Summary

Beliefs and practices surrounding the body, disease, and healing have defined Buddhist traditions around the world since the inception of the religion in northern India roughly two-and-a-half millennia ago. Buddhism’s therapeutic dimensions left a discernible impact on the history of premodern Japan, where Buddhism arrived in the 6^th century of the common era. Because Buddhist healers practiced medicine on all levels of society on the archipelago, the Buddhist imagination of disease found wide and enduring acceptance throughout the ancient and medieval periods. This included the notion of “karmic illness,” which provided a compelling etiological explanation for disease, disability, and injury by reference to the “physiomoral” causality expressed in the Buddhist doctrine of karma. Another Buddhist etiology that saw pervasive acceptance in Japan, especially with the rise of esoteric Buddhism throughout the Heian period (794–1185), was the attribution of illness to demons, malicious instigators of pestilence who had much in common with the plague deities thought responsible for epidemics since the Nara period (710–794) and earlier.

Buddhist healers in Japan engaged with disease through a staggering variety of ritual, devotional, and medical practices. In the Nara period, the state relied on large-scale sūtra recitation assemblies and repentance rituals, many of which were aimed at securing the safety of the realm at large by healing the body of the emperor. In the Heian period, political power became increasingly diffused over multiple political agents, a rising class of warriors, and powerful Buddhist monasteries; personal salvation became an urgent priority in what was considered the “age of the Final Dharma”; and private sponsorship of esoteric Buddhist rituals for therapeutic purposes became an everyday affair. These rituals, many of which were highly innovative, typically incorporated the use and ritual consumption of diverse medical substances. Some of these substances were acquired via trade with the continent, and others were found or cultivated locally on the archipelago. One consequence of the nearly ubiquitous use of physical therapeutic substances in rituals was that Buddhists in Japan came to possess extensive knowledge about materia medica.

New research on Buddhism and medicine in premodern Japan elucidates the historical and social contexts of Buddhist medicine. This research highlights the dynamic interactions between Buddhist healers, therapists of non-Buddhist medical traditions, and their patients.