Introduction to medicinal materials used in ancient India

Yi Jing was a monk rather than a doctor or pharmacist. Therefore, he did not systematically introduce the traditional medicinal materials of India and China in Nanhai Jigui Neifa Zhuan at that time; instead, he introduced medicinal materials that may have commonly been used by monks in the region where he lived. These included root of Xanthium strumarium L., Areca catechu L., A Myristica fragrans Houtt., Syringa oblata Lindl., Dipterocarpus turbinatus C.F. Gaertn., Typha angustifolia L., Bombax ceiba L., Senna tora (L.) Roxb., Terminalia chebula Retz., Crocus sativus L., Ferula assa-foetida L., Piper nigrum L., Zingiber officinale Roscoe, Piper longum L., Allium fistulosum L., Nepeta cataria L., ghee, sulphur, realgar, Glycyrrhiza uralensis Fisch. ex-DC., Dichroa febrifuga and Sophora flavescens Aiton [36].

Among the commonly used medicinal materials introduced by Yi Jing, we have identified numerous components that were also utilised in ancient Chinese medicine, including root of Xanthium strumarium L., Senna tora (L.) Roxb. Zingiber officinale Roscoe, Nepeta cataria L., sulphur, realgar, Glycyrrhiza uralensis Fisch. ex-DC., Dichroa febrifuga and Sophora flavescens Aiton. However, despite the prominent role of Glycyrrhiza uralensis Fisch. ex-DC. in ancient Chinese medicine, it is not commonly found in ancient or modern Indian medicine. Its prominence in ancient China may be attributed to Yi Jing’s frequent use of this herb in treating local residents during his travels, prompting him to specifically mention it in his works. On the other hand, there are numerous similarities between the common Ayurvedic drugs in modern India and the medicinal herbs utilised at ancient Indian religious sites. For instance, spices such as p A Myristica fragrans Houtt., Terminalia chebula Retz., Piper nigrum L. and Piper longum L. have widespread applications in India. Notably, India is the original habitat of herbs such as Piper nigrum L. and Piper longum L., making them integral components of Ayurvedic medicine since ancient times [37].

The functions and therapeutic strategies of ancient Indian medicinal materials are introduced

Volume 3, Sect. 28 of Nanhai Gigui Neifa Zhuan states, it is very rare that there are three medicines that can cure all diseases. It recommends an equal division of the peel of Harītakī (which is generally considered to be Terminalia chebula Retz.), the drier tuber of Zingiber officinale Roscoe and granulated sugar. The peel of Harītakī and Zingiber officinale Roscoe was to be crushed, a small amount of water was to be mixed with granulated sugar, and the resulting mixture was to be made into pills. Patients were recommended to take more than ten of these pills per day without any contraindications. Patients with dysentery were to take 2–3 doses. These pills could break Qi, remove wind and eliminate food to treat a variety of diseases. If there was no granulated sugar, molasses could be used. If one could chew the juice of Harītakī every day and swallow it, they would be free from disease for life. During the Tang Dynasty, Terminalia chebula Retz., Terminalia billerica (Gaertn.) Roxb. and Phyllanthus emblica L. were collectively referred to as triphala [38]; they were the most commonly used combination drugs in traditional Indian medicine. However, Yi Jing does not mention triphala in Nanhai Jigui Neifa Zhuan, possibly because the place where he lived was not suitable for the growth of these three medicines. During the Song Dynasty, with the spread of Buddhism and wider use of Indian medicine in China, Aquilaria sinensis (Lour.) Spreng. and Terminalia chebula Retz. were commonly used individually. Prescriptions such as Renshenlurong pills and Chenxianglurong pills can also be found in Taiping Shenghui Prescription [21].

The root of Xanthium strumarium L. had the effects of strengthening the teeth, eliminating oral malodour and improving digestion. Its use for two weeks could help eliminate oral malodour. A toothache would heal after three months of use. Generally, mineral medicines such as sulphur and realgar were used to detoxify bites from snakes and scorpions, so one should carry some sulphur and realgar in their daily life. A person with heatstroke could make a decoction of Glycyrrhiza uralensis Fisch. ex-DC., Dichroa febrifuga and Sophora flavescens Aiton. If a hunger strike did not help, a prescription would be needed to treat the disease. Kushen-soup was a cure for fever. Ghee and honey could remove wind-evil. In ancient India, patients had to go on a hunger strike for two weeks or even a month until they were well enough to eat. Before striking, monks would blend together Areca catechu L., Myristica fragrans Houtt., Syringa oblata Lindl. and Dipterocarpus turbinatus C.F. Gaertn., which were chewed to make the breath fragrant, aid digestion and cure heart disease [39]. These fragrant medicines had to be washed with water from a clean bottle and wrapped in fresh leaves before being given to the monks.

Storage and processing of ancient Indian medicinal materials are introduced

Yi Jing also discussed storing, purifying and processing medicinal materials in Nanhai Jigui Neifa Zhuan to heighten their therapeutic effect. All drugs should be placed in a clean warehouse for patients to access at will, which provides a record of how drugs were stored at the time. Volume 1, Sect. 9 of Nanhai Jigui Neifa Zhuan mentions Saṁpragata, or the idea that all poisons become delicious [40]. This behaviour is equivalent to processing medicinal materials, which means that toxic medicinal materials are processed into nontoxic ones. In ancient China, herbs and medicines were processed before being used in treatment, reflecting the commonalities between traditional medical systems. Through processing, the toxicity of herbs could be reduced, and their therapeutic effects could be enhanced, thereby better realising their medicinal value. This approach demonstrated ancient people’s profound understanding and ingenious utilisation of the nature and functions of herbs, representing a unique charm of traditional medicine [41].

Introduction to poisons and toxicology

Volume 3, Sect. 29 of Nanhai Jigui Neifa Zhuan describes the use of mineral medicines such as sulphur and realgar in ancient India to counteract the venom of snakes and scorpions. These mineral medicines were commonly carried in small quantities as a precautionary measure. If one had heatstroke, they could make Glycyrrhiza uralensis Fisch. ex-DC., Dichroa febrifuga Lour. or Sophora flavescens Aiton to alleviate their symptoms. Volume 4, Sect. 34 of Nanhai Jigui Neifa Zhuan states, ‘Between a poisonous environment and poison, which one is more harmful to the body? The answer is that there is a distant difference between poison and a poisonous environment. Eating poison will cause harm, while a poisonous environment can be eliminated with one’s mind.’

Comparison of ancient Indian medicine with ancient Chinese medicine

Chinese and Indian traditional medicine began to communicate in the Qin (221–207 BC) and Han (202–220 BC) dynasties and was directly related to the rise and fall of Buddhism [42]. The influence of Indian traditional medicine on Chinese medicine mainly involves medical theory, medical technology, prescriptions and medicinal materials. The famous surgical operations in ancient India were probably introduced to China during the Jin Southern and Northern Dynasties (265–589 AD) [43]. In the Sui and Tang dynasties (581–907 AD), ancient Indian medicine was introduced along with Buddhism. Buddhist Cikitsāvidyā scriptures were translated into Chinese, and there are many records from that period about prescriptions and medicines. Bukong Juansuo Zhoujing of the Sui Dynasty (581–618 AD) contains 25 kinds of medicines, such as Dipterocarpus turbinatus C. F. Gaertn., Piper longum, realgar and Shidai. The book Manshu Shilipasa Zhou records 19 kinds of medicines in the Tang Dynasty, such as danta-kāṣṭha, root of Achyranthes bidentata Blume, molasses and cattle milk; Avalokitesvara Bodhisattva Moneta Sutra records realgar, root of Curcuma aromatica Salisb., Piper nigrum, Piper longum, Zingiber officinale, Dipterocarpus turbinatus C. F. Gaertn., etc. The application of pathological products such as of Calculus Bovis, Moschus, Curcuma aromatica Salisb., Dipterocarpus turbinatus, Santalum album and Syringa oblata is described many times in Avalokitesvara Bodhisattva Secrets and Yiddish Incantations [42]. Sui Shu Jingji Annals records eight kinds of Indian medical works, including Prescription of Nāgārjunabodhisattva and Prescriptions of the Western Regions [44]. The titles of books often include the names of famous ancient Indian doctors, such as Jīvā and Nāgārjunabodhisattva [45]. Although there are few direct historical records of Chinese medicine being introduced into India, many indirect sources provide some evidence. In the Western Jin Dynasty (265–316 AD), Mai Jing (脉经, from approximately the third century AD), written by the imperial physician Wang Shuhe, was introduced into India through Tibet; Song Yun, an eminent monk in the sixth century, introduced the spread of Hua Tuo’s medical skills in India in Xingji [46]. According to The Records of the Ten Continents, the envoy of the Western King of Fenglin Island offered glue and Xi to Emperor Wu of the Han Dynasty in the third year of Emperor Wu’s Heavenly Han Dynasty (98 BC). Later, Emperor Wu thanked the envoys and left them behind, giving them such things as Paeonia × suffruticosa Andrews, which are unique in Western countries. Later, these drugs became traditional in Chinese medicine [42]. In Aṣṭāṅga Hṛdaya, mercury and other mineral medicines were taken orally for the first time, also influenced by traditional Chinese medicine [47].

Traditional Chinese medicine was also introduced into India by monks and merchants, such as Yi Jing, a famous monk in the Tang Dynasty, who introduced material medica, acupuncture, pulse diagnosis and health care longevity to Indians. According to Volume 3, Sect. 28 of Nanhai Jigui Neifa Zhuan, there were more than 400 kinds of rhizome medicinal materials produced in China, most of which had a unique colour, taste and fragrance that could be used to treat various diseases. The island countries of Southeast Asia did not have acupuncture, pulse diagnosis or health care and longevity medicine; these techniques were only used in China. Yi Jing, who was proficient in medicine, once shared his own recipe and taught the locals how to use Kushen-soup and tea to treat fever.

Yi Jing compared Chinese medicinal materials with those of India and other countries. Volume 3, Sect. 27 of Nanhai Jigui Neifa Zhuan notes that the medicinal materials in ancient India differed from those in Tang Dynasty China. However, there may also have been ancient Indian medicinal materials in China and Chinese medicinal materials in ancient India during the Tang Dynasty, which cannot be generalised. For instance, Panax ginseng C.A. Mey., Angelica sinensis (Oliv.) Diels, Polygala tenuifolia Willd., Aconitum carmichaelii Debeaux, Ephedra sinica Stapf and Asarum heterotropoides F. Schmidt were all medicinal materials produced in China. In ancient India, harītakī was abundant, Crocus sativus was produced in northern India, Ferula sinkiangensis K.M. Shen was abundant in northern India, and Cinnamomum camphora was rare and produced in the South China Sea (i.e. the islands of Southeast Asia). Alpinia hainanensis K. Schum. and Myristica fragrans Houtt. came from the country of Tohopodi (modern-day Loburi, Thailand). Syzygium aromaticum (L.) Merr. & L.M. Perry came from Pulo Condore. Nanhai Jigui Neifa Zhuan was one of the rare examples in China comparing traditional Chinese and Indian medicines at that time. Even today, there are few comparative studies on this topic, so this book can provide strong support in identifying ancient medical exchanges between China and India.

Health preservation

Liuyi (六意) encompasses six principles, including comprehending the profound essence of Buddhism, understanding the order of the Buddhist system, maintaining physical and mental cleanliness, having an open mind, fearlessness amidst others and living a long and healthy life. Nāgārjunabodhisattva, the founder of the Middle View School of Mahayana Buddhism, exerted a profound influence on all sects of Mahayana Buddhism. His practice of drinking water through the nose was a technique for attaining a long life. However, this behaviour could cause discomfort, and drinking water through the mouth had the same effect, that is, reducing disease over time.

During the Tang Dynasty, wooden pillows, which were hard and unable to conform to the skin, were commonly used, often leading to conditions such as Toufeng (头风) and headache. In cold weather, the neck was easily affected by wind-cold, which caused diseases such as typhoid fever during winter. During the same period in ancient India, pillows could be filled with different contents according to the climate or physical conditions. Generally, they were filled with pollen from Typha angustifolia L., Tamarix chinensis Lour., Bombax ceiba L. or soft leaf dry moss. In cold weather, they could be filled with cotton wool hemp and other materials to maintain warmth, while in hot weather, they could be filled with Senna tora (L.) Roxb., which could help clear heat, dispel wind and improve eyesight. Capsule pillows were more comfortable than wooden pillows, and their adjustability allowed for timely intervention to reduce the occurrence of diseases.

Jingxing (经行) refers to circular walking in a certain place, typically after meals, when feeling fatigued or sitting in meditation and falling asleep. Jingxing was not only advocated by ancient Indian monks but also practised by secular people, who believed that it could cure disease and help people digest food when they were not suffering from an illness [10]. Volume 3, Sect. 23 of Nanhai Jigui Neifa Zhuan noted that most of the walking places could be chosen at noon or dusk, but they had to be quiet. The focus was on walking slowly and straight back and forth on a path, which aided in the regulation of emotions and fostered physical and mental well-being. It had the added benefit of treating issues such as swollen feet and bellies, as well as sore arms.