Medical Monastic Matters!

Casual discussion amongst spiritual friends.

Medical Monastic Matters!

Postby Demarous » Mon May 04, 2009 9:12 pm

What happens in regards to the problems and medical matters in an Ordained capacity?

For instance, I have Type 1 Diabetes and asthma.

Firstly, how would one go about getting the medication for their needs if they had to pay for a prescription, as they are not allowed to handle money?
:broke:

Secondly, in the case of diabetes, what would be the situation if a diabetic monks sugars were low during a fasting period? :thinking:

Any idea anyone?

Metta,

Demarous.
"Happy, at rest, may all beings be happy at heart. Whatever beings there may be, weak or strong, without exception, long, large, middling, short, subtle, blatant, seen & unseen, near & far, born & seeking birth: May all beings be happy at heart."
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Re: Medical Monastic Matters!

Postby Cittasanto » Mon May 04, 2009 9:46 pm

Demarous wrote:What happens in regards to the problems and medical matters in an Ordained capacity?

For instance, I have Type 1 Diabetes and asthma.

Firstly, how would one go about getting the medication for their needs if they had to pay for a prescription, as they are not allowed to handle money?
:broke:

Secondly, in the case of diabetes, what would be the situation if a diabetic monks sugars were low during a fasting period? :thinking:

Any idea anyone?

Metta,

Demarous.


I believe the Vinaya has no prohibitions on taking medication at any time and I would imagine this would include foods which are used to regulate problems.
it would also depend on where you are some countries don't charge for lifelong medications, or subsidise the cost to make it affordable.
it is entirely possible that the monastery would pay from its funds but I would think it was a individual monastery decision.
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Re: Medical Monastic Matters!

Postby gavesako » Tue May 05, 2009 7:01 am

Since you live near Chithurst, you can discuss the details with the senior monks there, but generally the NHS in UK will cover you pretty well and the rest is paid for by the English Sangha Trust. In England monks can have breakfast as well, so you don't need to fast 24 hours like in other places. In the p.m. there are various "tonics" allowed, for example dark chocolate, honey, soya milk and cheese (if there is a reason, one is exhausted, low on energy, etc.).
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Re: Medical Monastic Matters!

Postby forestmat » Tue May 05, 2009 12:04 pm

Namassakarn Tahn Ajahn Gavesako,

you wrote:

In the p.m. there are various "tonics" allowed, for example dark chocolate, honey, soya milk and cheese (if there is a reason, one is exhausted, low on energy, etc.).


isn't there a danger of laypeople getting the wrong impression seeing monks eat these "tonic" or 'allowables" as I have sometimes heard them referred to?

By that I mean that laypeople are aware monks eat before midday.

I have been led to believe that Luangpor Chah was very much against this sort of thing.

Just a reflection on what I have previously heard (I have my tin hat on whilst posting this, because I know it's quite a sensitive topic!)

Metta

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Re: Medical Monastic Matters!

Postby Bhikkhu Pesala » Tue May 05, 2009 1:30 pm

The “Five Tonics” — ghee, butter, oil, honey, molasses — are allowable for one who is sick, not for one who is not sick. The meaning of “sick” is open to interpretation, but it means that one is not able to abide in comfort without using the medicines. Being famished due to heavy work is sufficient reason. So too is not being able to eat a normal meal due to stomach upset, not getting enough food on alms round, etc. The original allowance was made for bhikkhus suffering from jaundice, who could not hold down any solid food. The Forest Sangha monks do heavy manual labour on most days, humping logs, splitting firewood, sweeping tons of leaves, etc., so the use of tonics is justified.

Sweet drinks are allowable for one who is not sick.

Whether Plain chocolate allowable is a moot point, but it is mostly sugar. I don't see much difference between plain chocolate and boiled sweets containing some vegetable starch to solidify them.

Cheese is not allowable in my opinion. If there is doubt regarding what is allowable or not allowable because cheese as we know it was not used in the time of the Buddha, then one should compare it with what is known to be allowable, and what is known to be not allowable.

Is cheese more like milk (which is definitely not allowable), or more like ghee (which is definitely allowable)? If the former, then it not allowable, if the latter, then it is allowable.

If one is doubtful whether something is allowable or not, then it is not allowable.
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Re: Medical Monastic Matters!

Postby Demarous » Tue May 05, 2009 3:51 pm

I don't think cheese would be much use anyway as it doesn't contain any carbohydrate which would be needed to lift a diabetics sugar levels.

The problem i can see, is that if the diabetic monk has low sugars, they would need a fast sugary fix, which yeah, even sugar water would do, but then it would usually need to be followed up with some complex carbohydrate, like bread, etc to keep the sugar level from dropping again. i guess it could just be a case of trying to get enough carbs in the main meal so the sugars can't drop low enough!!!

Learn and adapt? does anyone know of any Ordained Diabetics that might be able to shed some light???

I will of course be going to Cittaviveka sometime this week and try to find out and post what i'm told!!!

On the prescription theme, how would the Monk usually go about putting in / collecting the prescription? would they leave the monestry or would someone else, a lay person for example to collect???

Metta,

Demarous.
"Happy, at rest, may all beings be happy at heart. Whatever beings there may be, weak or strong, without exception, long, large, middling, short, subtle, blatant, seen & unseen, near & far, born & seeking birth: May all beings be happy at heart."
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Re: Medical Monastic Matters!

Postby forestmat » Wed May 06, 2009 1:22 am

Namassakarn Tahn Ajahn Pesala,

thank you very much for your comments regarding the 5 Tonics.

Do you have any comment to make about soya milk? I always thought it was not allowable after mid-day.

I praise your commitment to the vinaya.

Metta

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Re: Medical Monastic Matters!

Postby Bhikkhu Pesala » Wed May 06, 2009 3:03 am

forestmat wrote:Do you have any comment to make about soya milk? I always thought it was not allowable after mid-day.

I think so too. If it contains any soya bean solids at all, then it is not allowable. If one is not sick, it is not allowable. There is no need for these things. Water is better for quenching thirst, fruit juice or sweet drinks are allowable for appeasing hunger.
Buddhist Monastic Code II: Medicies
For a body full of bad humors: One may drink a purgative. After the purgative has worked, one may take clarified conjey (which, according to the Commentary, is the clear liquid from rice porridge, strained to remove all rice grains), clear green gram broth, slightly thick green gram broth (which the Commentary interprets as green gram broth that is not oily or greasy), or meat broth (which again, the Commentary says, is just the broth without any meat). Some Communities extend these last allowances for any occasion, but the Canon gives them in the context of an antidote to the effects of a strong purgative, so there are those who will extend the allowance only to cases where a bhikkhu is weakened by diarrhea or other similarly severe conditions.
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Re: Medical Monastic Matters!

Postby gavesako » Wed May 06, 2009 6:54 am

Indeed, the "cheese & soya milk debate" has been going on for years and there is no end in sight. I think it depends on some fundamental attitudes towards precepts & practices (sila-vata) of the individuals concerned rather than on what's actually stated in the texts, which is always subject to interpretation. Ajahn Brahm has written some Letters on Grey Areas in the Vinaya a long time ago, and they are still worth reading if you have access to them. Similarly, arguments about "what LP Chah allowed or not" are often dependent on the context in which that happened. He would say certain things to monks in Thailand and quite different things when he visited England, he was quite flexible in that way.

But on the subject of allowable tonics or medicines, there is also a noticeable difference between characters: the greed (lobha) characters will tend to be more generous and allow more, whereas the anger (dosa) characters will always favour the strictest interpretation possible and see any relaxation of such a standard as a threat to the Sasana :toast:

In Thai forest monasteries, there is actually a great variety of things which is considered allowable (in the Vinaya it mentions "leaves, roots, fruits, etc."). So sometimes monks will have a kind of Greek salad with olive oil and bits of cheese for the afternoon drink! During the previous economic crisis in Thailand, Wat Pah Pong officially "banned" cheese as a medicine, but this was because it was considered something expensive and luxurious (not like in the West), and a few years later everyone was happy eating it again. Soya milk is another such issue: in Thailand it is usually sold in the same way as cow's milk and people simply consider it to be in the "milk" category, therefore "food". However, in terms of Vinaya it could fall into one of two allowable categories (see Ajahn Thanissaro's book), it depends on how you define it.

As the Buddha puts it in the Maha-viyuha Sutta:


Those for whom precepts
are ultimate
say that purity's
a matter of self-restraint.
Undertaking a practice,
they devote themselves to it:
'Let's train just in this,
and then there would be purity.'
Those who say they are skilled
are [thus] led on to becoming.
But if one of them falls
from his precepts or practice,
he trembles,
having failed in his actions.
He hopes for, longs for, purity,
like a lost caravan leader
far from home.

But one who's abandoned
precepts & practices2
— all —
things that are blamable, blameless,3
not hoping for 'pure or impure,'4
would live in compassion & peace,
without taking up peace,5
detached.

Dependent
on taboos, austerities,
or what's seen, heard, or sensed,
they speak of purity
through wandering further on
through becoming & not-,
their craving not gone
for becoming & not-.6
For one who aspires has longings
& trembling with regard to preconceptions.
But one who here
has no passing away & arising:
Why would he tremble?
For what would he long?"

http://www.accesstoinsight.org/tipitaka ... .than.html
Bhikkhu Gavesako
Kiṃkusalagavesī anuttaraṃ santivarapadaṃ pariyesamāno... (MN 26)

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