Buddhism and Medicine in Japan
Authors: Triplett Katja 
Published: August 2021

Buddhist institutions were first established in the Japanese archipelago in the 6th century ce. In the same period, the ruling families incorporated Chinese-style medicine and Daoist ritual healing techniques into Japanese culture and society. By the 8th century, Buddhism had become a dominant cultural force in Japan. The Japanese Buddhist textual tradition was shaped by translations from Sanskrit into classical Chinese, and Chinese texts remained paramount for all branches of scholarship. In the ensuing centuries, a rich and hybrid ritual, material, and intellectual culture emerged from combining these various religious and scholarly traditions, as well as elements of the local tradition of kami神 (gods) worship. This also resulted in a distinct tradition of Buddhist medicine, which blossomed in the Kamakura period (1185–1333). The esoteric (or tantric) tradition of Mahāyāna Buddhism with its idea of mutual empowerment (kaji加持) and unification of the ritualist and a buddha, bodhisattva, or other Buddhist deity, directing their power to heal, protect, etc., was the prevailing paradigm. Other traditions developed over the course of the centuries, too, notably Pure Land, Nichiren, and Zen Buddhism, and the vinaya restoration movement (Shingon Ritsu). These also had an impact on the ideas and practices of healing and medical care. All shared the aim of providing the means for salvation and ultimate liberation from sickness and suffering.

Lay patrons in early and medieval Japan funded the construction of hospitals and other care facilities as well as medicinal gardens. The Japanese monastics who studied the classical Chinese medical texts and treated their patients following the ideal of the compassionate bodhisattva were also familiar with basic ideas from Indian Āyurveda from translated sutras and commentaries. As such, etiology and diagnosis in the Japanese Buddhist context included epistemic and cosmological thought from both China and India.

In the Buddhist context, rituals such as elaborate fire-offering ceremonies (goma護摩) were commonly used to take care of patients of all ages. Buddhist treatments also included empowered medicines, acupuncture, and moxibustion. Buddhist priests provided palliative care, and deathbed rituals were conducted to protect the dying from evil forces and prepare them spiritually for a good death and future birth. Buddhist medical practitioners not only included monastic doctors, usually called sōi僧医 in modern literature, but also various kinds of exorcists and healers. These groups produced talismans and amulets, and offered protective rituals within the paradigmatic framework of Japanese Buddhism. Pilgrimage to sacred sites at Buddhist temples provided a way for monastics and lay people to find healing and support. The external treatment of afflictions often went hand in hand with internal, mental, or cognitive methods such as various forms of meditation. These methods were primarily practiced by the monastically trained, but some, such as naikan内観, “internal observation,” were practiced by a wider circle of practitioners. Buddhistic methods were also used to treat animals.