# Bathing Practices as a Religious and Medical Encounter: Water, Climate and Health Across Monsoon Asia

Francesco Bianchini

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Francesco Bianchini. Bathing Practices as a Religious and Medical Encounter: Water, Climate and Health Across Monsoon Asia. Religions, 2024, Beyond the “Spice Routes”: Indic and Sinitic Religions across the Asian Maritime Realm, 16 (1), pp.2. 10.3390/rel16010002. halshs-04855881

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Article

# Bathing Practices as a Religious and Medical Encounter: Water, Climate and Health Across Monsoon Asia

Francesco Bianchini

Special Issue

Beyond the “Spice Routes”: Indic and Sinitic Religions across the Asian Maritime Realm

Edited by
Dr. Andrea Acri and Dr. Francesco Bianchini

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Article

# Bathing Practices as a Religious and Medical Encounter: Water, Climate and Health Across Monsoon Asia

Francesco Bianchini

King's College, University of Cambridge, Cambridge CB2 1ST, UK; fb584@cam.ac.uk

**Abstract:** This study explores the intersection between religious and medical bathing practices across Monsoon Asia, with particularly reference to āyurvedic and Buddhist traditions. While previous scholarship has emphasised the ritualistic and social dimensions of bathing in Brahmanical and Buddhist contexts, this article complements it with discussions of its medicinal and healing functions, as outlined in classical texts and displayed in material culture. The research highlights how bathing was considered essential for maintaining bodily balance—a concept analogous to humoral theory in Galenic medicine—across different climatic and environmental conditions, particularly during the monsoon season. The article further examines the transregional circulation and localisation of these practices, considering how diverse Asian cultures adapted Indic bathing traditions to their unique climatic and cultural contexts. Notably, the study addresses the complex interplay between religious doctrines, health and environmental factors, drawing connections between āyurvedic principles and Buddhist medical discourses. The findings suggest that while the notion of balance in bathing practices was widespread, its interpretation and implementation varied significantly across regions, reflecting local environmental and cultural influences. Through a comparative analysis of sources from South Asia, China and Southeast Asia, this article provides a nuanced understanding of how religio-medical bathing practices were shaped by and responded to the diverse climatic realities of Monsoon Asia.

**Keywords:** water; health; Buddhism; Asia

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Academic Editor: Jeffery D. Long

Received: 23 September 2024

Revised: 5 November 2024

Accepted: 21 November 2024

Published: 24 December 2024

**Citation:** Bianchini, Francesco. 2025. Bathing Practices as a Religious and Medical Encounter: Water, Climate and Health Across Monsoon Asia.

**Religions** 16: 2. https://doi.org/10.3390/rel16010002

**Copyright:** © 2024 by the author.

Licensee MDPI, Basel, Switzerland.

This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license

(https://creativecommons.org/licenses/by/4.0/).

## 1. Introduction: Bathing in Classical Āyurvedic Texts and the Question of Monsoon Asia

Scholars of Indic religions have traditionally approached bathing practices from a ritualistic point of view. Brahmanical texts on ablutions set out complex and lengthy procedures that involve various body postures, hand gestures, mantra utterances and offerings.¹ Further ritualistic elements associated with bathing include mindfulness of cardinal directions, astrological alignments and the lunar calendar, as well as the symbolic re-enactment of social and cosmic hierarchies. Similarly, Buddhist texts on bathing show considerable concern with standardised practices, which besides ritual elements also focus on decorum and securing the approval of the laity (Heirman and Torck 2012). Thus, avoiding unpleasant smells and wearing clean robes projected an aura of respectability that was conducive to harmonic social interactions both within and outside the Saṅgha. Equally important to religious authors was the avoidance of improper behaviour that may occur while bathing, as the exposure of flesh and the possibility of intimacy may encourage the temporary forsaking of monastic vows. Thus, in both Brahmanism and Buddhism, complex rules and regulations are required to shape and facilitate the experience of bathing. In this article, my aim is to complement this approach by placing more emphasis on the medical
and healing aspects of bathing. But there are some aspects of ritual that cannot be entirely
left out. The ritualistic approach to bathing culminates in the concept of ritual purification,
a holistic notion that encompasses both spiritual and bodily wellbeing. This partially
overlaps with the medical narratives we are setting out to collect here. Concurrently,
the objective is to see to what extent views about bathing and health can be discussed
transregionally, following the circulation of Brahmanism and Buddhism across Asia in
the premodern period (for a discussion of the chronology, see below). This is particularly
important for Southeast Asia, which has traditionally been neglected due to the relative
paucity of surviving textual sources. Let us clarify both objectives before moving on to a
survey of primary sources connecting various regions.

Recently, a study of water in classical āyurvedic texts² has shed more light on the multiscalar dimensions of bathing, including its healing aspects, in premodern South Asia (Angermeier 2020).³ The study highlights how bathing was intimately connected with the notion of balance. This is to be expected, as āyurvedic aetiology is akin to the humoral approach of Galenic medicine: disease results from an imbalance in one of the three *doṣas* (Zysk 2021). While diet was seen as the key instrument in facilitating this balance, bathing too could serve such a purpose. But the study also highlights how the notion of balance is in fact multiscalar and involves other realms beyond that of the body and its constituents, including environments and topographies as well as wider climatic and cosmological settings. For example, different kinds of water bodies are said to have different medical properties depending on the seasons, especially the monsoons and the winter months.⁴ As in mediaeval European medicine, the approach taken is a holistic one, inasmuch as the human is seen in connection with their context and as subject to a dynamic flux of forces. In classical āyurvedic texts, some of the main medical benefits of bathing are listed as energising the body and mind, removing sweat, removing dirt, awakening of the senses, improving one's mood, enhancing manliness, purification of the blood, and pacification of the digestive fire.⁵ There are similar lists of benefits in Buddhist texts, which will be presented below.

In line with the objective of the present special issue, the main question here is whether
and to what extent views about bathing as a health practice can be discussed from a
transregional perspective. We are of course mindful to avoid a diffusionist model that takes
India as the source of cultural practices, and Southeast Asia or East Asia as the recipients.
Nevertheless, we take Indic practices as a starting point in order to show how multiple
cultural “centres” and actors across Asia selected and adapted some of these materials to
fit their own needs and agendas.⁶

Given that āyurvedic sources on bathing place emphasis on climate and the envi-
ronment, one wonders if this could be the starting point for building a transregional
framework, along with the traditional focus on the physical “humours”. It goes without
saying that there is one major weather event that characterises the macroregion including
India, Southeast Asia and parts of East Asia: monsoon rains and the cyclical environmental
changes associated with them. The term Monsoon Asia has a longstanding, and perhaps
controversial, historiographical pedigree, which after decades of neglect has recently made
a comeback. The improved and more nuanced theoretical backdrop avoids the dangers of
reducing highly diverse regions to a homogeneous and unrealistic whole.⁷ Rather, diversity
is emphasised at the same time as a complex web of encounters, facilitated by monsoon
and maritime connectivity. The high point of such connectivity networks is represented by
the circulation of Indic religions roughly between 600 and 1300 CE.⁸

While it does make sense intuitively that bathing practices across Monsoon Asia
would be somehow linked to each other, the ways in which they are linked defies initial
assumptions. We would assume that the climates of India, Sri Lanka, Cambodia, Java and
perhaps coastal China and even Southern Japan would expose people to similar sets of problems and pathogens related to water and bathing. My initial expectation was to find similar diseases linked to monsoon rain treated with similar emphasis in the available texts across these regions. For example, fungal infections or other skin conditions could be expected to figure prominently. However, as I progressed, I found that the texts were reluctant to offer straightforward accounts of aetiology, especially when it came to tallying directly with contemporary biomedical concepts of infection and disease. Also, I found that notions of humoral and elemental disharmony were far less homogenous than one might expect. A key issue here is the uneven distribution and typology of textual sources, which makes it difficult to compare practices, for example those in ancient Angkor with those of Hangzhou or Polonnaruwa. Nevertheless, I believe the evidence collected here allows for a first discussion of the health benefits of bathing in a transregional perspective. In this context, religious agents, texts and ideas played a key role in facilitating circulation, alignment as well as localisation (i.e., non-alignment) of practices. Generally speaking, I argue that the very notion of "balance" can be used as a starting point for a transregional discussion of bathing practices, and that environmental and climatic contexts formed an essential part of how this notion was locally interpreted. However, such a notion of balance cannot be seen as entirely detached from ritualistic purification. Separating the two would be artificial and anachronistic, given the holistic character of premodern healing traditions. This is particularly important for Southeast Asia, where the relative lack of medicalised narratives could result in the neglect of entire regions which have much to offer to the study of premodern bathing practices. If we are to build more compelling transregional studies in the future, an understanding of the multiscalar dimension of bathing will surely be a requirement.

## 2. Chinese Buddhist Sources on Bathing and Climatic/Seasonal Variations

Most of the available research on the transregional dimensions of bathing predictably focuses on Buddhist discourses and their reception in China up to and including the Song period, particularly in the context of monastic regulations (*Vinaya*) (see Kieschnick 2013). Crucially, such discourses have also found a material dimension in the Buddhist "bathhouse" or *jantāghara*. Archaeological remains of this important part of a Buddhist monastic complex can be found in South Asia and Sri Lanka.⁹ In China, in addition to the limited archaeological evidence, we have detailed descriptions of such bathhouses and even depictions in drawings of idealised monasteries.¹⁰ The most well-known drawings are those related to Daoxuan, in which the bathhouse is depicted as an annex building in the lower-right margin.¹¹ As the extant buildings from South Asia illustrate, the bathhouse primarily functioned as a steam house, with water levels reaching just above the ankle and with water heating facilities to generate the desired temperature. As mentioned above, Buddhist texts were concerned with the social aspects of bathing and the avoidance of impropriety both within the order and in its relation with the laity.¹² Apart from social concerns, Buddhist texts were also adamant that the hedonistic aspects of bathing, including the pursuit of cleanliness and beauty, should not constitute the main reason for bathing. In this context characterised by injunctions and prescriptions, one aspect that regulators could encourage was to seek baths for health purposes. In particular, the descriptions in Buddhist monastic codes (*Vinaya*) emphasise the usefulness of bathing against wind illnesses, which are associated with cold symptoms that can be alleviated through steam.¹³ This is parallel to the āyurvedic ideal of using water at different temperatures as a means of balancing the *doṣas*. However, in the context of Buddhist cross-cultural translations—of Sūtras as well as *Vinaya*—one typically discovers contrasting frameworks that can be hard
to reconcile. For example, the *Sūtra on Bathing the Saṅgha in the Bathhouse*¹⁴ lists various health benefits of bathing, such as bringing the four elements into equilibrium, curing wind illnesses, removing cold and replenishing feverish “Qi”.¹⁵ It is clear that the mention of balancing of “the four elements” rather than “the three doṣas” or indeed of “Qi” cannot be just simplistically traced back to Indic medical theories. In cases like this, one can either posit that Buddhist medical discourses recognised both a system of humours and one of elemental balance, or one may talk about Chinese reformulations of aetiology in accordance with local medicine. A recent study considers the *Fo yi jing* (T793) and tangentially discusses such complex matters (Lin and Radich 2023, pp. 886–87). Be that as it may, these examples illustrate two points: (1) that medical concerns are quite central in Buddhist discourses on bathing (indeed, the Vinaya commentary Pinimu Jing, possibly translated towards the end of the fourth century, goes as far as stating that “bathing is for no other purpose than to rid the body of illnesses caused by wind and cold)¹⁶ and (2) that the transregional dimension of these discourses is often one of divergence and localisation, rather than homogenisation.

The next question is whether it is possible to link such cross-cultural exchanges to climate and the environment. Once again, we are not attempting to reduce “Monsoon Asia” to a homogeneous region. Discussions about differences and contrasts in environments may prove more enlightening. References to climate-related disease do occur in Buddhist sources. First of all, the mention of wind illness could suggest a link with cold temperatures or sudden temperature drops.¹⁷ Furthermore, seasonal change (*rtupariṇāma*) is explicitly listed in the texts among the possible causes of disease, along with seven other factors recognised in canonical sources.¹⁸ Some widely circulating Mahāyāna texts—such as the one devoted to the adventures of Sudhana and also depicted in murals in Central Java¹⁹—offer insights into the climate-related aspects of illness. Specifically, a key section lists which doṣas increase or decrease according to the seasons, linking the monsoon season with an increase in *vāta* or wind-related ailments.²⁰ The monsoon season is particularly critical to health due to sudden changes from cooler moments following rainfall to moments of heat and very high humidity. This is in stark contrast to the summer months preceding the rain, in which temperatures are very high but are easier to cope with due to lower humidity. A passage in the Chinese rendering of the *Saṃyuktāgama* clearly defines this period of monsoon rain as both “hot and cold” (Sik 2016, p. 123 [T99.252c]) when discussing harm due to seasonal change.

While collecting passages on awareness of climatic impact on the body’s balance is rather straightforward, the task becomes more challenging when looking for texts that directly link seasonal health imbalances with the practice of bathing. Scholars working primarily on Chinese sources have identified a number of relevant passages, including non-scriptural sources. A Song inscription has been interpreted as referring to excessive sweat during hot months and the necessity of bathing in order to avoid falling ill (Kieschnick 2013, p. 25). This is mirrored by younger *Vinaya* passages that clearly stress the need for bathing in order to counteract the summer heat.²¹ Various discussions by Chinese and Japanese authors go into further detail regarding the frequency of bathing across different seasons. For example, one author encourages daily bathing in the summer and bathing every five days in the winter (Heirman and Torck 2012, p. 44). Another source speaks of a ten-day gap during the winter (Heirman and Torck 2012, p. 36).

In this context, there is one author whose works perfectly illustrate how such discussions took place on a transregional platform. Clearly, the different weather systems of India and China would represent a thorny issue for monks concerned with following monastic rules around bathing. So, it is not surprising that as early as the seventh century, the Buddhist pilgrim and traveller Yijing, who took the maritime route towards India, devoted ample space to this particular topic. Contrary to most discussions of *Vinaya* and cleanliness,
which focus on decorum and ritual, Yijing stresses the medical and health benefits of bathing, with a remarkable attention to climatic differences across regions. His discussions are made all the more fascinating by a considerable acquaintance with both āyurvedic and Chinese systems of medicine. For example, we read: "The customs regarding taking baths in India are different from those in China. In India the climate is temperate with slight variations in different regions. There are flowers and fruits throughout the year, even in the twelfth month. Snow and ice are unknown, except for a thin layer of frost. Although the weather is hot at most times, the heat is never unbearable. Even in hot weather, people do not suffer from prickly heat, and in the cold season, their feet are not chapped. Because of this [moderate climate], the people take baths frequently and set store by bodily cleanliness. Every day they do not eat before having washed themselves. There are ponds full of water in all places, and the people consider it a meritorious deed to dig ponds [...] At Nalanda Monastery there are more than ten large bathing pools, and every morning an instrument is sounded to call the monks to take baths".²² When discussing the method of making a bathhouse, Yijing also explicitly states that "the heat of the stove should be adjusted to the season" (Kieschnick 2013, p. 109).

These known examples from transregional discussions of Buddhist bathing practices speak to an awareness of the interaction between health and climatic factors, including of differences across the macroregion we may call "Monsoon Asia". However, the search for evidence becomes more challenging once we move out of the relatively abundant and well-researched Chinese sources. Can one integrate regions like Sri Lanka, Cambodia and Java within the tapestry of bathing narratives across Monsoon Asia?

### 3. Sri Lanka: From Monastic to Royal Dimensions of Bathing Practices

As we turn to evidence from Sri Lanka, it is useful to distinguish two major themes within discourses about bathing. One is the now-familiar theme of Buddhist monastic practices. The second major theme is a discussion of royal interventions and narratives, which are often informed by religious ideals. For example, there is evidence of royal patronage in the construction of bathing facilities in Lanka, acts which are also described in eulogistic passages in local chronicles. As can be expected, the amount and detail of the primary sources are less abundant than in the case of Chinese Buddhist discussions. Even more challenging is the detection of direct references to climatic and environmental factors. Some passages can however be readily identified and are referred to in this section. Another issue is the degree and character of the transregional dimension of these narratives. While in the case of Vinaya discussions or Yijing's travelogues, that dimension was prominent, here it is less explicit. However, it can be teased out through comparison with allied materials from neighbouring regions. With these preliminary remarks in mind, we may now turn to presenting an overview of the available evidence.

First of all, evidence from Sri Lanka can be easily integrated within discussions about bathing and Buddhist monastic regulations. Surprisingly, due to the highly specialised nature of contemporary academic practices, it is generally rare for scholars of Chinese Vinayas to incorporate these sources.²³ As we have already seen, one of Sri Lanka's contributions to these discussions starts with material culture. Here we find actual evidence of mediaeval "saunas" known as jantāgharas, an integral part of Buddhist cleanliness practices. Furthermore, monastic architectural remains testify to sanitation facilities and septic tanks.²⁴ It is very challenging to identify similar and co-eval structures on either the Indian subcontinent or indeed in Southeast Asia. Rather unique pieces of material evidence can be found in the so-called "sarcophagi" that can be found within some Ceylonese monastic complexes. These appear to date back to the ninth century. According to some scholars, the internal carvings of these structures, shaped in order to accommodate a person lying horizontally,
could have been used for medicinal immersions. Some attempts have been made to identify
descriptions of similar immersion pods within classic āyurvedic texts such as *Caraka* or
*Suśruta*, as well as within Buddhist texts (Mueller-Dietz 1996, p. 50). To the best of my
knowledge, the current consensus is this: while no specific description of these sarcophagi
has been found, various textual passages referring to immersion therapy and the use of
various unguents and herbs for healing purposes allow us to have some confidence that
these pods were used for healing immersions. Unfortunately, the main Buddhist medicinal
manual for this region, the 13th-century (?) *Bhesajjamanjusa*, does not seem to describe the
structures (Liyanaratne 2002). I have so far only been able to identify passing references
to bathing as a way to heal various ailments. But I have not encountered any detailed
descriptions that also relate to seasonal or climatic variations. Once again, the Pāli *Vinaya*
represents the main textual source here, as exemplified in particular by the *Bhesajjakhandaka*
section (Sik 2016).

I think the most fascinating materials from the island come not from Buddhist sources
but from sources related to the exercise of royal power. Such exercise was of course regularly
expressed with the help of religious themes and notions.

Starting from material evidence, it is easy to notice that parts of the island are criss-
crossed with a system of gutters, channels and tanks. Much of this infrastructure predates
the fifteenth century (Abeywardana et al. 2023). Such a remarkable system of irrigation
and water management is of course linked to the need to distribute and retain water in
one of the regions which is hit most strongly by monsoon rainfall (even if the island can be
divided into various subregions, some of which receive less rain). Tanks and ponds that
may have been used for bathing also constitute part of this network. While it is always
difficult to comment on the public dimension of bathing structures, some pools were clearly
created as bathing facilities for royals or aristocrats. Like the ankle-height water level of the
*jantaghāra*, some of the identified structures present stone seats. Others may also allow for
a full immersion of the body.²⁵ One set of written sources that can potentially throw light
on the construction and maintenance of these pools is epigraphic documents. Indeed, it
is possible to find reference to “baths” in the published volumes of *Inscriptions of Ceylon*
for the period under review. But these passages are mainly concerned with regulating
access to the baths and have little to say about their therapeutic use, let alone in accordance
with seasonal change. One inscription states that “no tenants shall be allowed in any bath”
attached to what could be a monastic infirmary.²⁶

For more explicit passages, one needs to turn to royal chronicles such as the *Cūlavaṃsa* and the *Mahāvaṃsa*.²⁷ These outline the alleged reasons for the construction of bathing facilities, with the intention of highlighting a ruler’s concern for the welfare of monastics. Most passages limit themselves to praising the generosity of the ruler, or listing the buildings and structures, either new or repaired. However, some can be more informative. One passage speaks of a ruler sponsoring “a fine bathing-house wholly of stone, a boundary wall and a garden which belonged to the *bhikku* community” (Geiger 1996, [reprint], section 78.83). This probably refers to a *jantaghāra*-style building. Another passage directly mentions seasonality and health: “For the bathing of the *bhikkhus* in the hot season, he had two charming ponds made there beneath hollow rocks” (Geiger 1996, section 79.5). This remark is in line with the āyurvedic and *Vinaya* injunctions presented above, namely to bathe more often during the hot months.

Another passage says: “in order to cleanse the outward impurity, that one might be
able to bathe in great heat he had eight bath-houses of stone erected [...], adorned with
pillars, staircases and railings” (Geiger 1996, section 78.45). Once again, remarkable acts of
patronage are justified by the wish to help the monastic community maintain health during
the hot months.
Putting aside these rare instances addressing health concerns directly, a number of
passages attest to the role of myth and poetical constructions of nature in relation to ideal
rulership. While such themes are not the primary objective of the current investigation,
these can be helpful where direct references to medicine are lacking. On the one hand, the
chronicles are replete with anecdotes that involve bathing ponds within an idealised and
idyllic natural environment. Royal power is thus constructed as a way to bring balance to
nature, partly through the management of bathing facilities. In this balanced and benevolent
natural "garden" (Shaw 2022), people are free from fear and danger.²⁸ On the other hand,
we find constructions of nature as dangerous and unpredictable. This is exemplified in
the figure of the Nāgas, the powerful serpentine creatures that are traditionally associated
with water bodies and the weather. While a number of sources construct royal power
as well as ritual and religious means as capable of taming these creatures, it is harder to
find direct references to bathing and health in this context. Some pools and tanks in Sri
Lanka occasionally bear carvings of Nāgas.²⁹ And Sanskrit manuals that deal specifically
with taming the Nāgas do mention bathing, but this is usually addressed in the context of
preparatory ritual purifications before engagement with the powerful creatures can begin.
The only example I have been able to find comes from the *Rājataraṅginī*, a Sanskrit chronicle
of the kings of Kashmir. One passage speaks of a Nāga king helping to cure the Queen's
eye illness. Water and immersions are included within the narrative as a way to access the
Nāgas' underwater realm (Hidas 2019, p. 28). While such narratives are not as pertinent as
āyurvedic or *Vinaya* materials, they did circulate widely and may prove useful in regions
where there is a paucity of extant literary sources. For example, the Nāgas are also part of
the Indic myth of the churning of the ocean with Mount Meru. A result of this churning
includes the distilling of *amṛta* or "nectar of immortality". It is easy to see why discussions
about *amṛta* could be relevant to the interpretation of bathing sites, for example involving
the use of springs as healing waters. As we move our survey to mainland and insular
Southeast Asia, it will be helpful to keep this in mind. However, in most cases, I have been
able to identify at least a few textual passages that speak more directly to medical concerns.

4. Angkorian Step-Pools and Hilltop Springs

There is a remarkably extensive literature on water management and pool-like struc-
tures of the Khmer Empire (ca. the 9th century to the late 14th century) (Lustig et al. 2018).
However, most archaeological studies—and indeed most epigraphic references—address
first and foremost the preoccupation with agriculture and societal sustainability through-
out the monsoon cycle. While bathing facilities are integrated within this wider water
management network, one needs to look further to unveil the medicinal and therapeutic
aspects of bathing. Where such aspects cannot be found, or remain otherwise implicit, one
needs to explain why.

As expected, the vast majority of available structures—including art historical pieces
and epigraphic references—address ritualistic concerns. Although it is possible to explore
health-related themes on the basis of ritual, that should be done with considerable care.
For example, an inscription mentions the bathing of images of Buddhist deities (Green
2014, p. 41). The sanctified water is then used to irrigate the surrounding fields. In this
sense, one sees how a ritualised form of bathing is integrated within communal concerns
with sustenance, balance and possibly wellbeing. The same notion is further stressed
by epigraphic passages that enjoin the bathing of Buddha statues at times of danger or
inauspicious astrological events (Green 2014, p. 83). Here too, one can at least identify a
concern with communal wellbeing and the protection of the people. Where human bathing
is addressed, this is often from the perspective of ritualistic purification, with various
procedures accompanying the ablutions, from the uttering of mantras to the pouring of water, from facing certain directions to the use of ashes (Green 2014, p. 215ff.).

There is also some evidence that constructing and administering different bathing structures could have significant social implications. For example, the Bat Chum inscriptions distinguish between the so-called *taṭāka* (reservoir) and the *parikhā* (canal) structures, possibly indicating that the structures would be available to either Buddhist or Brahmanical officials. However, I failed to identify any clearly expressed healing or cathartic concerns in the inscriptions (Mertens 2005). As mentioned above, āyurvedic texts mention the specific medical characteristics of different water bodies, natural or constructed. Even if such connotations are typically related to drinking water, rather than for immersion, the discussions include the same kinds of canals and reservoirs mentioned in the inscriptions. Perhaps some ritual officiants would have been aware of such medical connotations, but these concerns are rarely addressed directly in Angkorian epigraphic texts. There is firm but limited evidence that āyurvedic medicine was known in Cambodia, since at least two inscriptions mention the classic *Suśrutasaṃhitā*.³⁰

To narrow our search down, we can identify at least two places that stand out for their connection to bathing and ritual and may possibly be construed as having a healing dimension too. One is Neak Pean, within the Angkorian archaeological park. The other is Phnom Kulen, in the hills to the northwest of the Angkor Thom citadel. Neak Pean has long been linked to healing baths in popular culture and archaeo-tourism. Unfortunately, there appears to be little hard evidence to back up these intuitively appealing speculations. That is leaving aside the common identification of *barays* with the mythological "oceans of milk", the distilling of the elixir of eternal life (*amṛta*) or indeed the presence of Nāga sculptures.

More specifically, the artistic symbolism of Neak Pean has been linked by scholars to the mythological lake Anavatapta, typically found in Buddhist cosmological narratives involving Mount Meru. Such narratives typically stress the association between the lake and the elixir of eternal life (*amṛta*). As Indic cosmologies travelled across Asia, we find depictions as well as descriptions of this lake as far away as China and Japan.³¹ There is some textual evidence that links the Anavatapta lake with medicinal concerns and healing. For example, a Chinese text on meditation sickness states that even remembering this lake can help recovery from disease.³² Other aspects of the artistic programme of the lake are images of Avalokiteśvara, who is known for his compassion and help towards devotees and is also like many other Buddhist figures linked to various health practices. Some scholars have also associated the four figures carved around the pond—an elephant, a lion, a man and a horse—with the four bodily elements (Stark 2022, p. 391). This is taken as potential evidence for a Khmer humoral system and for an architectural example of bathing as seeking balance among the bodily constituents. Although somewhat speculative, this suggestion deserves more attention in future studies. Unfortunately, inscriptions associated with the site fail to mention specifically medical themes or concerns. Stanza 170 of the Preah Khan inscription states that “Far out in [the lake] is an island whose charm lies in its artificial pond filled with a single body of water from sacred bathing-places. [The island] washes away the mud of sin from those who make contact with it; it is a boat for crossing beyond the ocean of worldly existences”.³³ We do find here a mention of bathing linked with ritualistic purification, as is usual in this context, but no explicit medical terminology.

The situation is similar with Phnom Kulen (or Mahendraparvata), the forested hill to the Northwest of Angkor Thom. While most of the literature emphasises the role of the associated river in terms of water management and agriculture, it is clear that water on Phnom Kulen was invested with ritualistic and symbolic significance. If we read a contemporary fieldwork report, we immediately find observations of contemporary pilgrims
involved in ritual bathing and purification. A local guide is reported as having explained that some of the pilgrims were likely showing their gratitude to the gods after recovering from an illness (Lefferts and Cort 2008, p. 291). Reports like this, or anthropological studies on spirit mediums (*kru boramei*) and their use of water for healing, are easy to find. Today, it is also common to find stalls selling herbal and animal-derived remedies in the vicinity of waterfalls. And there is at least one spring near the linga-decorated river which is considered sacred. To the best of my knowledge, the water from the spring is drunk and is not used for ablutions or immersions. Further into the mountain, we find a series of rock-cut shelters near the famous reclining Buddha statue. Some of these rock-cut shelters have tanks for the collection of water, and pilgrims have been known to drink this water as a blessing, as it is considered sacred. Unfortunately, mediaeval sources are quite silent on bathing practices on Phnom Kulen, with occasional discourses framed in purely ritualistic and religious terms.³⁴

There is however one set of inscriptions issued under Jayavarman VII (ca. 1182–1281) that are more explicit on medical matters. These steles record the foundations of “houses of health” (*ārogyaśālas*) and explicitly mention āyurveda as a branch of knowledge, as well as the provision of medicines and the employment of physicians.³⁵ A number of relevant structures have been identified around the Angkorian citadel (usually counted as four sites) and in the provinces of the former Khmer Empire, in what is now Northeastern Thailand (over twenty sites). It has been suggested that if any actual hospice facilities did exist, these could have been wooden structures. What currently remains are an enclosing wall, a central chapel (thought to house the Buddha of Healing) and an annexed building within the otherwise empty courtyards. Yet there is one more feature of these still largely mysterious “houses of health” that is relevant here: the step-pools regularly found on the outside of the wall perimeter, towards the northwest. These pools are a stable feature of Jayavarman’s “houses of health”.³⁶ Given the explicit medicinal dimension of these sites (at least according to the inscriptions), one may at least assume that the pools would have been used for healing purposes. However, to what extent bathing was enjoined as a therapeutic practice is debatable. First of all, the inscriptions do not go into any detail on the uses of the pools. Secondly, allied Indic descriptions of “houses of health” from āyurvedic texts in Sanskrit do speak of the need for nearby water bodies, but mainly as a way of securing a stable provision of water (Wujastyk 2022, p. 12).

This leaves us with one final piece of evidence in terms of sources dating back to
the Angkorian period: the notes and descriptions by Chinese diplomat Zhou Daguan
(ca. mid-13th–mid-14th century). The visitor does devote various sections to health and
medicine, including one on childbirth and one on illnesses. As the latter addresses bathing
directly, it is worth quoting it here in its entirety:

"The people of this country are frequently ill, and can often cure themselves by immersing themselves in water and repeatedly washing their head. At the same time there are a lot of lepers—they are everywhere on the roads—and local people think nothing of sleeping and eating in their company. They sometimes say that disease occurs because of particular local conditions. It is also said that the king once contracted the disease so people are not troubled by it. In my humble opinion people contracted disease because they so often go into the water and bathe after making love. I have heard that local people always go and bathe as soon as their lovemaking is over. Out of every 10 people that contract dysentery, eight or nine die. They have people who sell medicines in the markets, as with us, but the medicines are not the same as the ones in China and they do not know what they are made of. There are also witchdoctors of some kind that give people their help".³⁷
Here, we encounter the kind of medicalised description we intended to emphasise. However, there are a number of issues. First of all, while there is a reference to bathing as a therapy, there is no mention of either Indic or Sinitic aetiology involving humours or elements. That would have made it easier to link this passage to transregional concerns. Whether or not “leprosy” is the right translation for the underlying Chinese is debatable, but there appears to be at the very least a reference to a condition that affects the skin. Skin issues are a common problem in tropical climates, which makes the topic relevant to a discussion of Monsoon Asia. The fact that Zhou Daguan acknowledges the unfamiliarity of Khmer medicines, and thus possibly the uniquely local *materia medica*, reminds one to view Monsoon Asia as a highly diverse zone, even if tightly interconnected. As for the mention of love making in the context of bathing, Caraka mentions it in Śarīrasthāna 8 (bathing before coitus and sprinkling the woman with cold water afterwards). Generally, there is an acknowledgement that water, especially perhaps in a tropical climate, could be the source of disease. Overall, this passage does prove valuable in linking Angkorian bathing practices to health and the wider tapestry of Monsoon Asian climates.

To sum up, in the case of Angkor, the few medicalised sources on bathing exhibit a localised character rather than a cosmopolitan one. Most of these sources address the importance of ritual purification. Why is this the case? First of all, one needs to address the issue of source typology. While South Asia has preserved a plethora of āyurvedic treatises, only epigraphic sources survive from pre-1400 CE Cambodia. These may refer to medical texts, but their main purpose is to record royal donations and generous acts of patronage. The first half of the inscriptions typically offers a poetic eulogy of the ruler and his lineage, while the second half lays out administrative details including boundaries, taxation and access regulations. There is little scope here to bring out medicalised discourses. On the other hand, religious narratives about purification fit very well, for they serve to legitimise the ruler's power or praise the piety of religious figures. The Khmer evidence also poses the following question: what does “medicalised” mean in the context of the premodern world? Āyurvedic texts and Buddhist Vinayas express very specific and technical aspects of the effects of bathing on the human body, but these should not be seen in opposition to religious or ritual benefits. Within the holistic stance of premodern medicine, ritualistic purification and medical balance overlap, as exemplified at Neak Pean and other bathing sites.

## 5. Springs in East Java

The situation is somewhat similar in Nusantara (maritime Southeast Asia), where we find an overwhelming majority of references to ritualistic purification and fewer to medicalised discourses. There have been some attempts at linking water management infrastructure with the history of tropical diseases, particularly with regard to Majapahit's capital (e.g., Miksic 1999). However, these attempts are still speculative, and there is a lack of consensus on the very form or extent of water management in ancient cities such as Trowulan. A more solid starting point in terms of material evidence is the sacred bathing facilities known as *petirtaans*, of which Jolotundo in Eastern Java is a key example. There are of course various bathing spots in Central Java as well, including Ratu Boko or Cabean Kunti.³⁸ Some include hot springs like Candi Umbul or Candi Ngampon. Other places of interest for sacred bathing are Candi Gembirowati and Sengang Beji.³⁹ However, the studies on the symbolism of eastern sites are possibly more advanced at the present stage. Jolotundo was constructed near a natural spring on the sides of a mountain, intended as a holy bathing site and closely connected with political discourses as well as agricultural needs. In order to understand any possible connections with health, one can turn to the carvings and decorations on its walls and the spring itself. Some of these architectural elements are now housed in museums but have been documented by scholars. As pointed
out by a number of specialists, it appears that the main cosmogonic notion associated with the site is that of Mount Meru, which is symbolised both by the mountain itself and by sculpted heads around the spring, adorned with Nāgas. This is an indication that the waters of Jolotundo were linked to the concept of *amṛta*, nectar or the elixir of eternal life.⁴⁰

There is little else at the site or in associated epigraphic material that could offer further insights into healing practices. The concept of *amṛta* does have medical connotations, but as usual, these are conceived as a side dimension to the more central idea of ritual purification, a religiously constructed concept in which physical health is subsumed within a holistic paradigm. But these early Javanese “SPAs”, with their cosmopolitan natural symbolism linked to Mount Meru, are not the only source of evidence.⁴¹

To gain further information, one needs to look at the relatively extensive literary works in Old Javanese, most notably *kakawin* poetry, as well as *tutur* religious literature. While there are indeed references to bathing, the overwhelming majority of these deal with idealised depictions of nature or with erotic scenes. Other passages refer to how bathing and cleanliness reflect a sense of decorum, respectability or even royalty. It is possible however to identify a common theme of bathing in order to restore one's energy and feel refreshed after a fatiguing journey.⁴² Unsurprisingly, similar benefits are listed in both āyurvedic and Buddhist texts. Another theme potentially more relevant to medicine is that of toiletry and personal care. Some *kakawin* descriptions of washing either the body or one's hair refer to powders, oils and ointments. One description identifies a particular kind of medicinal leaf and refers to powders and unguents in the context of a beautifying bath.⁴³ More relevant to the present line of enquiry, a passage describes the collection of holy waters from various bathing places and links it with alchemical efficacy and methods, in a hyperbolic depiction of its power.⁴⁴ The term used for alchemy is the Sansritic term rasāyana, which thus carries a cosmopolitan connotation, at least on the surface. Its occurrence in a context that directly addresses bathing is suggestive of underlying notions of bathing as a process that affects the body in transformative ways. However, presently, I am unaware of any passage linking bathing to balancing either the humours or bodily elements. It is likely that more relevant material will be brought to light by scholars of Old Javanese in the future.⁴⁵

This leaves us with religious sources. A later text directly refers to bathing as a way of removing sweat and dirt, which parallels āyurvedic and Buddhist discourses but has little medicinal value, inasmuch as the connection between hygiene and illness was not as clear in the premodern world as it is today.⁴⁶ The religious hymns preserved in Bali are mainly concerned with religious and spiritual purification but occasionally include some information on holy water too.⁴⁷ For example, one hymn concerned with bathing with ashes could be construed as implying that normal bathing with water might be beneficial for skin conditions (Goudriaan and Hooykaas 1971, p. 83). However, the reference to “skin” is reliant on a certain reading which is not uniform across the manuscripts. In cases like this, the risk of overreading is considerable.

A final source of information is anthropological studies on bathing in Javanese culture. To the best of my knowledge, the most relevant studies point to ritual bathing in connection to stage of life, such as a girl's first menstruation or marriage. In this context, various unguents or substances may be involved in the ritual washing. Modern bathing practices in Bali are also linked with the pursuit of mental health.⁴⁸ Even in cases where a medical dimension is more clearly detectable, it remains challenging to find allied materials in extant, pre-1400 CE literary sources. This remains, however, a promising field for further research.

In general, the narratives and bathing sites of Java offer close parallels with the Khmer ones. One point of divergence is the large body of ornate literature (*kāvya*) preserved
in Old Javanese. These sources primarily address the erotic aspects of bathing and only secondarily touch upon medical and ritual themes around purification and health.

**6. Conclusions**

In this transregional overview of sources on the therapeutic aspects of bathing, we began by noticing common threads linking distant literary cultures. Buddhist texts and agents offer insights into the circulation of Indic ideas spelled out in parallel āyurvedic sources. Buddhist monastic texts are particularly keen on medicalised discourses as a way to emphasise that bathing is more than self-indulgence and sensuality. Thus, we could highlight (1) the view of bathing as helping balance the humours, especially wind, as well as helping with digestion and skin conditions, and (2) the concern with seasonal adjustments, mirrored by changes in the frequency and style of bathing. With the circulation of Buddhism, these views were debated by Chinese scholars and adapted to the local cultural and climatic contexts. Therefore, these materials are essential to complement the more common scholarly focus on the ritualistic and social aspects of bathing.

The next question was whether cultural zones that have preserved fewer or different literary sources could be included within this discussion. In the case of both mainland and insular Southeast Asia, we showed that bathing practices can be first approached under the rubric of "ritual purification". The symbolism of *amṛta* then opens the door for discussion about bodily health. Both in the case of Angkorian and Old Javanese sources, we were also able to identify a few examples that speak more directly to the medicinal and therapeutic aspects of water use. These examples were usually of a localised character. This is due primarily to the uneven typology of the primary sources and to the specific political and literary purposes they serve. Of course, it is also possible that medicalised bathing took place in contexts for which we currently have no evidence. We should also be careful not to overemphasise the importance of bathing within medical regimens, as diet and other forms of therapy would have usually taken precedence. Although preliminary, the incorporation of these findings opens the door for further study, especially in the case of Old Javanese *kakawin* and *tutur* literature, which has hardly been studied from the perspective of the history of medicine. Although we could not identify clear references to monsoon climatology in the presented Southeast Asian texts, the symbolism of Mount Meru and its sacred lakes offers at least some insight into how climate and environments were integrated with discourses on water use and health benefits.

Ultimately, this study proposes looking beyond the fields of āyurvedic studies, Buddhist studies and Southeast Asian studies, suggesting ways in which different typologies of sources could be brought together to form coherent research agendas. This approach has hardly been attempted so far, despite considerable advances in all of these separate fields. In the future, along with further research on textual sources, we hope to include more archaeological and archaeo-medical materials to further enrich this dynamic picture.

**Funding:** This publication has been supported by the French National Research Agency (ANR), project MANTRA—Maritime Asian Networks of Buddhist Tantra (ANR-22-CE27-015), coordinated by Andrea Acri (EPHE, PSL University, Paris).

**Institutional Review Board Statement:** Not applicable.

**Informed Consent Statement:** Not applicable.

**Data Availability Statement:** No new data were created or analyzed in this study. Data sharing is not applicable to this article.

**Acknowledgments:** This manuscript was published in the special issue "Beyond the 'Spice Routes': Indic and Sinitic Religions across the Asian Maritime Realm," with Dr. Andrea Acri and Dr. Francesco
Bianchini serving as guest editors. The paper was presented at the "Beyond the Spice Route" symposium at King's College, University of Cambridge on 7 November 2023, part of the King's College "Silk Roads Programme". The event was co-funded by the French EPHE, GREI and ANR. The paper was also presented at the Summer Programme co-organised by the SOAS-Alphawood Group (SAG), EPHE, and NMAA, which took place in Siem Reap from 12–24 July 2024.

**Conflicts of Interest:** The author declares no conflict of interest.

## Abbreviations

CBETA Chinese Buddhist Electronic Text Association, http://www.cbeta.org.

## Notes

1. For a recent overview on the Brahmanical *snāna*, see *Paul* (2021).

2. I follow *Angermeier* (2020, p. 2) in defining the "classical period" of āyurveda as 300 BCE to 550 CE. The Caraka and Suśruta compendia were developed within this range. This is also the same time span for the core development of most Buddhist Vinayas.

3. On the related topic of seasons in āyurvedic medicinal texts see *Angermeier* (2022).

4. See the discussion and references in *Angermeier* (2020, pp. 221–22). *Suśruta* 6.64.025ab (bathing in a hot room), *Bhelā* 3.06.014 (bathing in hot water), *Aṣṭāṅgasaṃgraha* 1.04.017 (lukewarm water), *Caraka* 1.06.024, *Suśruta* 6.64.036 and 038–039a (on spring).

5. The following two passages are discussed in *Angermeier* (2020, pp. 220–21 and pp. 216–17), respectively. *dīpanaṃ vṛṣyam āyuṣyam snānamūrjābalapradam* (67) / *kaṇḍūmalaśramasvedatandrāṭrṇdāhapāpmajit* / *uṣṇāmbunādhaḥkāyasya pariṣeko balāvahaḥ (68) / *tenaiva tūttamāṅgasya balahṛt keśacakṣuṣām* / *nānāplutya śiraḥ snāyān na jale' lpe na śītale (69) / *snānodakāvataraṇasvapnānnagnonacācaret / pañcapiṇḍān anuddhṛtya na snāyāt paravāriṇi (70)*

*(Aṣṭāṅgasaṃgraha* 1.03.067cd–070). "Bathing helps digestion, virility, long life, and gives strength; it is effective against issues such as itch, dirt, lack of energy, sleepiness, sweat, thirst and burning. The pouring of water on the lower part of the body brings energy; on the upper part it benefits hair and the sense of sight. One should not bathe without immersing the head, not in too little water, not in too cold water [...]". See also the following passage: *nidrādāhasramaharaṃ, svedakaṇḍūṭṛṣāpaham / hṛdyaṃ, malaharaṃ śreṣṭhaṃ, sarvendriyavibodhanam* (57) / *tandrāpāpmopaśamanam, tuṣṭidaṃ, puṇṣtvavardhanam / raktaprasādanaṃ cāpi snānam agneś ca dīpanam* (58) / *uṣṇena śirasaḥ snānam ahitaṃ cakṣuṣaḥ sadā / śītena śirasaḥ snānaṃ cakṣuṣyam iti nirdiśet* (59) / *śleṣmamārutakope tu jñātvā vyādhibalābalam / kāmam uṣṇamśiraḥsnānaṃ bhaisajyārthaṃ samācaret* (60) / *atiśītāmbu śīte ca śleṣmamārutakopanam / atyuṣṇam uṣṇakāle ca pittaśoṇitakopanam* (61) / *tac cātisārajvaritakaraṇaśūlānilārtiṣu / ādīmānārocakājīrṇabhuktavatsu ca garhitam* (62) (*Suśruta* 4.24.057–062). "Bathing (1) reduces sleepiness, burning and tiredness; (2) gets rid of sweat, itch and thirst; (3) is beneficial to the heart; (4) removes dirt; (5) increases virility; (6) awakens the senses; (7) removes apathy; (8) gives contentment; (9) clarifies the blood; (10) helps the digestive fire. [...] When Phlegm or Wind are out of balance one should resort to washing the head with warm water depending on the severity of the condition [...] too cold water in Winter causes an imbalance in Phlegm and Wind, and too hot water in Summer causes imbalances in Bile and Blood. [...] Bathing can be helpful in cases of Fever, Wind diseases, lack of appetite and digestive problems [...]".

6. For further considerations and examples of this methodology in relation to Buddhist cults, see *Bianchini* (2024).

7. See the overview and critical remarks on "Monsoon Asia" in *Acri* (2023, p. 64), who regards this region not as "a static and reified geographical expression", but rather as "a metaphor spatializing dynamic social networks that may help us to make sense of complex historical processes [...] a geographical arena with a shared history of human migration, long-distance trade, linguistic contact and dispersal, and cultural transfer".

8. The sources quoted in this article, although very diverse, are all relevant to the study of this period. In the case of Sanskrit text, these are notoriously difficult to date and may have formed over centuries. Some texts, like āyurvedic classics or the Vinayas, may have formed earlier than 600 CE, but they continued to exercise influence during the period in question. Other texts, like some chronicles from Sri Lanka, may have been composed later but address this same period, possibly by reworking earlier sources and materials. Due to the longue durée approach of the present article, we offer date estimates only where deemed particularly important.

9. While dating these diverse structures precisely can be challenging, at least some of the Sri Lankan examples can be traced back to what *Davis* (2013, pp. 77–94) calls the "Early Mediaeval" period (600–1200 CE). They are associated with monastic complexes of the Pavvata Vihara and Padhanaghara Parivena types. For further information on the extant structures, see *Kulatunge* (2019). *Kieschnick* (2013) and *Heirman and Torck* (2012) represent valuable introductions to this subject.

11. The bathhouse is the second building from the bottom in the depiction presented in *Heirman and Torck* (2012, p. 39).
12 See for example the following remarks: "When advocating bathing, Indian monastic texts tend to stress its importance in relation to health, hygiene, cleanliness, decorum, seniority and the danger of sexual attraction. However, these various motives for washing are discrete and not necessarily linked to one another. For instance, bathing is said to aid in the treatment of health problems resulting from such factors as summer heat and overeating, and it is strongly recommended as a means to remove dirt and sweat. But these two benefits of bathing are not causally connected. Dirt is rarely viewed as an unhygienic substance. Instead, it is usually abhorred because it contributes to a loss of dignity. The texts advise that nakedness and any kind of shame should be avoided for a similar reason", Heirman and Torck (2012, p. 46).

13 (Kieschnick 2013). 增壹阿含經》卷28(36 聽法品):「爾時,世尊告諸比丘:「造作浴室有五功德。云何為五?一者除風,二者[1]病得差,三者除去塵垢,四者身體輕便,五者得肥白。是謂,比丘!造作浴室有此五功德。是故,諸比丘!若有四部之衆欲求此五功德者,當求方便,造立浴室。如是,諸比丘!當作是學。」」(CBETA 2024.R1, T02, no. 125, p. 703a3-8) "Five virtues accrue from making bathhouses. What are these five? First, bathhouses allow one to extirpate "wind"; second, they cure illness; third, they remove dust and grime; fourth, they make the body feel light and easy; fifth, they make one soft and white. These, bhikkhus, are the five virtues of the bathhouse. For these reasons, bhikkhus, if any among the four assemblies [monks, nuns, laymen and laywomen] wish to obtain these five virtues, they should take the necessary measures and build bathhouses. This, bhikkhus, is what you should do" (Kieschnick 2013, p. 151).

14 The traditional ascription to An Shigao should probably be revised. The third and fourth century CE appear more likely estimates of a first composition of this text.

15 See Salguero (2017, p. 84ff.) 佛說温室洗浴衆僧經》:「「佛告耆域:『澡浴之法,當用七物,除去七病,得七福報。何謂七物?一者、然火;二者、淨水;三者、澡豆;四者、[1]蘇膏;五者、淳灰;六者、楊枝;七者、内衣。此是澡浴之法。何謂除[2]去七病?一者、四大安隱;二者、除風病;三者、除濕痺;四者、除寒水;五者、除熱氣;六者、除垢穢;七者、身體輕便,眼目精明。是為除[*]去衆僧七病。」(CBETA 2024.R1, T16, no. 701, pp. 802c28–803a6) "[...] Such is the method of bathing. And what are the seven illnesses that are removed? 1. The Four Great Elements will be in equilibrium. 2. Wind Disease is removed. 3. Damp Paralysis is removed. 4. Piercing Cold is removed. 5. Feverish Qi is removed. 6. Impurities are removed. 7. The body [becomes] light and at ease, and the eyes sharp and bright. Such is the removal of the Sangha’s seven illnesses. From making such a donation, you will accrue seven merits".

16 復更為說，此澡浴者不為餘緣，但欲令除身中風冷病，得安隱行道故洗。是名浴室中上座所作法用。」(CBETA 2024.R1, T24, no. 1463, p. 835a15-b11)， translated in Kieschnick (2013).

17 Wind illness can also be caused by many other factors, including diet.

18 (Sik 2016, p. 123). 或從風起苦,衆生覺知,或從痰起,或從涎唾起,或等分起,或自害,或他害,或因節氣。彼自害者,或拔髮、或拔鬚,或常立舉手,或蹲地,或臥灰土中,或臥棘刺上,或臥杵上、或板上,或牛屎塗地而臥其上,或臥水中,或日三洗浴,或一足而立,身隨日轉。如是衆苦精勤有行,尸婆!是名自害。他害者,或為他手石、刀、杖等,種種害身,是名他害。尸婆!若復時節所害,冬則大寒,春則大熱,夏寒暑俱,是名節氣所害。(CBETA 2024. T 99.252c22-253a2). "[...] it is very cold in winter, very hot in spring, [and] both cold as well as hot in summer—this is called being harmed by seasonal change". For more passages mentioning the eight causes, see Vetter (1988, p. 91) and Zysk ([1991] 2010, p. 30).

19 I am referring to Prajñā's version of the Gaṇḍavyūha (T293), who was active during the Tang dynasty. The Borobudur panels relate to the Bhadhracarīpranidhāṇa section.

20 Salguero (2017, p. 98). The passage in question is translated by William Giddings.

21 Heirman and Torck (2012, pp. 28–29) "The vinaya further warns that people become ill and develop blisters (pao fei 痢) as a result of prickly heat during the hottest time of the year (the last forty-five days of spring and the first month of summer)". On this, see the following source: 《四分律》卷16:「爾時諸比丘,盛熱時身體[31]疱[32]瘡出,[33]污垢臭穢,畏慎不敢洗浴,恐犯過半月洗浴。諸比丘白佛,佛言:「聽諸[34]病比丘熱時數數洗浴。自今已去應如是說戒:若比丘半月應洗浴,除餘時,若過,波逸提。餘時者,熱時。」如是世尊與比丘結戒。」(CBETA 2024.R1, T22, no. 1428, p. 674c5-11).

22 夫論洗浴之法,西國乃與東夏不同,但以時節調和稍異餘處。於十二月花果恒有,不識冰雪薄有微霜,雖復多暑亦非苦熱。熱則身無[13]痺子,寒乃足無皴裂,為此人多洗沐體尚清淨,每於日日之中不洗不食。又復所在之處極饒池水,時人皆以穿池為福。若行一驛,則望見三二十所,或寬一畝五畝。於其四邊種多羅樹,高四五十尺。池乃皆承雨水,湛若清江。[...]那爛陀寺有十餘所大池,每至晨時寺鳴[14]健稚令僧徒洗浴,人皆自持浴裙,或千或百俱出寺外,散向諸池各為澡浴。(CBETA 2024.R1, T54, no. 2125, pp. 220c04–221a6), translation by Rongxi Li (2000, pp. 102–3).

See also the following passage by Yijing on the topic of bathing. 《南海寄歸內法傳》卷3:「又洗浴者並須飢時。浴已方食,有其二益:一則身體清虛無諸垢穢,二則痰癢消散能減飲食。飽[1]方洗浴,醫明所諱。故知飢沐飽浴之言,未是通方之論。」(CB ETA 2023.Q1, T54, no. 2125, pp. 220c28–221a2)

《南海寄歸內法傳》卷3:「若著三尺浴衣,褊小形露;或元不著,赤體而浴者,深乖教理也。應用四幅洗裙,遮身可愛,非直奉遵聖教,亦乃不愧人神。餘之可不,智者當悉。夜浴尚不改容,對人寧無掩蔽耳。」(CBETA 2023.Q1, T54, no. 2125, p. 221a2-6) "Furthermore, one should take a bath before eating food. There are two benefits derived from eating food after taking a bath. First, the body is pure and empty, without any dirt. Second, one will have a good appetite, as one's phlegm and mental depression are dissolved after taking a bath. Bathing after taking a square meal is forbidden by the science of medicine. Thus we may know that
the saying about "washing one's hair when one is hungry and taking a bath with a full stomach is not the opinion of an all-round scholar", Rongxi Li (2000, p. 104).

23 Salguero (2017, 2022) represents a welcome exception.

24 See the photographic documentation here: https://ccdl.claremont.edu/digital/collection/p15831coll15/id/672/rec/40 (accessed on 1 August 2024).

25 For online photographic resources on architectural finds, see https://ccdl.claremont.edu/digital/collection/p15831coll15/id/750/rec/49 (accessed on 1st August 2024).

26 Paranavitana (Paranavitana 1970–2015, V.3, p. 39).

27 The complexities of dating cannot be tackled here. For a summary, see Abeywardana et al. (2018, p. 7). This work also discusses pre-1400 water management structures on the island and includes a section on epigraphic sources.

28 See also *kāvya* works from Sri Lanka presented in Biedermann and Strathern (2017).

29 E.g., the Naga Pokuna of Mihintale.

30 Inscriptions K323 and K528 are quoted in Lustig and Lustig (2015, p. 28).

31 On the transregional mythology of Anavatapta lake, see Gao (2020).

32 《治禪病秘要法》卷1：「「治之法者，先服肥腻世間[A3]美藥，然後仰眠，數息令定，想阿耨達池其水盈滿，滿一由旬，底有金沙、四寶、金輪，生黃金華大如車輪。花中有四寶——獸頭象鼻出水、師子口出水、馬口出水、牛口出水——繞池七匝，阿耨達龍王七寶宮殿在四獸頭間。」(CBETA 2024.R1, T15, no. 620, p. 335b2-7) [A3]美【CB】【麗-CB】，美【大】(cf. K19n0744_p0689b04)

"[1.6] [The Method for Curing Blockage] [1.6.1] [The Arising of Blockage] Further, Śāriputra, if a forest-dwelling monk employs his mind [in meditation] with too much tension, is too rough with his breathing, or sleeps in too Spartan conditions, he will, owing to external winds, become afflicted by cold. As a result, his stomach tube and spleen and kidney channels will become agitated, and wind will stir within his tendons. A reverse qi (逆氣) will stagnate in his chest. All his joints will leak water, which will accumulate in his chest. His blood will roil (激血), his qi will erupt (氣發), his head will ache, his back will swell (背滿), and all his tendons will seize up. This must be treated quickly.

[1.6.2] [The Waters of Anavatapta] The method for curing it is as follows. First, the practitioner must take excellent, nourishing worldly medicine. He should then lie down on his back, count his breaths, and settle himself. He should then imagine Lake Anavatapta [...]". Translated in Greene (2021, p. 261). Chinese text reported here only for paragraph [1.6.2].

33 Maxwell (2007, [ed.]), Stanza 170:
yasyāntare tīrthajalaikaśi- /
khātābhirāmaṃ pulinaṃ parārddham //
saṃsparśināṃ kṣalitapāpapaṅkaṃ /
vahitrabhūtan taraṇaṃ bhavāvdheḥ //

34 On Phnom Kulen in general, see for example Jean-Baptiste Cheavance et al. (2019).

35 See the digitised epigraph at https://siddham.network/inscription/k368/ (accessed on 1 August 2024).

36 For plans of these structures, see Dagens (1991).

37 Harris (2007, p. 66)国人常有病,多是入水浸浴及频频洗头,便自痊可。然多病癩者,比比道途间。土人虽与之同卧同食亦不校。或谓彼中风土有此疾,曾有国主患此疾,故人不之嫌。以愚意观之,往往好色之馀,便入水澡洗,故成此疾。闻土人色欲才毕,皆入水澡洗。其患痢者十死八九,亦有货药于市者,与中国不类,不知其为何物。更有一等师巫之属,与人行持,尤可笑。

38 See Degroot (2008) for a short survey of bathing places. On water symbolism see also Patt (1979).

39 I thank Marijke Klokke and Eko Bastiawan for suggesting various places of interest.

40 Robson and Sidomulyo (2021, pp. 94–95), Kieven (2013, p. 115).

41 I should also point out the existence of a twelfth-century bathtub or sarcophagus kept in the Kediri Museum of Eastern Java (Acri 2024, p. 3 [with photograph]). It is unclear what purpose it actually served, but ritual ablutions or consecrations with water cannot be excluded. Although the medicinal aspect is not explicit, they may be compared to the structures from Sri Lanka mentioned above. Other such bathtubs can be found in East Java and at the National Museum in Jakarta.

42 Śiwarātrikalpa, Teeuw et al. (1969, p. 79). In transliterating Old Javanese words, I retain the w of the original transliteration system, also opting for ě over ō and for ng over ſi.

43 Worsley et al. (2013, p. 227):
narendramahiṣī lawan sang Aja madyus akaramas aśokapādapa
paḍēṇjuḥ akase wěrěh harěp ing endah araras awěḍak-wěḍak lumut
“The queen and King Aja bathed and washed their hair with aśoka leaves. Excitedly they used the foam as unguent and the moss as powder, desiring to make themselves lovely”.
(Sumanasāntaka 164.4.)

44 Robson (2008, p. 127):
bañu ning śatatīrtha pinupulakèn ing ghata hīra pitu
rasapinda rasāyana sakalawajadrava sapta ghata
amrtântuk ing anglwangi śaśadhara pūrna pitung kalaśa
salikur manikumbha saha widhi samāhita pangdyus ira

"The water of a hundred holy bathing-places collected in seven diamond pots, Seven pots of rasapinda, rasāyana and every kind of wajadrawa, Seven jars of nectar obtained by distilling the full moon, And twenty-one jewelled pitchers with the prescribed rites were assembled to bathe him". (Arjunawiwāha 29.6.)

45 Dr. Jiří Jákl has informed me that doṣas were known in Java, even if their conception was highly localised (personal communication June 2024). I would also like to alert the reader to a forthcoming publication co-edited by Andrea Acri, Francesco Bianchini and Jiří Jákl on the topic of medicine and healing in pre-1400 CE Java and Bali. The chapter is due to appear in a volume published by Brill.

46 West (2021, 161). The text is the fifteenth-century *Bujangga Manik*.

47 Apsu deva-pavitrāṇi, Gaṅgā-devi namo 'stu te sarva-kleśa-vināśanaṃ, toyena pariśudhyate / Sarva-pāpa-vināśini, sarva-roga-vimocane sarva-kleśa-vināśanaṃ, sarva-bhogam avāpnuyāt //

"Goddess Gaṅgā, honour be to Thee; [by Thee] destruction of all stains, one is completely cleansed by [Thy] water. O Thou Who destroyest all evil. Who redeemest from all disease; [by Thee] destruction of all stains, one obtains all kinds of enjoyment". Goudriaan and Hooykaas (1971, Ganga Hymn)

48 See the anthropological documentary *Breaking the Chains* directed by Erminia Colucci (Royal Anthropological Films).

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