Bull-headed God Buddhists prayed to during the 'Gion' festival answered their prayers and brought an end to smallpox epidemics in the form of Jenner's vaccine.

The recognition of self and non-self has a role in both immunity and Buddhism. Immunity is concerned with the discernment of self and non-self and is indispensable in order to recover from infectious diseases. During fetal development, our immune system learns to distinguish between our own bodies。。and。。foreign bodies, such as viruses, through the thymus. If the immunoreaction becomes weak, the resistance to pathogenic organisms declines which results in illness. By the time we are in our twenties our immune system has already started to die. In old age our immune system's ability to discriminate self from other fades, which is disastrous for our body. However, what is a disaster for the immune system may be salvation for the spirit since our self consciousness and our immune systems are on different planes.

Gilbert Ryle wrote "The Concept of Mind", and showed the logical mistake in Descartes's 'cogito, ergo sum', known in English as 'I think, therefore I am'. He wrote:
It is, namely, a category-mistake. A foreigner visiting Oxford or Cambridge for the first time is shown a number of colleges, libraries, playing fields, museums, scientific departments and administrative offices. He then asks 'But where is the University? I have seen where the members of the Colleges live, where the Registrar works, where the scientists experiment and the rest. But I have not yet seen the University.'

Ryle's category-mistake is identical to what Buddha talked about. Buddha said 'Is this body me or mine?' 'Is this perception me or mine?' Is this conception me or mine?' Buddha said, what I can control freely according to my desires is mine. But, what I cannot control freely according to my desire is not mine. We do not have control over our bodies as far as birth, aging, disease and dying are concerned. So, in order to control ourselves we must recognize that our bodies are not our own. There is nothing that can be said to be mine or myself because even this body does not belong to me. If a person considers oneself thus, one does not discriminate others from oneself. This is the wisdom of equality in Buddhism.

Buddha said that Buddhism itself is like a raft that takes us to the other shore, but upon arrival, we should not cling to that raft. With neither attachment to self nor to Buddhism, Buddhists can have compassion for all people and affirm all religions equally.

Unique Buddhist manners and rituals for dying were developed in Japan. While a disease can be controlled by medicine one must never give up nor accept death. But if there is no way to be healed, one must not cling to life. A dying patient should pray to their principal object of worship, confess to that object, imagine the other shore of one's ideal personality of worship and prepare for death by concentrating one's mind on their ideal personality of worship.

As mentioned at the beginning, today we have conquered old known infectious diseases, but new types of infectious diseases to which we have no immunity may cause disaster. Advances in air travel make it possible to transfer viruses all over on the earth in a short time. As Buddhist priests we must help people to be selfless and allow science to function freely as it looks for medical advances that benefit all. A new influenza crisis is imminent. The so-called Spanish flu killed around 2.5% of the world population. Before another worldwide influenza pandemic occurs, we must take steps to prevent it. It was a Japanese researcher who first synthesized a type A influenza virus artificially. However, he didn't do it in Japan. There we can not conduct this kind of high-risk research despite the fact that we have at least two fully functional BSL-4 laboratories. The problem is not a lack of technical skill, but a lack of cooperation from the people in Japan. The communities surrounding the BSL-4 labs refuse to let them operate. They fear exposure to a leaked experimental virus or bacteria. Japanese researchers are forced to do this kind of research in foreign countries. Perhaps it strikes some people as unbelievable that Japan finds itself in such a silly situation. Our facilities for this kind of research are sufficient, but our ethics are lacking. And, Buddhists must bear some of the blame for it.

Buddhism was undermined by Japan's Meiji period revolutionary government in 1868. To counter Western pressure and to secure political control, the government terminated Buddhist involvement in the social-political system and promoted the belief in a single national religion which was a version of Shintoism with all of Buddhism's merciful influence removed - a policy that ended with the unfortunate incidents of World War II. The selfish tendency of Japanese people gradually prevailed during that time, and we live in its shadow today. Japanese Buddhists must take on the responsibility to counter this tendency. We Buddhists must also have conferences like these to discuss the relationship between religion and things like infectious diseases and learn from Vatican to be a religion which is actually useful for the happiness of the world.

Thank you.

Masahiro Tanaka, M.D. Chief Priest at "Buddhist Temple Saimyouji", Physician at "Medical Clinic Fumon-in", Mashiko, Japan