Tetsunori Koizumi, Director
The Middle Path appears in the first discourse the Buddha delivered to the five bhikkhus in Benares after reaching enlightenment. In this discourse the Buddha told the five bhikkhus, with whom he used to train together in search of enlightenment, that the kind of extreme self-mortification practiced by them would not lead to salvation. The message the Buddha conveyed to them was that a middle path of avoiding the two extremes of self-indulgence on the one hand and self-mortification on the other is the path that leads to peace of mind, to wisdom, to enlightenment.
What is noteworthy is that the Middle Path of avoiding the two extremes of self-indulgence and self-mortification contains a holistic conception of health when interpreted in the context of the Buddha’s overall systems view of the world. In fact, the concept of health implied by the Middle Path can be interpreted as the state of “systemic balance” at the three levels of human existence—operational balance at the level of the human body as an aggregate of digestive, immune and other physiological systems, “organizational balance” at the level of the individual human being as a composite system of mental states and physical substances, and “orthogenetic balance” at the level of the global system defined as the space of interaction between humans and natural systems.
While not a physician by trade, the Buddha must have been well versed with the medical theory and practice of his time, judging from the way he presented the Four Noble Truths about the human condition in the world as if he were treating an illness. The Buddha starts off with the first truth about dukkha, or suffering, offering his diagnosis of what is wrong with the world, the fact that the world is full of suffering, including aging, disease, and death. The Buddha next offers his analysis of the cause of this illness of suffering, which, to him, comes from tanha, or craving. Having diagnosed an illness and discovered its cause, the next step for a physician would be to assess whether the illness can be cured. Thus, the Buddha presents his third truth, saying that this illness of suffering can indeed be cured. Finally, the Buddha offers a treatment program for this illness in his fourth truth, which is the Noble Eightfold Path.
The Noble Eightfold Path, which the Buddha presented as a concrete treatment program for the illness of suffering, spells out what the Middle Path means. To avoid the two extremes of self-indulgence and self-mortification entails, in the first place, that we take good care of our body: “To keep the body in good health is a duty, for otherwise we shall not be able to trim the lamp of wisdom, keep our mind strong and clear.”1 To maintain the body in good health is important, the Buddha tells us, because that is the precondition for keeping the mind strong and clear so that we may see the light of enlightenment. The Buddha, then, goes on to spell out a concrete treatment program consisting of eight principles of right view, right thought, right speech, right action, right livelihood, right effort, right mindfulness and right concentration.
The Noble Eightfold path is indeed a comprehensive program, involving both mental and physical activities, where mental activities are represented by the four principles of right view, right thought, right aspiration and right mindfulness, and physical activities by the four principles of right speech, right behavior, right effort and right livelihood.2 Dividing the eight principles into those which deal with the activities of the mind and those which deal with the activities of the body makes it clear that the Buddha the health scientist was concerned with the overall health of humans, that is, health interpreted holistically as a state of balance between reflection and action, between mind and body, in short, as a sate of systemic balance.
First, health can be defined as a state of “operational balance” in the operation of the human body as a system. To be more specific, the human body is an aggregate of digestive, immune and other physiological systems, which the Buddha was clearly aware of, judging from his detailed analysis of kaya, or body, in Mahasatipatthana Sutta. The Middle Path of maintaining balance between indulgence and mortification means that the human body is kept in good health in the sense of maintaining systemic balance in the operation of the body as a system.
Second, heath can be defined as a state of “organizational balance” in the human person as a composite system of mental states and physical substances. The Buddha had a systems view of man in that he saw man as an organism of many aggregates, consisting of the material form (the body) and the mental states as represented by perception, thought, mental formations and consciousness. Needless to say, we can expand on the Buddha’s conception of man by talking about the human body as an aggregate of cells, tissues, muscles, bones, organs and so on, and the human mind as an aggregate of emotions, feelings, sensations, and thoughts. What is important here is that both mental states and physical substances, both mind and body, must be kept in “systemic balance” in order to ensure the health of the human person as a composite system, as an organization, which is what the Noble Eightfold Path as a concrete embodiment of the Middle Path implies. To keep mental and physical activities in balance is important for our health because there is increasing evidence that our immune system, for example, is affected by our mental states.
Third, health can be defined as a state of “orthogenetic balance” in the natural environment. As the Buddha saw it very clearly, man is an open system in that he is in constant interaction with his environment, engaging in physical interaction with the use of his five senses and spiritual interaction with the use of his consciousness. The environment influences human health in many ways: light, gravity, physical stress such as temperature and noise, and psychological stress such as fear, tension and uncertainty. In turn, man influences the health of the environment through his consumption of food and other materials and production of goods and services from the use of raw materials found in the environment. Indeed, man can cause “stress” on the environment in the form of pollution, ozone deletion and other types of environmental degradation. In view of such mutual influence between the health of man and the health of the environment, it is clear that the holistic notion of health must contain the notion of “environmental health,” which can be represented by the concept of “orthogenetic balance.”
The Buddha presented the Middle Path—and the Noble Eightfold Path—as a concrete program for guiding his disciples and followers to enlightenment. The Noble Eightfold Path, in particular, spells out what the Middle Path entails as far as transforming the Buddha’s message into a concrete program of action. In the form of eight principles, the Noble Eightfold Path shows us how we need to maintain balance between mental and physical activities and between human and natural systems. It may be recalled that conceiving health as a state of balance is the common theme among Eastern philosophies, from Ayurveda to Yin-Yang theory. Coming out of this philosophical tradition of the East, it is not surprising that the Buddha had a notion of health that is holistically conceived in the context of his systems view of the world.
- Carus, Paul, The Gospel of Buddha, Oxford: One World, 1994, p. 51.
- Koizumi, Tetsunori, “The Noble Eightfold Path as a Prescription for Sustainable Living”, in How Much Is Enough? Buddhism, Consumerism, and the Human Environment, edited by Richard K. Payne, Somerville: Wisdom Publications, 2010.