The Buddha Medicine
By Bhikkhu U. Dhammajiva
Edited by: Swedish novice Dhammasami (Samuel Nordius)

"Glad at heart, I pay homage to the supreme sage- the giver of blissful peace, the grate ocean of virtue, the physician for the samsaric ills of beings, the sun that dispel the pitchy darkness of false views!" – Lo-wáda Sangarava, 15th century Sinhalese poem

In Burmese meditation-centers, as in monasteries in most Theravada-Buddhist countries, you often find a peculiar kind of medicine: Yellow Myrobalan nuts (in Pali: Hritaki, in Latin: Terminalia Chebula) pickled in cow’s urine. The Burmese people calls it Pheya-se, ‘The Buddha Medicine’, since it’s based on a recipe found in the oldest Buddhist texts, the Pali Tipitaka. It’s considered to be a panacea for many diseases. But does it really follow the original concept of the Buddha’s recommendation to use muttam (urine) as medicine? That is what I intend to clarify in this article by refering to four of the oldest Buddhist scriptures: 1.) The Vinaya-Pitaka, the ancient collection of Buddhist monastic rules. 2.) The Sutta Pitaka, the ancient collection of the Buddha’s discourses. 3.) The so-called ‘Commentary’ and ‘Sub-commentary’, texts written by bhikkhus (Buddhist monks) in the centuries following the Buddha’s death to clarify the meaning of the texts found in the two collections first mentioned.

In an English translation of the Mahakkhandhaka (a text in Mahavagga found in the Vinaya-Pitaka) the Buddha says:

"The religious life has decomposing urine as medicine for its resource.
Thus you must endeavor to live all your life. Ghee, butter, oil, honey, and molasses are extra allowances. "

An alternative translation says; 

"Going forth [into the Holy Life] has fermented urine as its support. For the rest of your life you are to endeavor at that. The extra allowances are; Ghee, fresh butter, oil, honey, sugar. "

There are four such necessary supports/resources listed in the Vinaya Pitaka. In Pali, the language of the oldest Buddhist texts, they are called "the Four Requisites", considered to be an absolute minimum for the bhikkhus to be able to live the Holy Life in line with the Buddha’s teaching. The above mentioned item, fermented urine, is the fourth of these resources. All the four must be taught to the newly ordained bhikkhu in the ordination hall immediately after his higher ordination ceremony. It’s the responsibility of the preceptor to make sure that all young bhikkhus knows them according to the following prescription of the Buddha. 

"I prescribe, O bhikkhus, that he who confers the higher ordination (on a bhikkhu), tells him the four resources."

These are all the four resources listed in the Vinaya-Pitaka:

1. Robes: robes made of rags taken from a dust heap as a resource
2. Alms food: morsels of food given in alms as a resource
3. Dwellings: a dwelling at the foot of a tree as a resource
4. Medicines: decomposing urine as medicine as a resource

These four requisites/resources the Buddha described as being indispensable or the bare minimum. Accordingly a Buddhist monk must endeavor to live all his bhikkhu life dependent only on them. He who is contented and satisfied with whatever comes across along with these bare minimums is always phrased in the community, as well as in the Commentary, as having contentment with whatever four requisites he has. Whatever extra things he comes across beyond these four items is just a result of his past good deeds, but they are usually also allowed for the bhikkhus. As the founder of the Order, and therefore its first bhikkhu, the Buddha assured all the bhikkhus that the prescribed bare minimums are quite abundant. Besides, they were, at that time, free to find wherever a bhikkhu would go.

In the Vinaya Pitaka, the books of monastic discipline, this medicine (urine) is mentioned in several places. At one occasion, for example, the Buddha recommend the yellow Myrobalan fruits pickled in urine for a monk who was sick with jaundice (probably anaemia) to be taken orally:

"O, monks! I allow that urine and yellow Myrobalan be drunk."

At another occasion the Buddha included urine as an ingredient in a mixture to be used as an antidote for poisonous snake bites. The other ingredients are excrement, soil and hot ash. This quote is from the Vinaya Pitaka:

"For snake bite a medicine may be made of the four great filthy things: excrement, urine, ash and clay. If there is someone present to make these things allowable, one should have him/her make them allowable. If not, one may take them for oneself and consume them."

The Commentary adds that this medicine is not only for snake bites but also for any other poisonous animal bite.

Now, let’s have a look at the second ancient collection of Buddhist texts, the Sutta Pitaka. According to the Ariyavaüsa Sutta in Anguttara Nikaya the Buddha phrases four requisites of noble clans (or lineages of traditions) in nine terms:

"Bhikkhus, these four [requisites] belong to the noble clan, were recognized by those gone by, were honored from the past, recognized by the clan, was not confusing in the past and will not confuse in the future and are not blamed by recluses, brahmins and the wise. What four?" The following four items are then listed:

1. Robes 
2. Alms foods, 
3. Dwellings and 
4 . (delight in development of) Meditation.

In the two different lists so far mentioned the first one (quoted from the Vinaya Pitaka) says that the four requisites for a monk are 1. robes, 2. alms foods, 3. dwellings and 3. medicines. In the second list (which is quoted from the Sutta Pitaka) the first three are identical to the first list while the forth item in the first list, medicines, has been replaced by (delight in development of) meditation.

The Commentary to the Ariyavaüsa Sutta says that even though the list, as it appeares in the Sutta Pitaka, drops the forth item given in the Vinaya Pitaka (medicines) that item should be included in the second item of the Sutta (alms food). Furthermore, confirming the same idea, the forth item, (delight in development of) meditation, is specified as "contentment with whatever four requisites comes" in the same Commentary. It says:

"Among these four belonging to the Noble clan the first three items, inclusive of thirteen austerities, are elaborated in the Vinaya pitaka while the item of (delight in development of) meditation is elaborated in the rest of the two baskets (pitakas or collections of Buddhist texts)."

To summarize, in the Sutta Pitaka you find only the first three of these four requisites, with no urine or medicines mentioned, but the Commentary says that the forth should be included in the list, in the alms food so that all should be in completion to make delight in development of meditation possible.

Hence decomposing urine as medicine can claim for all the above mentioned attributes, that is: urine was "recognized as a medicine by those gone by, those honored from the past; that it was recognized by the clan; it was not confusing in the past and it will not confuse in the future; and it’s not blamed by recluses, Brahmins and the wise."

I would like to quote another translation of the same Sutta which goes as follows:

"O monks, these four noble lineages pristine [including decomposing urine as medicine], of long standing, traditional, ancient, unadulterated and never before adulterated, which are not being adulterated and which will not be adulterated, not despised by wise ascetics and Brahmins."

The authors of this translation added a footnote saying that in ancient Sri Lanka this was a very popular Buddhist discourse among people of all walks of life and that it became the inspiration for an annual festival. In traditional Sinhalese translations, as in Burmese and Thai ones, the medicine mentioned in the text has been taken to be cow’s urine or, more specifically, Myrobalan fruits pickled in cow’s urine. Owing to this translation some of the attributions of this medicine mentioned by the Buddha doesn’t appeared to be very convincing or practical since it would sometimes be hard for a bhikkhu to find both the Myrobalan fruit and cow’s urine. However, in recent English translations we get some new practical sense to this medicine.

Let me add here that it’s not only in Buddhism that we find urine as a medicine but also in other denominations such as Christianity (in The Holy Bible), Hinduism (in Damar Tantra) and, some claims, in Islam too (in The Holy Koran). These traditions, however, have a somewhat different interpretation than the Buddhist texts on how to use the medicine.

I can think of two reasons for why the usage of urine as medicine resurfaced again contemporaneously in many traditions in our time. The first is the increasing number of complications in the prevailing allopathic or chemotherapeutic treatments of diseases which has made an increasing number of people interested in alternative medicines. The second is the general trend of searching for more holistic health systems, even ancient ones based on different religious lines. Whatever the reasons may be the urine-method has its own intriguing nature and might, I believe, still find a growing group of followers.

A closer look at this therapy, under the current trend, irrespective of creed, one finds a vast number of convincing testimonies and subjective evidences on the benefits of the medicine. Buddhism can contribute in its own way with its canonical and historical references on this subject – provided that its ideas are presented in correct translations! So far we’ve traced some quotations from the Vinaya Pitaka with relevant information prescribed to bhikkhus. However, I think that the commentarial text has interfered in a questionable and imperfect manner. In the traditional Buddhist countries, such as Sri Lanka, Burma or Thailand, no efforts have been made in resent history to get a clear idea of how the medicine was intended to be used, or how it was used at the time of the Buddha.

The increasing amount of literature on the subject, with testimonies and evidences from the other sources, made me think twice and urged me to renew the way I read the quoted passages in the Buddhist canonical sources. I went back to the original scriptures, untouched by the prevalent traditional translations. When investigating the Sutta Pitaka with this inquisitive pragmatic approach I came across the following quotation in the Majjima Nikaya (the Middle Length Discourses of the Buddha), Sutta number 46 called Dhamma Samadana Sutta:

"Bhikkhu, a man would come along suffering from jaundice and he is told: ‘Friend, there is a drink made out of putrid urine, with various kinds of medicines put in it. If you desire – drink.’ When drinking it would not be agreeable to sight, smell or taste but drinking it you will get over your illness. He reflects about it and drinks it. It would not be agreeable to sight, smell or taste, yet he would get over that illness. I say this observance of the Teaching is comparable to this, as it is now unpleasant and brings pleasant results in the future."

The Commentary to this Sutta says: 

"[The Pali word] Putimuttan means just ‘urine’. So it’s said, that even if a person is golden in color his body is described as repulsive in the scriptures. Even? born the very same day the vine called Galocilata is also called Patilata (literary: repulsive creeper). Even so, extracted in that very moment, the young (or fresh) urine is called just puti (usually translated as ‘putrid’ or ‘fermented’)."

The Sub-commentary continues to explain: 

"[The Pali word] Putimuttan means urine which is repulsive in nature. Tarunan means fresh or young; as it flows out it is warm?. From that urine the early part of the flow is meant here. The urine flowing out from the genital? remains warm due to the body temperature."

These details indicate that the prevailing translations of the Vinaya Pitaka might be incorrect. The Commentary and Sub-commentary leads us to a more practical and pragmatic end, supported by the direct translation of the Dhamma Samadana Sutta. Yet they’re often interpreted as meaning only putrid urine from a cow.

Just by consulting the relevant Commentary and its Sub-commentary all doubts regarding the real meaning can be cleared out. They state that urine – to be specific: one’s own urine – would not be agreeable to sight, smell or taste and accordingly has puti as an adjectival prefix. It is puti not because it is rotten or fermented but because its intrinsic nature is repulsive to the senses. If the common translations are changed in line with this interpretation the basic idea of using urine as a medicine becomes more palatable and, not to diminish, quite agreeable with the current research and literature on the subject.

It’s also interesting to note that the medicine mentioned in the Dhamma Samadana Sutta (one’s own urine mixed up with other herbal medicine) is recommended to any individual who’s suffering from jaundice rather than to a just to the bhikkhus as is otherwise the case in the Vinaya Pitaka. This tells that the medicine was not seen as just a ‘last choice’ but as a truly effective remedy.

Conclusive remarks

In the light of this information we should look again at the very first quotation in this essay. The main theme so far is that repulsive urine as medicine, which is the last of the four requisites for bhikkhus, is considered to be the absolute minimum of medicine that a bhikkhu will need through out his life.
 
The Pali term Putimuttabhesajja is a compounded term made out of at least three pali roots; puti, mutta and bhesajja. As we’ve already seen this word has been translated as:

1.) Decomposing urine as medicine. Or as: 2.) Fermented urine as support.

The word puti literally means either decomposing or fermented, sometimes translated as rancid or putrefied. Muttam means urine, sometimes translated as cows’ urine, and occasionally as ammonia. Bhesajjam means medicine.

In the Vinaya Pitaka, whether with the consultation of its Commentary or not, there is little chance to find out what kind of urine is meant because neither the Vinaya nor its Commentary adds any further light on the subject. In the Sutta Pitaka, on the other hand, especially in MN. Sutta No 46 and its relevant Commentary and Sub-commentary, there’s enough evidence to suggest a more pragmatic meaning than that commonly accepted today. "It would not be agreeable to sight, smell or taste" suggests that the adjective putidoes not mean any decomposition, fermentation or putrefaction but that urine is naturally disagreeable to sight, smell or taste – a statement most people would agree with. The original recommendation may not have meant any decomposition, fermentation or putrefaction at all, as the translators’ has interpreted it so far. Nor do the scriptures in any way indicate that it was cow’s urine that the Buddha originally referred to.

The Sub-commentary says:
"As urine pass out from the genital it is warm due to the body heat". There is not a word or clue justifying the assumption that cows’ urine is meant.

The interpretation I prefer, on the other hand, is quite in line with the Commentary and the Sub-commentary to the above mentioned Sutta and with the contemporary idea of using one’s own urine. Hence the translation to the first quotations could be rectified as follows:

"The religious life has your own (repulsive) urine as medicine for its resource. Thus you must endeavor to live all your life. Ghee, butter, oil, honey, and molasses are extra allowances."

Or: "Going forth [into the Holy Life] has your own (repulsive) urine as its support. For the rest of your life you are to endeavor at that. The extra allowances are; Ghee, fresh butter, oil, honey, sugar."

Likewise, all other quotations could be corrected accordingly. This should give a radical new approach to the prescription given by the Buddha. It certainly does give a new hope for a healthier lifestyle – not only for the bhikkhus but for all who seek to live a more independent kind of life.