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On the relationship between doubt and disease

Shan Yan
Shan Yan
Since 2022 till now, I have been following the kind mentor of BPI to start the journey on Buddhism....Read More

Essay Writing of Buddhas’ Practice Incorporated
—–(Issue 14)—–

On the relationship between doubt and disease
Instructor: Shi Ziju
Author: Shi Fafu
September 3, 2023, AD

I. Introduction

In contemporary society, diseases have become one of the focuses of people’s attention. However, in addition to physical diseases, Buddhist teachings also mention a psychological disease, namely “doubt”. This paper aims to explore the relationship between doubt and disease and provide in-depth understanding and insight from a Buddhist perspective.

This paper adopts the method of literature research (sutra, medical literature) and the method of example argumentation (medical examples) as the basis, mainly to argue that the relationship between “doubt” and disease is manifested as follows: “doubt” is a kind of annoyance disease, which can lead to physical and mental diseases. In this paper, the author will focus on dementia as an example. Specifically, the following aspects will be studied:

Firstly, the author will discuss the definition of “doubt” and disease from both worldly science and Buddhism. Based on this definition, it can be concluded that “doubt” itself is a disease.

Next, the author discusses the relationship between “doubt” and dementia. Firstly, the author defines dementia; secondly, the author analyses the definition and cases of dementia, focusing on the characteristics of cognitive impairment, to explore how “doubt” triggers physical and mental diseases.

Finally, the conclusion section summarizes the findings of the study and highlights the fact that “doubt” as a disturbing mental disease can lead to physical and mental illnesses. It also suggests implications for individuals and society and outlines the value and shortcomings of this paper.

II. The definition of doubt and disease

(Ⅰ). The definition of disease

i. The definition of disease in worldly science

The disease is summarized in the “A+ Medical Encyclopedia”:
Disease is an abnormal life activity process that occurs due to the disorder of homeostasis of the body under the damaging effects of a certain cause. In most diseases, the body mounts a series of anti-damage responses to the damage caused by the cause. Disorders of homeostasis, damage and anti-damage responses manifest as various complex abnormal changes in function, metabolism and morphological structure during the disease process, and these changes can cause differences between various organ systems of the body and between the body and the external environment. The coordination relationship is disrupted, causing various symptoms, signs and behavioral abnormalities, especially the weakening or even loss of environmental adaptability and labor ability.

This definition emphasizes the damage and dysfunction of the disease to the body, as well as the impact on various organs and the overall adaptability. In the worldly scientific perspective, disease is seen as a disturbance in the health of the body and the normal functioning of life.

ii. The Buddhist definition of disease

There are many definitions of diseases in Buddhist scriptures, such as Volume 57 of the Mahabharat Sutra:
When such a person is born and grows up, he will suffer from many diseases in his body, such as head, eyes, ears and nose, tongue, teeth, throat, chest, abdomen, hands and feet, scabies, leprosy, madness, edema, cough, wind, yellow, fever and leprosy, as well as numerous malaria and painful joints. Nanda! The human body is suffering from illness like this. There are one hundred kinds of wind diseases, one hundred kinds of yellow diseases, one hundred kinds of phlegm diseases, one hundred kinds of collective diseases, and a total of four hundred kinds of diseases, which arise from within. Nanda! The body is like a carbuncle and an arrow, caused by many diseases. There is no temporary pause and thoughts cannot be stopped.

According to this teaching of the Buddha, disease can be defined as a painful phenomenon closely connected with human existence. There are four hundred and forty kinds of diseases in the human body.

Combining the concepts of worldly science and Buddhist scriptures, disease can be defined as a kind of pain that is damaging and obstructive to the body and mind.

(II). The definition of doubt

i. The definition of doubtful diseases in worldly science

The doubtful diseases are summarized in “A+ Medical Encyclopedia” as:

Hypochondriasis is also called hypochondriacal neurosis. It refers to a kind of neurosis that makes unrealistic and pathological explanations for one’s own feelings or symptoms, causing the entire mind and body to be occupied by the resulting doubts, worries and fears. Characterized by excessive concern for one’s own health and holding indelible prejudices… The personality characteristics of such patients are sensitive, suspicious, subjective, stubborn, and cautious.

As described in the above paragraph, from a worldly scientific point of view, hypochondriacal patients are self-centered, suspicious of themselves, and hold prejudices that are difficult to eliminate. They are characterized by doubts and worries. For example, if you are afraid of suffering from a certain disease, you still feel uneasy after repeated visits to the doctor.

ii. The Buddhist definition of doubtful disease

It is recorded in Volume 1 of Abhidana on the Distribution of All Things: “What is the knot of doubt? It means that the truth cannot be understood.” It can be seen that “doubt” arises from doubts and unclear understanding of the true meaning. It is also said in Volume 8 of the Surangama Sutra:

The eighth consists of the habit of expressing wrong views, such as those of satkayadrishti, prohibitions, grasping, and other deviant insights and the karma involved in these, which result from contradiction and opposition. From these there come into being court officials and deputies holding documents, whom one meets as if they were people coming and going on the road. Because these two habits influence one another, there come into being official inquiries, baited questions, examinations, interrogations, public investigations, exposure, the youths who record good and evil, carrying the record books of the offenders’ arguments and rationalizations, and other such experiences. Therefore, the Tathagatas of the ten directions look upon evil views and name them the pit of views. Bodhisattvas regard having false and one-sided views as they would standing on the edge of a steep ravine full of poison.

The Buddha taught in this passage that wrong views will lead to “doubts” and acting according to them will backfire and rebirth (produce the opposite result). For example, people yearn for wealth and peace, but they do not believe in Buddhism, do not listen to the instructions of their ancestors, and are stingy and indiscriminate in killing. This will lead to poverty, low status, many diseases, and a short life.

Also, in Volume 8 of the Abhitan Eight Gandava Treatise, it is said: “Who has achieved the problem of doubt? The answer is: ‘If desire and love are not exhausted, if the wisdom of the Tao and Dharma has not yet arisen.'” This treatise points out: Because there is no wisdom, there is greed, so there is “doubt”.

It is also said in Volume 17 of The Theory of Great Wisdom: “Doubts cover the mind because doubts cover the mind, and the mind cannot be calmed in all dharma; there is no reason to calm the mind, and there is nothing to gain from the Buddha’s dharma. For example, if a person enters the treasure mountain, if he has no hands, “Nothing can be achieved.” The “doubt” mentioned here is a kind of trouble covering, which is manifested in the lack of determined faith in Buddhism and will lead to nothing.

According to the above-mentioned Buddhist teachings, the disease of doubt is caused by doubts and unclearness about the true meaning. This doubt stems from people’s wrong views on things and the mentality of unfulfilled greed. The disease of doubt is a kind of affliction, which manifests itself as a lack of firm confidence in the Dharma, resulting in people’s inability to truly believe in the true meaning of the Dharma and to achieve real achievements.

Combining with the analysis of the definition of hypochondria in the world science and Buddhist scriptures, it can be concluded that doubt itself is a disease.

III. The relationship between doubt and dementia

(Ⅰ). The definition of dementia

i. The definition of dementia in worldly science

Dementia is described in Wikipedia as:

Dementia, classified as a neurocognitive disorder with various forms or subtypes, is a type of brain disease that causes long-term and gradual deterioration in thinking and memory, and affects an individual’s activities of daily living. Other common symptoms include mood problems, language problems, and reduced mobility, but personal awareness is not affected.

According to this paragraph, from a worldly scientific perspective, dementia is a cognitive impairment that causes problems with language, movement, and thinking.

And there are many papers talking about dementia. For example, Zhao Jiangang’s paper “Research on Dementia Prediction Model”, about dementia (according to the definition of dementia in “Wikipedia”, it can be seen that dementia and dementia is the same name) the definition mentions:

People with dementia may have problems such as communication difficulties, repetitive speech and behavior, lost items, wandering, aggressive behavior, suspicion, and delusions. And behavioral confusion, cognitive impairment and loss of functional abilities are the three major aspects that explain the functional loss of the elderly with dementia.

This paper points out the salient characteristics of people with dementia: behavioral confusion, cognitive impairment, loss of functional abilities, and the emergence of doubts, delusions and other problems.

Also, in Wang Xiangqin’s paper “Discussion on the Application of Salvia Miltiorrhiza Combined with Acupuncture at Baihui Point in Delaying Vascular Dementia”, he talks about the behavioral and mental symptoms of dementia and vascular dementia:

The mental symptoms of patients with dementia generally include delusions, hallucinations, anxiety, depression, and apathy. Behavioral disorder includes restlessness, verbal and physical aggression, inappropriate behavior, abnormal sexual behavior, convulsions, wandering, sleep disorder, sundown syndrome, day and night confusion… (Patients with vascular dementia) The clinical symptoms include cognitive dysfunction, limb weakness, Slurred speech, difficulty swallowing, incontinence of urine and feces, unsteady gait, stiff hands and feet, and slow movements. Psychiatric symptoms include emotional instability, passivity, changeable temper, depression, delusions, hallucinations, uncontrollable crying and laughing, and sleep disorders.

This paper also mentioned the symptoms of dementia: behavioral confusion, cognitive impairment, delusions, hallucinations and other mental problems.

In summary, from a worldly scientific perspective, dementia is classified as a neurocognitive disorder characterized by long-term deterioration in thinking ability and memory, as well as an impact on activities of daily living. Common symptoms also include mood problems, language problems and reduced mobility, which is a manifestation of a combination of physical and mental illness. However, the Buddhist definition of dementia goes much deeper.

ii. The Buddhist definition of dementia

In the Buddhist classics, the definition of “dementia” is called “demented delusion”, “delusional thinking” and “fusion delusion”. (This is discussed in the author’s fifth issue of “On Foolishness and Dementia”.) People with dementia think right or wrong and have cognitive disabilities. For example, in the Sutra of Manjushri’s Questioning, Volume 1, it is written, Dementia is the forgetfulness and loss of awareness. Forgetfulness and loss of awareness are manifestations of dementia. Another Zen Samadhi Sutra, Volume 1, states:

Characteristics of foolish people: “Doubtful and regretful, lazy and ignorant, complacent and unbearable, arrogant and uncomfortable, trustworthy or disbelieving, disbelieving and yet believing. Not knowing how to be respectful, always believing in the direction, being irritable with many teachers, not being shy and offending, He is careless in his work, but he is unruly in teaching, he is fond of teachers and different ways, he does not distinguish between good and evil, he is easy to forget, he is lazy in his practice, he has no compassion in his heart, he destroys the Dharma bridge. Can’t get into trouble, doesn’t look at things with anger, has no wisdom, seeks too much, is suspicious and trusts little, hates good people, destroys sins and rewards, doesn’t say good things, can’t explain mistakes, doesn’t accept teachings, is separated from relatives and hates resentment. He doesn’t know etiquette, and he speaks evil words. He has long beards, hair and claws, dirty teeth and clothes, and he drives others around. He is not afraid when he is afraid, he is sad when he is happy, he is happy when he is sad, he smiles when he is sad, he is sad when he laughs, he is able to lead and follow. Enduring hardship, not distinguishing between tastes, and being unable to dissociate from desire are all serious sins and are signs of ignorance.

This passage describes in detail many of the distinctive features of ignorance (dementia), such as: suspicion, laziness, ignorance (cognitive impairment), arrogance, impatience, lack of shame, lack of self-improvement, lack of compassion, etc. These characteristics reflect the behavioral and psychological pathologies of people with dementia. (Specific cases of these pathologies can be found in the two papers “Research on the Prediction Model of Dementia”, “Discussion on the Application of Salvia Miltiorrhiza Combined with Acupuncture at Baihui Point in Delaying Vascular Dementia” and “A+ Medical Encyclopedia”.)

In summary, from the Buddhist perspective, dementia can be defined as a cognitive disorder that manifests itself in a multitude of physical and mental disorders. So how do these disorders come about?

In the following, we will discuss how “doubt” triggers a series of physical and mental disorders, especially in the context of dementia.

(II). Taking dementia as an example, explore how doubt causes physical and mental illness

In the previous section, regarding the definition of dementia, it can be seen that one of the obvious characteristics of dementia is cognitive impairment.

What does this symptom have to do with doubt? In Volume 49 of of the Avatamsaka Sutra of Dafang Guangfo, it is said, “Because of excessive greed, anger, and evil views, one achieves the obstacles of the mind.” Because of greed, anger, and evil views, there are obstacles in the mind karma , i.e., cognitive deficits. It is also said in Volume 2 of the Zhengfa Mindfulness Sutra: Wrong views are the root of all knots. It can be seen that wrong views are the root of all afflictions and the root of greed. In other words, wrong views are the root cause of cognitive impairment. Due to their inherent wrong views, people do not know what is suffering and what is bliss, and mistakenly regard suffering as bliss. Specifically, when people mistakenly believe and firmly believe that gluttony is good and can bring bliss to people and are lost in the instant satisfaction brought by gluttony, they cannot truly believe in and uphold the Buddha’s teachings – non-greediness. that is, having doubts about the Buddha’s teachings. This kind of doubt will make people continue to pursue greed, and the cognitive obstacles caused by this will become more and more serious.

The occurrence of “doubt” will lead to physical and mental illness, which is recorded in many Buddhist scriptures. For example, in Volume 35 of the Avatamsaka Sutra of Dafang Guangfo, it says: “Among these, the sin of killing can cause all living beings to fall into hell, animals, and hungry ghosts; if they are born among humans, they will get two kinds of retribution, one is short life, and the other is much sickness. ” People do not believe in the Buddhist precept not to kill. In order to satisfy their temporary appetites, they dare to commit evil deeds of killing animals and obtain the delicious taste of meat, which will inevitably make them sick.
And because people’s desires are endless, in order to continuously satisfy their greedy good feelings, they will inevitably overeat, which will also lead to diseases. For example, in “Buddha Speaks of Buddhist Medicine Sutra”: “The Buddha said: ‘Eating too much has five sins: first, too much sleep; second, too much illness; third, too much sexual intercourse; fourth, not being able to recite sutras satirically; fifth, too much attachment to the world. “Especially in modern society, many foods are ripened by drugs, and excessive use of industrial chemicals and additives can directly cause diseases in the body. Once you eat too much, you will definitely get sick. This is caused by people not believing in the Buddha’s teachings and eating too much.

What’s even more frightening is that satisfying greed again and again will bring difficulties to the body, speech, and mind. For example, in the Ten Good Karma Sutra says: “If you are free from greed, you will achieve the five kinds of freedom. What are the five? 1. The three karmas are free, because all the roots are sufficient… 5. The things obtained are beyond the original place. Seeking a hundred times greater success is because I was not jealous in the past.” In this passage, the Buddha taught: Not being greedy will lead to the freedom of the three karma of the body, speech, and mind. On the contrary, if there is greed, it will make the three karma of body, speech, and mind difficult, that is, it will become more and more difficult in behavior, speech, and thinking and intelligence. This is completely consistent with the symptoms of dementia patients mentioned above: cognitive impairment, reduced thinking ability, memory, language problems, and reduced mobility. And as the amount of food increases every day, dementia will become more and more serious. This is mentioned in many places in the “A+ Medical Encyclopedia” that dementia is irreversible. It can be seen that having “doubts” about Buddhism, being unable to truly believe in and uphold Buddhism, and indulging in greed will lead to dementia and even a series of physical and mental diseases.

Another example is recorded in Volume 1 of the Past Vows of Earth Store Bodhisattva Sutra: “If you meet someone who eats excessively, he will suffer from hunger, thirst and throat disease.” Excessive eating can cause hunger, thirst and throat diseases. This is consistent with the situation in real life where many patients are unable to eat normally due to various diseases (such as esophageal cancer, late-stage dementia) and need to eat through nasogastric tubes. This is also a terrible consequence of people’s inability to believe in the Buddha’s teachings and their inability to restrain gluttony.

It also says in Volume 7 of the Lotus Sutra:
If there is anyone who despises them, saying: ‘You are mad. This practice of yours is in vain and will attain nothing at the end,’ they will have no eyes lifetime after lifetime as a retribution for this wrongdoing. If there is anyone who pays them homage and praises them, he will attain tangible rewards in this life. If anyone sees those who preserve this sutra and speaks maliciously about their faults, whether true or not, such a person will suffer from leprosy in this life. If anyone scorns them, that person’s teeth will be either loose or missing; their lips will be ugly, their nose will be flat, their limbs will be crooked; they will squint; their body will stink and be dirty, suffering from evil tumors, oozing pus; their belly will swell with water; and they will have tuberculosis and other evil and serious illnesses. For this reason, O Universal Worthy, if you see anyone who holds to this sutra, you should stand up and show your respect even from afar, just as you would pay homage to the Buddha.

If you do not believe in the teachings of the Buddha and despise or slander those who accept and uphold the Lotus Sutra, you will suffer from various diseases. These cases are common in real life, and the corresponding symptoms can also be found in the “A+ Medical Encyclopedia”.

To sum up: the root cause of various diseases is that people adhere to wrong views, cannot truly believe in the Buddha’s teachings, and have “doubts” about the Buddha’s teachings, which will inevitably lead to various physical and mental diseases.

Ⅳ. Conclusion

Through an in-depth study of “consciousness” in this paper, the following conclusions can be drawn:

Firstly, “consciousness” is an important concept in Buddhism, which is the nature and function of human consciousness. Secondly, the nature of “consciousness” is illusory, and once pursued, it leads to suffering. This is because people’s pursuit of and attachment to consciousness leads to misperception of and attachment to the world, which in turn leads to pain and suffering.

The research in this paper has implications for both readers and academics. For readers, this paper provides a deeper understanding of the Buddhist perspective on “consciousness” and helps readers to better understand Buddhist teachings and thoughts. For academics, this article provides new ideas and perspectives for Buddhist studies and academics.

However, there is still room for improvement. For example, the concept of transmutation of consciousness into wisdom is only skimmed over without detailed discussion. Therefore, future research can provide more insights and references by exploring in greater depth the nature of the illusion of consciousness and the method of transmutation of consciousness in Buddhism.


Ⅰ. Ancient texts (in chronological order of dynasties)

[Wu] Translated by Zhu Luyan: “Buddha Speaks of Buddhist Medicine Sutra”, Taisho Collection, vol. 17.
[Hou Qin] Translated by Sangha Deva Gongzhu Buddha’s Thoughts: “Abhidamba Gandava Treatise”, Taisho Collection, vol. 26.
[Hou Qin] Translated by Kumarajiva: Zazen Samadhi Sutra, Taisho Collection, vol. 09.
[Yuan Wei] Translated by Prajna-Liu Zhi: “Zhengfa Mindfulness Sutra”, Taisho Collection, vol. 17.
[Liang] Translated by Sanghabara: “Manjushri Questioning Sutra”, Taisho Collection, vol. 14.
[Tang] Translated by Yijing: “Dabao Ji Sutra”, Taisho Collection, vol. 11.
[Tang] Translated by Emperor Prami: Surangama Sutra, Taisho Collection, vol. 19.
[Tang] Translated by Shishananda: The Past Vows of Earth Store Bodhisattva Sutra, Taisho Collection, Volume 13.
[Tang] Translated by Shisha Nanda: The Ten Good Karma Sutra, Taisho Collection, vol. 15.
[Tang] Translated by Shisha Nanda: The Avatamsaka Sutra of Dafang Guangfo, Taisho Collection, vol. 10.
[Song] Translated by Qiunabhadra Gongbodhiyasa: Abhidan Treatise on the Divide of All Things”, Taisho Collection, vol. 26.

Ⅱ. Others

“The Concept of Disease”, website name: “A+ Medical Encyclopedia”, URL: E7%90%86%E5%AD%A6/%E7%96%BE%E7%97%85%E7%9A%84%E6%A6%82%E5%BF%B5, search date: August 2023 4th.
“Hypochondriasis”, website name: “A+ Medical Encyclopedia”, website:, retrieved on August 4, 2023.
“Dementia”, website name: “Wikipedia”, website:, retrieved on August 4, 2023.
Zhao Jiangang: “Research on Dementia Prediction Model”,, retrieved on August 4, 2023.
Wang Xiangqin: “Study on the application of Salvia miltiorrhiza combined with acupuncture at Baihui point in delaying vascular dementia”,, retrieved on August 4, 2023.

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