A Lecture on the theme of Illness

Antiochus and Stratonice

I first came across this story from the vinaya (Vin i.301) and Sangharakshita's book A Guide to the Buddhist Path, and then later a fuller version in his talk: "A Case of Dysentery". I've always found it extremely moving. This is no allegory, and it is not ambiguous. Quite simply the Buddha requires that members of his community care for each other, most especially when they are ill. To not do so is a wrongdoing (dukkaṭa) - wrongdoing here is quite a literal translation. The text speaks for itself, so rather than saying much more, I'll simply give you my translation and add one or two comments at the end. 

The Pāli title of this passage is Gilāna-vatthu-kathā 'A lecture on the theme of illness', hence my title.

Lecture on the Theme of Illness

Once there was a monk who was afflicted with dysentery. He lay on the ground covered in his own shit and piss. The Lord was out on walkabout with Ānanda as his sidekick, when he approached the dwelling of that monk. He saw the monk lying in his own filth and went up to him.

"Monk", he asked, "what is wrong with you".

"I have dysentery Lord".

"Is there no one to care for you?"

"There is not Lord."

"But why not?"

"I don't do anything for the other monks, so they do not care for me," he told the Lord.

Then the Lord asked Ānanda to go and fetch some water so they could bathe the monk. Ānanda agreed and soon returned with water. The Lord sprinkled water over the monk, and Ānanda washed him. Then, with the Lord at his head and Ananda at his feet, they lifted him up and put him to bed.

Then the Lord called the monks together and questioned them.

"Monks", he asked, "is there a sick monk in that dwelling there?"

"There is Lord" they replied.

"And what illness does he suffer from?" asked the Lord.

"He has dysentery, Sir."

"Is there no want to care for him?"

"No, Sir."

"Why is that?"

"Well, he is useless, Sir. He does nothing for us, so we don't care for him", the monks explained.

"Monks," said the Lord, "you have no mother and no father to care for you. If you don't care for each other, then who will care for you? If you would care for me, then tend to the sick."

He went on to say: "If a preceptor is present then they should care for you until you are well, and remain with you until you are on your feet again. Or if an instructor is present; or a fellow practitioner; or a pupil; or someone with the same preceptor, or the same instructor, they should care for you until you are well and remain with you until you are on your feet again. If none of these are present then you should be cared for by the community. If you are not cared for it is an offence of wrongdoing."

My translation is a mix this time - at times I go for modern idiom, at times I'm more conservative. The Pāli is not very fancy, and only gives the bare bones. I've tried not to elaborate on it too much, though I think it could stand a dramatic retelling.

The passage continues on to describe the ideal kind of patient and the ideal kind of nurse. There is a full translation on the Access to Insight website. Bhikkhu Thanissaro his chosen to entitle the passage in Pāli Kucchivikara-vatthu (lit 'on the theme of dysentery') and in English 'The Monk with Dysentery'. In his reference to this text Ven. Thanissaro has "Mv [i.e. Mahāvagga] 8.26.1-8; PTS: Horner vol. 4, pp. 431-34" - normally the abbreviation PTS points to the Pali Text Society's Pāli version, but in this case it refers to the Miss Horner's English translation (which mixed up the order of the texts making Mv vol 4.). The correct citation should be: PTS Vin i.301.

One small point to make here is that though there is a clear ecclesiastical hierarchy in the milieu of the Vinaya, no one is exempted from caring by their status within that hierarchy. You may be a preceptor or an instructor, but you are no less responsible for caring for the members of the spiritual community than the juniors. Perhaps we may say that the preceptor or instructor has a greater responsibility, because not only must they participate in caring, they must set an example for the others. The great danger of more senior members of the spiritual community being seen not upholding the values and virtues of the community, is that it can be used as a rationalisation for laziness, or otherwise ignoble behaviour on the part of others. Of course there is no excuse for ignoble behaviour, but we are apt to find rationalisations.

Sangharakshita gave a talk on this passage in 1982 as part of a series on incidents from the Pāli Canon. It's available from freebuddhistaudio.com: A Case of Dysentry [sic]. There is also an edited transcript of the talk (with correctly spelt title). An extract from this talk forms the section entitled 'Unfailing Mutual Kindness' in Sangharakshita's excellent introduction to Buddhism: A Guide to the Buddhist Path, p.121f. Note that Sangharakshita relied on the translations from 'Some Sayings of the Buddha', translated by F.L. Woodward (Buddhist Society, London, 1973), which now seem very dated.