Indian Journal of History of Science, 43.2 (2008) 137-161GLIMPSESOF AYURVEDAINMEDIEVALCHINESEMEDICINEVIJAYAJAYANTDESHPANDE*(Received4February2008;revised31March2008)Sino-Indian contacts through the Buddhist monks facilitated theentryofideasofAyurveda,ancientIndianmedicine,intoChina.ItisevidentinBuddhistcanonicalworksaswellasinpopularandhistoricalliteratureinChina,inlegendsofBuddhaandBodhisattvaandinmanuscripts,engravingsofmedicinalrecipesandtreatmentsfoundatexcavatedcaves.Thesecontactshavebeenstudiedbyagenerationofscholars beginning from the early twentieth century. A resurgence of thisactivityiswitnessedinthelastquarter.Muchnewmaterialhascometolight through recent studies. It goes a long way to dispel doubts regardingthe long-term effect of these medical transmissions. Major references andsuggestions are found in Chinese medical works, compilations as well aspharmacopoeia.Thesubjectmatterofthesecross-culturalmedicalcontactsisseen to be very diverse. It includes ophthalmology, gynecology, obstetrics,pediatrics,psychology,physicalfitnessandtherapeutics.Itrangesfromphilosophicalandtheoreticalconceptstopracticalmethodslikesurgery.Present article takes a brief account of varied sources that highlight thesemedicaltransmissions.Ophthalmologyisintheclassofitsownsinceseveral Chinese works have titles delineating their Indian origin. The time,route and extent of transmissions of the ophthalmic in particular that arestudied by the author are reviewed here bringing out their Ayurvedic roots.Key words: Buddhist canon, Dunhuang manuscripts, Gynecology,Kasyapa,Medicaltransmissions,Monasticmedicine,Nagarjuna,Ophthalmology,SpreadofBuddhism.INTRODUCTIONIt is a well known fact that the introduction of Buddhism from IndiaintoChinainearlymedievalperiodpromotedexchangeofamultitudeof* 76/37A,Erandawana,Pune-411004138 INDIAN JOURNAL OF HISTORY OF SCIENCEideas between them. Along with philosophical ideas those related to variousarts and sciences were exchanged too. Buddhism being intimately concernedwith deliverance from sufferings, medicine played a prominent role in theseexchanges. Asamatteroffact,Buddhistmonkswerewellacquaintedwithmedicinesinceitwaspartoftheirformaltraining.1Itwasforthepurposeof attending the sick among them. Monks invariably practiced various medicalspecialtiesincludingsurgeryandprovidedtreatmentfortheresidentsofmonasteries as well as the lay people. Through these practices ancient IndianmedicinefounditswayintoChinesemedicine.Greatmanyscholarshavealluded to Sino-Indian Buddhist contacts2, Buddhists interests in medicine3and the possibility of transmission of Ayurvedic ideas to China in medievalperiod.Moreover,afewofthemhavealsoexpresseddoubtsregardinganylastingimpressionsthesecontactscouldhaveledto4. Recent researches inthis field by scholars5 including the author of this article point at noticeablecontinuedinfluencesinvariousfieldsofmedicine.Hereisanattempttocollatesomeoutstandingdeductionsandpointoutdirectionsforfurtherstudy.InvolvementoftheBuddhistswithmedicine,boththeoreticalandpractical, as well as its connection with Ayurveda or ancient Indian medicineisdepictedinfollowingdiverseways.1. Canonicalworksrefertomedicineanditsvariousdisciplinesinlargenumber.2. Buddhist monks used to provide medical treatment to the residents of themonastery as well as to lay people and it is reflected in Chinese historicalandpopularliterature.3. Legends of Buddha and Bodhisattva as Bhais.ajyaguru abound in China,Japan and elsewhere. They refer to Buddha teaching medicine and handingover medical texts to disciples and also bestowing medicines to the needy.4. Buddhist caves depict engravings of medicinal formulae and pictures ofmedicaltreatmentgivenbymonks.5. ChinesemedicalworksandpharmacopoeiafromthefifthcenturyADonwards, include materials suggesting connections with Buddhist medicinethatusuallyhave Ayurvedicflavor.139AYURVEDA IN CHINESE MEDIEVAL MEDICINE6. TwoworksonophthalmologyattributedtoNgrjunaexistinChinesemedicine and they were important standard works studied by the studentsof ophthalmology till the sixteenth century AD. Their study by the authorillustrates parallels with ophthalmic contents of ancient Indian medicine.1.MEDICINEINBUDDHISTCANONICALLITERATURETheChinesecametoknowaboutBuddhaandhisteachinginthesecondcenturyBCthroughtheircampaignsinCentralAsia.6Lateron,EmperorMinginthefirstcenturyADinvitedBuddhistmonksKyapaMtan.gaandDharmaratnatoChinatoteachBuddhistphilosophyandtotranslateBuddhistclassicsintoChinese. TheearlyarticlesofDacang,theChinese Buddhist canon, primarily contained Buddhist philosophical literatureexpressly created for the Chinese audience.7 Basic tenets of the school wereexplained in these texts. Before long, the monks translated standard BuddhistphilosophicalworksintoChineseandtheybecametheearliestpartofthecanon.Chinese monks then visited India for pilgrimage and to collect morecanonical works. Indian monks also visited China primarily to participate intheirtranslationintoChinese.Asamatteroffact,authorsoftheChineseBuddhist canon in addition wrote elaborate articles on systematic learning ofSanskritorFanwenasitiscalledeventoday.TheycompiledspecializeddictionariesaswelltotranslateSanskritandPaliworksintoChineseandTibetan.Thesedictionariesformapartofthecanonicalliterature.8AfterthefirstcenturyAD,therebeganaregularflowofBuddhistmonks between India and China. While religious interests were the foremost,other scholarly interests also prevailed and significant exchange of scientificideas took place at this time. These exchanges were related to sciences likeastronomy,mathematics,alchemy,medicine,metallurgyetc.Graduallymedicineacquiredaleadingpositionintheseexchanges.TranslationofcanonicalworksintoChinesebeganinthesecondcentury AD.ItwasatitspeakduringthethreehundredyearsbetweentheeasternHan(25-220 AD)andtheJin(265-420 AD)dynasties.Itcontinuedin the Tang dynasty (618-907 AD). Chinese, Indian as well as Central Asian140 INDIAN JOURNAL OF HISTORY OF SCIENCEBuddhistmonksparticipatedinit.Tobeginwith,thetranslationworkwasshouldered by the Central Asian monks since they were acquainted with bothlanguages.Kumrajvawaspioneeramongthem. AnShigao,theprinceofthecountryofAnXiinCentralAsia,whoreachedLoYangin147AD,translatedlargenumberofmedicaltextsintoChinese.SubsequentlySongYun and Hui Sheng in the early sixth, Yi Jing and Xuan Zang in the seventhand Fa Xian in the early eleventh century AD made outstanding contributions.Veryfewoftheseworkshavebeenstudiedfromthepointofviewoftheirmedicalcontentandconnectionwith Ayurveda.Amongthemedicine-relatedessaysofBuddhistscriptures,somereferredtomedicineingeneral9andotherstosomespecificdisciplineofmedicinee.g.pediatrics,ophthalmologyandwomensdiseasesetc.10 Thesereferences have a deep imprint of ancient Indian medicine. Standard Ayurvedictreatments of internal medicine and surgery for various diseases are mentionedincanonicalworks. Furthermore,theyoftenmentiontheTridos.atheory11thatformsthebasisofdiagnosisandtreatmentin Ayurvedicworks.12OneofthearticlesinChineseBuddhistcanonviz.Nengqingyijieyanjibingdolonijing- Aclassiconthespellwhichcanclear(cure)alltheeyediseasesorCaks.urviodhanavidy,waswritten/translatedbyAmoghavajra13. He contributed a large number of works to Chinese Tripit.akabetween749and770AD.ThisparticularentryintroducesaDhrani.e.Mantra or invocation which claims to cure all eye diseases. Although it doesnotcontainmaterialofanyrealmedicinalvalue,itdoestouchuponthestandardetiologyofeyediseasesasdefinedbytheTridos.atheoryofAyurveda.Itmentionscommonsymptomsofeyediseasesalso.Thethreedoasaretranslatedasfollows.vta-fengmeaningwindpitta-huangmeaningyellowkapha-tanmeaningphlegmThere are numerous references to Ngrjuna, Jvaka, and Kyapa inChinesecanonicalliterature.Theyarewithrespecttospecificmedicalspecialties. Buddha himself was revered as a great physician and was calledBhais.ajyaguru/Bhais.ajyarja (medicine teacher or king of medicine) for thatreason.141AYURVEDA IN CHINESE MEDIEVAL MEDICINEAll the three viz. Ngrjuna, Jvaka and Kyapa are important figuresin ancient Indian medicine. Ngrjuna14 is traditionally known to have revisedSur.utasam.hit, the famous ancient Indian medical classic. Ngrjuna is alsoknownasarenownedBuddhistphilosopherofthesecondcentury ADandthe founder of Madhyamaka philosophy of Mahyna school of Buddhism.HisworksformapartoftheChineseBuddhistcanon. OneoftheearlyreferencestoNgrjunainChineseTript.akaisintheworkLongshuwuminglun or Ngrjunas Pancavidy.15 Jnnabhadra, an Indian BuddhistmonkwhovisitedChinainthesixthcenturyAD,translatedthisworkincollaborationwiththreeothermonks.TherearereferencestomedicalpersonalitieslikeJvakaorQipoandmedicineincludingophthalmology,gynecologyandobstetricsinthiswork16.JvakaandKyapasnamesarecloselyrelatedtoancientIndianfemale pathology and pediatrics. Although famous compendia of Caraka andSusr.utacontainsectionsonthetopicKyapasam.hit17,alsocalledasVr.ddhajvakatantra,itisonlyaseparatework.ScholarsascribeitadateoffifthcenturyADwhiletraditiontakesitbacktotheBuddhistperiod.Interestingly, it mentions China in one of its chapters while suggesting dietaccordingtotheplaceofliving,substantiatingtheearlycontacts.An Shikao, a central Asian prince-convert-monk translated two worksin147 ADthatwereaccreditedtoJvakaandKyapa.TheywereNainuqi po jing or Jvakas classic on womens standard diseases18 and Ka ye jinjiejingorAclassicofKyapasprohibitions(forpregnantwomen)19whereas Fa xian in the early eleventh century AD translated Ka ye xian renshuoyinurenjingorAclassiconwomensdiseasesastoldbythesageKyapa into Chinese.20 The fact of Kyapas name being linked with femalepathology in Chinese literature as back as the second century AD goes a longwaytosupportearlierdateforKyapa.BagchihasstudiedabovethreeworksandtranslatedthemintoEnglish.Indian drugs and their applications too were mentioned in canonicalliterature. An Indian monk named Bao si wei jing or Ratnacint, was translatorofBuddhistworks.HewroteQuanshiyinpusaruyimonituolonijing(AClassic of Bodhisattva Avalokitevaras Cintman.i dhran.i)21 in Tang dynasty.ItmentionsmedicineslikeHujiao(Barbariansorforeignersspice)or142 INDIAN JOURNAL OF HISTORY OF SCIENCEpepper (Piper nigrum L), Niu huang (meaning cows yellow or Gopitta sincepittawastranslatedashuang)ordriedgallstoneofdomesticcattleetcinthe treatment of eye diseases. These drugs are often used in preparations ofAyurvedic medicines.2.BUDDHISTMONASTERIESANDMEDICALPRACTICESince Indian monks, who visited China in the medieval period, wereconversantwithcertainmedicalskillsasapartoftheirofficialinstruction,they extended medical service to Chinese nobles and laity whenever needed,probablyoutofcompassion. Yet,thepurposeofeasyendorsementtherebyofBuddhistphilosophyinthenewlandcannotberuledout.Episodes of Buddhist monks curing patients with their very effectivemedicinearefrequentlyrecordedinChinesehistory.Quiteafewoftheseepisodes are about Buddhist monks performing cataract surgery. Tang poetsBo Juyi (772-846 AD) and Liu Yuxi (772-842 AD) wrote about Ngrjunaswork on ophthalmology and a Brhmin removing the cataract using a goldenprobe.22Thispartisdiscussedinaseparatesectionbelow.MedicineforBeriberi: Beriberiisadeficiencydiseasethatisnowknown to be caused by deficiency of thiamine. It was widely prevalent in theworldinancientandmedievalperiod.Beriberiwasaknowndiseaseinancient China and it is recorded under different names in medical literature.Su Jing in the seventh century AD revised the famous Tang pharmacopoeiacalledorXinxiubencao(Newlyrevisedmateriamedica)23 andnoteddowna remedy as Brhmins prescription in his pharmacopoeia. Later in 752 ADa large compendium Waitai miyao fang (Medical secrets of an official) waswritten by a famous medical writer/compiler Wang Taoof the Tang dynasty.24The author in the chapter on Jiao qi or Beriberi records a prescription by thenameBrhminsprescription.Thesehistoricalrecordssuggestthatasuccessful cure for Beriberi was made known to the Chinese in all probabilitybyanIndianBuddhistmonk.3.LEGENDSOFMEDICINE:BUDDHAANDBODHISATTVAAsonelooksbackinhistory,manymedicalpersonalitiesattainalegendary status for lack of concrete historical evidence. It is often witnessed143AYURVEDA IN CHINESE MEDIEVAL MEDICINEin ancient Indian medicine also. Jvaka, Kyapa, Caraka, Sur.uta, Ngrjunaetc were great medical men of their time, considering large body of referencesas well as works attributed to each one of them. Their dates and contributionsareonlysurmisedafteranalyzingalabyrinthofliteratureandlegends.References to these famous medical personalities of ancient India in Chineseliteraturecouldbeusefulintheprocess.There exist many anecdotes of medicine about Buddha and Bodhisattvaas well as Buddhist monks in Chinese culture. They relate to their deliveringmedical instruction, medicines, and medical texts. Cui Zhuti, the Minister ofrevenue in the Tang dynasty, wrote two books viz. Cui shi zuanyaofang (Mr.Cuis collected medicines) and Chantu (Birth maps). He attributed the successofhismidwiferytotheworkofaBuddhistmonkTanLuan.BothCuiZhutisandLuansworksarenomoreextant.TheironlysourceisWaitaimiyaofang.25Similarly,thereexistsmuchinformationaboutintroductionofophthalmic knowledge from China into Japan through the Buddhists. It existsin the form of facts intertwined with legends. A monk Majima Seigan practisedcouchingofcataractandfoundedanophthalmicschoolinJapaninthefourteenth century AD. This school continued to be active till the seventeenthcentury. As one story goes the monk Majima Seigan had a dream when theBhais.ajyaguruappearedbeforehimandtaughthimthemethodsofhealingandthenextmorninghefoundabookthatgavedetailsofeyediseasetreatments.MajimaSeiganthenrepairedatempleofYiwangshenyaoshisi (Temple of the king of healing Bhais.ajyaguru) located near the city Nagoya.Thistemplewasallegedlyfoundedin802 AD.Again,aJapanesemonkinthesixteenthcentury ADstatedthathisancestorwenttoChinain809ADandstudiedunderLongshupusaorBodhisattvaNgrjuna.AlthoughtheJapaneselegendsarenotreliablehistoricalevidence,theirdategoclosetothefirstChinesereference(BoJuyis)totheearlierophthalmicworkattributedtoBodhisattvaNgrjuna.Aforesaid Japanese legend supports the idea that Ngrjunas discourse oneyes was indeed being circulated in China in early ninth century AD. WhetherinrealitytheJapanesetravellermonklearntophthalmictechniquesfromamonkbythatnameorheissimplyreferringtothefamousbookishardto144 INDIAN JOURNAL OF HISTORY OF SCIENCEverify.Nevertheless,thefactthatthisophthalmicworkfounditswaytoJapanandpromotingophthalmicstudiesthere,isacertainty.26As monastic medicine flourished, gradually some monasteries becamefamousfortheirmedicaltreatment.ThemonasteryofbenevolentaidorHuijisiislocatedattheXiaoshancountyinZhejiangprovinceofChina.Itis locally called Zhulinsi or the Bamboo grove monastery. It has been famousfor its practice of medicine till the nineteenth century AD. Monks of Bamboogrovemonasterywereregardedasexpertsinthetreatmentofwomensdiseasesi.e.gynecologyandobstetrics.27This monastery was first founded in the tenth century AD at the siteof a pre-existing temple. According to a legend, the tenth century chief of themonastery once hosted a wandering monk who gave him a medical treatiseon womens diseases. These remedies turned out to be very effective and thetraditionoftreatingwomencontinuedfromthenonwardsatthisplace.Handbooks on efficaciousmedicineswereprintedinthismonasteryand they were distributed among needy people during the eighteenth and thenineteenth centuries. These formulae were revered as excellent remedies fornumberofgynecologicaldiseaseslikeinfertilityandmiscarriage.Theseformulaeweresuccessfullyusedbymoderngynecologistaswell.28 Theseremedies of handbooks given out by the Bamboo grove monastery need tobestudiedfromtheviewpointoftheirpossiblerelationtoancientIndianmedicine.4.PICTURESOFMEDICALTREATMENTANDENGRAVINGSOFMEDICINALFORMULAEINBUDDHISTCAVESBuddhismthrivedinChinaduringtheTangdynastyandnumberofBuddhist monasteries and temples increased rapidly. Early Tang emperor Taisong(627-650AD)intheseventhcenturyADdevelopedcontactswithseveral Indian kingdoms including Magadha that was ruled by the powerfulking Hars.avardhana. Nalanda University therein was a famous seat of learningatthattimeandChineseBuddhistmonksvisiteditinlargenumbers.SinceinterestsinIndianmedicineandothersciencesweregrowing,thesemonk-travelerswroteaboutthedistinctivenatureofIndianmedicineintheir145AYURVEDA IN CHINESE MEDIEVAL MEDICINEtravelogues as seen in Da tang xiyuji (The great Tang dynasty travels in thewestern regions).29 By and by, under the directive of Tang emperors, ChinesemonksandvisitorssearchedforfamousIndiandoctorsanddrugs.PracticeofmedicineinChinesemonasteriesalsogrewrapidlyanditisreflectedinliterature,caveinscriptionsandcarvingsofthetime.Ancient caves at Dunhuang (of the sixth to tenth century AD) in theNorth-western part of China on the other hand symbolize cultural developmentwhen Buddhism was at its peak. The famous monk traveler Xuan Zang afterhislongstayinIndiareturnedtothethencapitalChanganviaDunhuang.BeinglocatedontheancientSilk-road,asBuddhismprosperedduringtheTangdynastyDunhuangbecameamajorcenterfortradeandtravel.AlthoughbeginningoftheconstructionofcavesatDunhuangistracedbacktotheSui(581-618 AD)dynasty,itwasduringtheTangthatmajor caves, murals and sculptures were carved.30 The caves were excavatedinearlytwentiethcenturyandthousandsofpaintings,Buddhistscripturesandhistoricaldocumentswerebroughttolight. Amongthevastnumberofmanuscriptsthatwerediscoveredtherearesomemedicalmanuscriptsaswell.31Interestingly,DunhuangmedicalmanuscriptscontainedonenamedQiposhu or Jvakapustaka. It was written both in Sanskrit and Brhmi. It isextensivelystudiedbyChenMing.32JeanFilliozatfoundthatsomefiveformulaeinQiposhuarefromCarakasam.hit.33Likewise,Longmen(Dragongate)cavesatLoyanginnorthChinacontainedthreecavescalledtheCaveofprescriptionswheremedicalformulaeareengravedunderthetitleLongmenfangorLongmen(Dragon-door) formulae. Considering the style of engraving and literature and patternsofBuddhastatuesaroundit,scholarsascribethedateofseventhcentury(650-653 AD)toit.IthasbeennotedthatLongmenformulaeandQiposhuorJvakapustaka foundinDunhuangcaveshavemuchincommon.Lately,Longmen formulae have been translated into English and they form anothersourceforstudyingancientmedicalcontacts.34Qiposhu employs special drugs in its formulae viz. San guo and Sanxin. San guo (three fruits) are Hartak (Terminalia chebula Retz), Vibhtaka146 INDIAN JOURNAL OF HISTORY OF SCIENCETerminalia belerica Retz) and malak (Phyllanthus emblica L) i.e. TriphalinSanskrit.Sanxin(threepungentorhotsubstances)arepippal(Piperlongum L), marca (Strychnos potatorum L) and uth (Zinziber officinalisRosc) i.e. Trikat.u in Sanskrit. Both are common ingredients of ancient Indianmedicine.Cave paintings at Dunhuang are based on Buddhist stories. A numberof these frescoes depict Buddhists medical practices. Illustrations of medicaltreatmentsthrowlightonmedicaltechniquesofthetime.5.MEDIEVALCHINESEMEDICALWORKSANDCOMPILATIONSINCLUDEDMATERIALFROMBUDDHISTMEDICALWORKSANDPHARMACOPOEIAAsseenearlier,Sino-IndianBuddhistcontactsfacilitatedentryofancient Indian medical ideas into China and Buddhist monks in the capacityof travelers, translators and at times medical practitioners, acted as catalystsin this process. Soon after, some of these ideas entered main stream Chinesemedicineandtheywerereflectedincontemporarymedicalworksandcompilations.Manyintermediaryworksthatformedalinkbetweentheearliestideas that entered through the Buddhist channel and their final depiction inpopular Chinese medical texts, are no more extant. They are listed in ancientbibliographies e.g. Sui shu (the bibliography of Sui dynasty) and indicate theextentoftransmission.TaoHongjing,SunSimiaoandtheirworks:WritingsofTaoHongjing (456-536 AD), famous medical writer, alchemist and pharmacologistdepicted influence of Buddhists four element theory Si da for the first time.AcenturylaterfamousmedicalwriterandphysicianSunSimiao(581-682AD)referredtoIndianmedicineinabigwayinhistwocompilations.35Sun Simiao was conversant with all the three established philosophiesof medieval China viz. Confucianism, Buddhism and Taoism. He emphasizedthe need for love and compassion as advocated by the Buddhist philosophyforethicalmedicalpractice.36147AYURVEDA IN CHINESE MEDIEVAL MEDICINETransliteratedSanskrittermspointingat Ayurvedicconnectionsarenumerous in Sun Simiaos works e.g. Agatuo wan meaning Agada pill. HeintroducedconceptsofhealingofmentalsufferingsbymeansofChanorDhyna and Yoga.37 He mentioned a method of Indian massage An mo fa inhis writings and called it a Brhmins method.38 Sanskrit name for jaundicei.e.KmalasKamoloalsoappearsinthistext.39Sun Simiaos famous work Beiji Qianjin yaofang [important medicinalformulae (worth) a thousand (pieces of) gold] also contains a lot of medicinalformulaeattributedtoJvaka.40Inasectiononmedicinalsubstanceshewrites, A great medicine man of India Jvaka has said that all things underheavenhaveefficacy.41ItisaquotefromCarakasam.hit.42Interestingly,the term Sun Simiao used for a suppository in the Womens diseases sectionofBeijiQianjinyaofangviz.zuodaoyao(sitting-directingmedicine)43 goesclosetothegeneraltermusedforenemaandsuppositoryinSanskritviz.Netrabast(directing-sittingmedicine).44 Although suppositories were usedinChinaearlierasseeninSengshenfang(profoundmedicinalformulaeofthe Buddhists), a fifth century work; they were not under this name.45 Thesefacts hint at Sino-Indian medical ties in the field of gynecology and obstetricsthathavebeenoverlooked.Theyalsounderscoretheneedforfurtherinvestigation.46SunSimiaoexplicitlyrecordedsurgicaltreatmentforglaucomaorQing mang, so also for several other eye diseases like polypus of the whitepartoftheeyeforthefirsttime.47 ThiswastheentryofIndiantechniquesof ophthalmic surgery into China. Detailed account of these techniques wasrecordedaboutacenturylaterintheworkattributedtoNgrjuna.WangTaosWaitaimiyao:WangTao(670-755AD),afamouspersonalityofearlyTangperiod,wasaninfluentialgovernmentofficialaswell as a physician. He wrote a large compendium Waitai miyao fang (Medicalsecrets of an official). In its chapter on ophthalmology he included sectionsfromaworkofIndianoriginviz.Tianzhujinglunyan(Indianclassicofdiscussiononeyes).Justasthenameindicates,itscontentsindeeddepictparallelswithancientIndianmedicine.148 INDIAN JOURNAL OF HISTORY OF SCIENCEAcording to the Indian classic of discussion on eyes merely physicalfactorslikesenseorgansandsupplyofbile,areinsufficientforvision.Itconsidereddivineknowledgeasanecessaryfactor.ItstatesTheflowofqi from the liver channel to the eye, three lights, the divine knowledge, allcombine to enable the eye to see. Carakasam.hit also includes factors otherthanphysicaltoexplainthephenomenon.ItstatesConsciousperceptionarises from the fusion of the tman (self), mind, senses and sense organs48.Furthermore,thegoldenprobemethodfortheremovalofcataractthat became very famous in following centuries in China was first mentionedin this compilation Waitai miyao fang.49 Aforesaid Brhmins prescriptionforBeriberiisrecordedinthisverytext.50TanbaYasuyoriandhiscompilationYixinfang:TanbaYasuyori,an984 ADJapanesescholar,madeacollectionofChinesemedicalworksviz.Yixinfang(Centralmedicinalformulae).51 It contains material from Jin(265-420 AD) to Tang (618-907 AD) dynasties. Therefore it provides materialfor the study of history of medicine of that period. Interestingly, among thesources used by the compiler of Yixinfang there are many related to BuddhismingeneralandtotheIndianexpertsmentionedabove.52This work records over ninety articles related to Qipo yifang (JvakasMedicine).Qipoyifangdoesnotexistasaseparatework.53 Thesearticlesinclude formulae for womens diseases like stomach ache during menstruation,pregnant womans chest pain, stomach ache and problem of continued bleedingafterdelivery,postpartumstomachandchestpain,treatmentforinfertilityetc. On the other hand, the incomplete work Qiposhu or Jvakapustaka, thatwas excavated in Dunhuang is a short version meant for practical use and itismuchquotedinothermedicalworks.Yixinfang also quotes a Sanskrit Dharan. or Mantra from a canonicalworkDajituolonijing(Mahdhran.classic).Itistobeutteredtoeasedifficultchildbirth.54ItconsistsofwritingaSanskritMantrainvermillioninkontheskinofapheasantthatisthenburnttoashes,mixedwithclearwaterandgiventothepregnantwomantodrink.AstheuseofIndiandrugsincreased,theyfoundentryinChinesepharmacopoeia, e.g. Bencao shiyi (A supplement for the pharmaceutical natural149AYURVEDA IN CHINESE MEDIEVAL MEDICINEhistories) of 725 AD by Chen Zangchi. He added 368 new entries includingA-le-boorragvadha(CassiafistulaL).HealsowroteaboutBolomenzaojia(Brhminsoapbeantree).55DuanChengshialsodescribeditinhisworkYuyangzazu(Miscellanyof YuyangMountains)of860 AD.6.NAGARJUNASWORKSONOPHTHALMOLOGYEntry of ancient Indian ophthalmic knowledge into China was closelyrelatedtoBuddhistphilosophicalassumptions.Buddhawaslookeduponasasurgeonwhocouldextractfourpoisonedarrowsthatofanger,greed,prideandjealousywhichpiercedthehumans.Furthermore,ananalogyofBuddharemovingthescreenofignoranceusingtheprobeofwisdomtothe surgeon who removes cataract and enables the patient to see clearly wasvery popular. A symbolic operation upon cataracts with the alk or probeisdescribedinthesetexts.Theriteconsistedofthemasterinitiatingtheinspirer by touching his eyes with a metallic wand, saying, Vaidya-Rja orking of physicians clears away the membrane or pat.ala of ignorance witha golden probe. It is cited in Vairocanastra in Chinese translation.56 ThismetaphorgaverisetonumerousreferencestoeyesurgeryintheBuddhistcanon.Thus,ideasrelatedtoophthalmicsurgery,whichwasanoveltytoChinese medicine, were introduced in the second century AD onwards. Thiswasanunintentionaltransmissioninitsinitialstages. Theearliestentryofthese ideas in the form of analogies and metaphors, as seen in the Buddhistliterature, probably made the Chinese aware of new therapeutic possibilities.Since ophthalmic surgery was not practiced in China at that time, it alertedtheChineseBuddhists,someofwhomwerealsomedicalmenlikeSunSimiao.Chineseophthalmologytookaturnatthispoint.FromtheeighthcenturyADonwards,aboutacenturyafterSunSimiaosworks,threeophthalmicclassicsrelatedtoIndiacameuponebyone. The first work was Indian classic of discussion on eyes of the eighthcentury ADmentionedabove.TheothertwowereattributedtoNgrjuna.TheyareLongshupusayanlun(DiscourseofBodhisattvaNgrjunaoneyes)ofearlyninthcenturyADandLongmuzonglun(Ngrjunas150 INDIAN JOURNAL OF HISTORY OF SCIENCEcomprehensivediscourse)oflateeleventhcenturyAD.Theseworkswerefunctionalasstandardtextbookstillsixteenthcentury ADinChina.57These ophthalmic works played a major role in the early developmentofChineseophthalmology.Theyconsiderablychangedthestateofthedisciplineandeventuallyledtotheintegrationoftwomedicalsystemsinmanyways. Allthesethreeworksexisttothisdayassectionsinmedievalmedicalcompilations.EntryofIndianophthalmicinformationencouragedthefoundingofa separate discipline of ophthalmology in Chinese medicine. From an empiricalapproachasseeninNeijing,theearliesttextattributedtothelegendaryYellowEmperor,itledtoitssystematicstudyinthemedievalperiod. Asaresult of exposure to Indian ophthalmology, eye diseases were classified onthebasisofeyeanatomyasinthecaseofAs.t.n.gahr.daya,Susr.utasam.hitandothermajor Ayurvedicclassics.BroadcategorizationinChineseworkswasonthebasisofinnerandouterpartsoftheeye. Acleardifferentiationbetween various kinds of glaucoma, between glaucoma and cataract and alsobetweenvariouskindsofcataractsisfoundinNgrjunaslaterworkevenmoreexplicitlythaninancientIndianworksthatinfactwastheirstartingpoint. In the last section of the chapter on ophthalmology, Sur.uta discussessomeadditionaleyediseasesthatarenotincludedintheseventy-sixcasesdiscussed by him. These are traumatic injuries and childrens eye diseases.58Likewise,Ngrjunasworkalsodiscussestraumatic/externalinjuriesandchildrenseyediseasesinthelastsections.Efficacywasevidentlytheforemostreasonbehindtheintroductionand acceptance of cataract surgery in China. To a degree, Fan Ka Wai considersthe reason may be that this kind of surgery could be interpreted in terms ofacupuncturethatwasanage-oldpractice.59 Variousaspectsofsurgeryaretakenintoconsiderationin Ngrjunasworks. Theyincludedsuitabletimeandplaceforsurgery,selectionofmethodandinstruments,pre-operationalcautionsandcare,contra-indicationsofsurgery,precisioninsurgery,indicationsofsuccessorfailure,post-operationalcareincludingthatofbandage,diet,movementsetc. Allthisgoescloseto Ayurvedicinformationcontainedinclassics.60151AYURVEDA IN CHINESE MEDIEVAL MEDICINECONCLUDINGREMARKSSino-IndianBuddhistcontactsthatbeganinthefirstcenturyADresultedinexchangeofideasbetweenthetwocultureareas.Alongsidephilosophical ideas, those related to science and technology, were transmittedtoo. In view of the Buddhists involvement in liberation from sufferings forthe mankind, they had an inherent interest in medicine. It led to transmissionofideasrelatedtoancientIndianmedicineor AyurvedaintoChina.Itwasdepicted in diverse ways. Chinese Buddhist canon contains several medicine-related works. Allusions to Indian monks and their medical skills are numerousinChinesehistoricalandpopularliterature.LegendsofMedicineBuddhaand Bodhisattva abound in Chinese culture. Again, Buddhist cave engravingsincluded pharmaceutical formulae too. Buddhist monks often provided medicalservicetothecommunity.Lastly,standardChinesemedicalworksandcompilationsofsucceedingperiodsincorporated Ayurvedicinformation. Even though the entry of Ayurveda into China through the Buddhistconnection is known for some time, the foremost historian of Chinese scienceJosephNeedhamandafewotherstoodoubtedanylong-lastinginfluence.Recent studies by the author and other scholars help dispel these reservations.Medieval Chinese ophthalmology was the foremost to depict Indian influence.ThreeexistingChineseophthalmicworksrelatedtoIndiarevealparallelswith ancient Indian ophthalmology in many ways. The key similarities beingclassification of eye diseases based on anatomy of the eye and incorporationof cataract-removal and other surgical methods that also form major part ofophthalmic surgery in Indian works. Although ophthalmology outshines others,fields like gynecology, obstetrics, pediatrics, psychology, physical fitness etcalsomadetheirstamp.AllinallBuddhistmedicinecontributedintheevolutionofvariousdisciplinesofmedicineinmedievalChinaandhadashare in overall medical practice of the time. To it goes the credit of introducingancient Indian medicine with its concepts, techniques and drugs into Chineseculture.ThisisbynomeansanexhaustivereviewofSino-Indianmedicalexchanges of medieval period. Yet it points at the period, path and scope ofmedical contacts between these neighboring cultures and indicates directionandsourcesforfurtherstudy.152 INDIAN JOURNAL OF HISTORY OF SCIENCE153AYURVEDA IN CHINESE MEDIEVAL MEDICINE154 INDIAN JOURNAL OF HISTORY OF SCIENCEACKNOWLEDGEMENTSThanksareduetotherefereewhosevaluablecommentsledtoanimprovedversionofthepaper.NOTESANDREFERENCES1. AstudyofbiographiesofsometravelermonksrevealthefactthattheyhadstudiedPancavidy i.e. astronomy, writing or script, mathematics, medicine and tantra in theirearlylife.SeeP.K.Mukherji,IndianliteratureinChinaandtheFarEast,PrabhasiPress,Calcutta,1931,p139.2. P.K.Mukherji(1931),op.cit.D.P.Singhal,BuddhisminEastAsia,Books&Bookspublishers,NewDelhi,1984.3. MarkTatz(Tr.)-BuddhismandHealing:DemievillesarticleByofromHobogirin,(UniversityPressofAmerica,Lanham,NewYork,London,1985;Unschuld,Paul-MedicineinChina,AHistoryofIdeas,Berkley,Los Angeles,London:UniversityofCaliforniaPress.1985;CharlesLeslie(ed.)AsianMedicalSystems:AComparativeStudy. Berkeley: University of California Press, 1976; Jyotirmitra - Ayurvedic materialinBuddhistLiterature,TheJyotirlokaPrakashana,Varanasi,India,1985,p.48.4. Needham Joseph, Science and Civilization in China, Vol V part 3, Cambridge UniversityPress,1976. Also,Unschuld,Paul(1985)op.cit.5. ChenMing,TheTransmissionofIndianAyurvedicDoctrinesinMedievalChina:ACaseStudyofAtgaandTridoaFragmentsfromtheSilkRoad,AnnualReportofTheInternationalResearchInstitutefor AdvancedBuddhologyatSokaUniversityforthe Academic Year 2005, Vol ix, March 2006, Liao Yuqun - Yindugudaiyaowufenleifajiqikenengduizhongguoyixuezhanshengdeyinxiang - Journal of Dialectics of nature, Vol 17,Sumno96,No2,1995,p62.155AYURVEDA IN CHINESE MEDIEVAL MEDICINE6. Singhal,D.P.opcit.7. Nanjo Bunyo, A Catalogue of the Chinese translations of the Buddhist Tripitaka, Oxford1883.8. Takakusu & K. Watanabe (ed.), The Taisho Shinshu Daizokyo - The Triptaka in Chinese(Society for the publication of the Taisho Tripitaka. Tokyo, 1968). See TT1420 pp. 957,966.TT2130Fanfanyu(TranslatingSanskrit)TT2131Fanyimingyiji(Collectionoftranslatednames)MahvyutpattTT2133Fanyuqianziwen(AthousandcharactersofSanskritlanguage)TT2134Tangfanwenzi(TangSanskritscript)9. TT.795-Fo zhi shen jing or [A classic on Buddha curing the (diseases of) body] - AnShigaoTT.1323ChuyiqiejibingtuolonijingorSarvarogapraamandhran(Aclassiconspelltocurealldiseases)by Amoghavajraintheeighthcentury ADTT.1325 Liao zhi bing jing or Arsaprasamanasutra. (A classic on curing all hemorrhoid-relateddiseases)byYiJingwhovisitedIndiabetween671-696 AD.TT.793-Foyijing(Buddhistmedicalclassic)byJikuritsuen&Shiotsu10. TT.131- Polomenbisijing (ABrahminclassictoavoiddeath)and TT.554-Nainuqi po jing (Jvakas classic on womens standard diseases) by An Shigao in the secondcentury AD.TT.1326-Zhoushiqibingjing[AclassicofincantationpoemfortheQi(seasonal)epidemicdiseases]; TT.1327--Zhouchijing[Aclassictoexhort (diseasesof)teeth];TT.1328 - Zhou mu jing [A classic to exhort (diseases of) eyes], Caks.urvisodhanavidy,TT.1329--Zhouxiaoerjing[Aclassictoexhort(diseasesof)children]-allbyTanMalochen(Dharmalocana?)duringtheperiodof381to395 AD.TT.1324-Nengjingyiqieyanjibingdolonijing(Aclassiconaspelltocurealleyediseases)-Caks.urviodhanavidyby Amoghavajra,TT.1330- Lu bu na shuo jiu liao xiao er ji bing jing A classic told by Rvan.a on curingofchildrensdiseases-FaxianwhovisitedNalandaaround1001 AD.TT1691- Ka ye xian ren shuo yi nu ren jing (A classic on womens diseases as told bythesageKyapa)-byFaxianTT.620-Zhichanbingmiyaofa(SecretmethodstocuretheChandiseases)Sokokyosho~457 AD.11. Tridos.atheory-Accordingtothistheorybodyissustainedbythethreeelementsordhtuwhicharekapha,thephlegm,vta,thewindandpitta,thebile.Theseareessential for the growth and maintenance of the body, a balance of the three keeps body156 INDIAN JOURNAL OF HISTORY OF SCIENCEingood,healthystate. Animbalanceofthethreeontheotherhandcausesillnesses.Thus when a dhtu is rendering an adverse effect due to its being in deficit or excess,itiscalledados.a.Anyillnessischaracterizedbyeitheroneormoreofthedos.as.Sometimes all the three dos.as together cause a disease in which case it is called as duetosanniptaorconcurrenceofthedos.as.SeeCarakasam.hit:Sutrasthna,7-39andVimnasthna,6-13.As.t.ngahr.daya:Sutrasthna,11-1to3,alsoinSurutasam.hitwithDalhanat.ik:Sutrasthna,14-20.12. Surutasam.hitandCarakasam.hitfamousSanskritworksonmedicinethataretraditionally taken as belonging to the first millennium BC. Their present versions aretakentoberevisionsmadeintheearlyfirstmillennium AD.13. TT132414. NgrjunaisacontroversialfigureinIndianhistory.Heisrelatedtoanumberofinterrelated areas of medieval scholarship like Buddhist philosophy, tantrism, medicineas well as alchemy. See Deshpande Vijaya - Ngrjuna and Chinese Medicine in TheHuman Body, at the Crossroads of Multiple Indian Ways of Knowing Papers Presentedto Arion Rosu by his Colleagues and Friends on the Occasion of his Eightieth Birthday,STVDIAASIATICA,VOL.IV(2003)-V(2004),p.241.AlsoseeK.R.SrikantaMurty-NgrjunainHistoryofMedicineinIndia(Ed.P.V.Sharma),INSA,NewDelhi,1992,p.291andMabbettI.TheproblemofthehistoricalNgrjunarevisited,JournaloftheAmericanOrientalSociety,118(1998)332.15. WuminglunorPancavidycomprisedoffivesectionsviz.Sabdastra(scienceofwords,grammar,philology),Bhais.ajyastra(medicine),ilpastra(architecture),Matras.tra(probablytantrawithalchemy)andMudrstra(printing).SeeVijayaDeshpande,MedievaltransmissionofalchemicalandchemicalideasbetweenIndiaandChina.IndianJournalofHistoryofScience,22.1(1987)15-28.16. TT1420p957,966.17. P.V.Tewari,Kyapa-sam.hit(Vr.ddhajvakyamTatramv),TextwithEnglishtranslationandCommentary,(HaridasAyurvedaSeries)ChaukhambhaViswabharati,Varanasi,1996.18. TT.55419. TT146920. P.C.Bagchi,Rvaakumrtatra,IndianCulture,,269-286.P.C.Bagchi,Kayexianrenshuoyinurenjing,Kyapaiproktastrcikitsstra,IndianCulture,,53-64.]21. TT108322. Ji Xianlin, Indian ophthalmology in ancient China, Researches in National Studies,Vol.2, 1994, p555, also see Levy Howard S (tr.) - Translations from Po Chu-is collectedworks, Paragon Book Reprint Corporation, New York, 1971, vol. 2, p58, and Unschuld,157AYURVEDA IN CHINESE MEDIEVAL MEDICINEMedicine in China A History of Ideas, Berkley, Los Angeles, London: University ofCaliforniaPress.1985,p146.23. Xinxiu bencao (Tang bencao) compiled by Su jing in 659 AD Shanghai guji publications1981.24. WangTao(8thCentury AD)-Waitaimiyao-PeoplesHygienePublications,1996.25. Jen-DerLee,ChildbirthinEarlyImperialChina,NANN,7.2(2005)216-286.26. SaiichiMishima,TheHistoryofOphthalmologyinJapan,2004,chapter6entitledTheBirthofEyeSpecialistinJapanandDevelopmentofophthalmologyinthe16thand17thcenturies.27. Yi-Li Wu,TheBambooGroveMonasteryandPopularGynecologyinQingChina,LateImperialChina21.1(June2000):41-76.28. Yi-LiWu(2000)op.cit.p48.29. TT208730. ArchaeologicalexcavationsMaWangdui(secondcenturyBC)unearthedmanuscriptsthatincludedsomemedicalmanuscripts.ItpointsatthelongtraditioninChinaofstoringthedocumentsandrelicsinthecavesforsafe-keeping.MaWangduitombsbelongtothetimebeforetheentryofBuddhismintoChinaandmedicalmanuscriptsthereinthusrepresentindigenouspracticesinancientChina.31. Vivienne Lo and Christopher Cullen (eds), Medieval Chinese Medicine: The DunhuangMedicalManuscripts,London:RoutledgeCurzon,2005.32. Chen Ming, Yixinfang zhong de Qipo Yiyaofang lai yuan kao, jianyu Dunhuang (Qiposhu)zhi bijiao, (An inquiry into the source of Qipo Yiyaofang in Yixinfang and simultaneouscomparisonwithQiposhuofDunhuang),Wenshi,Vol2,2002,p145.33. JeanFilliozat,JournalAsiatique,235(1946-47)134-5.34. ZhangRuixian(ed.),ExplanationsofLongmenRecipe,Zhengzhou,1999.35. Beijiqianjinyaofang,[Importantmedicinalformulae(worth)athousand(piecesof)gold], written by Sun Simiao (581-682 AD), first published in 652 AD, Peoples HygienePublicationsBeijing,198736. Tatz,Markopcitpp.370-88.37. Qianjinyifang,pp.200,201.38. Beijiqianjingyaofang,p.580.39. Tianzhuguo-Qianjinyifang,p.201Qipowan-Qianjinyaofang,p.276158 INDIAN JOURNAL OF HISTORY OF SCIENCEAgatuowan-Qianjinyifang,pp.326-7DhyanaQianjinyifang,p.201Anmo-Qianjinyaofang,p.58040. Qianjin yifang Chapter 12 Yang sheng, Yang lao shi liao di si, Qipo wan. Also Beijiqianjinyaofang-Chapter12QiPowanbingwan-JvakasballmedicinefortenthousandillnessesQiPoebingfangJvakasmedicinesforillnessescausedbyevilspiritsQiPotangJvakassoupQiPodashizhirenwuzangliufuneiwanbingjibuyizhangnianbulaofangJvakasmedicineforprolonginglifewithoutgettingold41. Beijiqianjinyifang,chapterYaomingdier,p842. Carakasam.hit,Sutrasthna-.26-12,29.43. BeijiQianjinyaofangVol2:WomensRecipes,SeekingaChild.44. Surutasam.hit,Cikitssthna,chapters35to3845. Yixinfangp43246. RoleofforeignmedicineinshapingSuiandTanggynecology,unpublishedms,paperreadinthe56 thannualmeetingofthe AssociationforAsianStudiesatSanDiego,March4-7,2004.47. Beijiqianjinyaofang(1987)p.12748. Carakasam.hit,Strasthna,chapter1,verses8to1449. Zhongyiyankexuefazhanjianshi(AsimplehistoryofthedevelopmentofChineseophthalmology),inZhongyiyankexue(AStudyofChineseOphthalmology),PeoplesHygienePublications1985p.150. WangTao-op.cit.p.519.51. TanbaYasuyori-TheessentialsofmedicineinancientChinaandJapan:YasuyoriTambas Ishimpo translated with introduction and annotations by Emil C.H. Hsia, IlzaVeith,RobertH.GeertsmaLeiden:Brill,1986.52. Qipofang- Jvakas pharmaceutics, Sengshenfang - Profound pharmaceutics of the monks,LongshufangNgrjunaspharmaceutics,LongmenfangDragon(Nga)gatepharmaceutics,Dajiduoluonijing-Mahdhraclassic,QipomaijuejingJvakasclassiconpulseexamination.53. TanbaYasuyori(1986)-op.cit.p.160.54. TanbaYasuyori(1986)-op.cit.p.464.159AYURVEDA IN CHINESE MEDIEVAL MEDICINE55. Glenditsia Sinensis56. MarkTatz (1985) op. cit. p. 10, 11. Tathagata - Thus Come One surpasses mundanephysicians in ophthalmology because he understands how to cut off the cataract (timira)of ignorance with the iron of wisdom. This is an idea expressed in Samyuktagama (T99:36:259c-260c)attributedtotheeasternJindynasty(350-431 AD).ThesekindsofreferencestocataractremovaloperationsareespeciallynumerousinearlyBuddhisttextswhichweretranslatedfromoriginalBuddhistcanonintoChinese.57. Joseph Needham, op cit Vol V, part 3, Cambridge University Press, 1976, p. 163. Alsosee N. Sivin (ed.) Science and Civilization in China, Vol. 6 Pt. 6, Cambridge UniversityPress,2000,pp.107,108.58. Surutasam.hitUttaratantra,19-1to8and8to16respectively59. Fan Ka Wai Couching for cataract and Sino-Indian medical exchange from the sixthto the twelfth century AD in Clinical & Experimental Ophthalmology 33 (2), 188190,2005.60. 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