About three months ago I had a fresh attack of amoebiasis. The manifestations were as follows: increased abdominal discomfort, 'hungry' feeling in the afternoon (except after thick curd), specific tenderness about the region of the left end of the transverse colon, abdominal distension, increased quantity of mucus (I normally have little), thick opaque mucus with traces of blood (not thought to be due to piles), slightly increased constipation. During the last few days these manifestations have recurred, and this morning I noticed a trace of blood in the thick mucus. On the principle of Occam's Razor, which says that entities should not be multiplied unnecessarily (a thing the amoeba have yet to learn), I presume this recurrence is due to inadequate treatment two months ago (though, just as I have regular dána dáyakas, it is possible also that I have amongst them a regular amoeba dáyaka who re-infects me from time to time). I wonder, therefore, if you would give me some indication of the best course to follow, both to eradicate the present infection and prevent recurrence and also to guard against fresh infection (which I seem to get rather easily in these parts).

Stomach trouble is really the principal occupational hazard of the bhikkhu (who has no control over the preparation of the food he gets), and we must expect to have to put up with a certain amount of it. But amoebiasis is very damaging to the practice of concentration (though perhaps in other respects it may not be very serious -- 'Just a little scarring of the intestine' as one doctor told me, rather leaving me wondering whether he would describe a bullet through one's brains as 'Just a little perforation of the head'), and it seems worthwhile taking precaution against it if that is at all possible.

B.N. tells us that one of the principles of the Oxford Group is 'Absolute Unselfishness', which is perhaps worth discussing briefly. Some casual English visitors (two 'grisly English faces' -- Cyril Connolly's phrase -- hitchhiking around the world) came the other day and asked me whether it wasn't rather selfish to sit here alone seeking my own welfare. The idea was, no doubt, that I should busy myself with helping others, like Albert Schweitzer, who is generally regarded these days as the model of unselfish devotion to the service of others. Another Albert -- Einstein -- has something to say about this:

Everything that the human race has done and thought is concerned with the satisfaction of felt needs and assuagement of pain. One has to keep this constantly in mind if one wishes to understand spiritual movements and their development. Feeling and desire are the motive forces behind all human endeavour and human creation, in however exalted a guise the latter may present itself to us. ('Religion and Science' in The World As I See It, p. 23)

The welfare of oneself should not be neglected for the welfare of others, however great; recognizing the welfare of oneself, one should be devoted to one's own welfare. (Dhammapada 166)

I enclose a cutting[1] from a piece of the Daily Telegraph in which some dána was wrapped (these scraps of newspaper provide me with a window through which I can see what is going on in the outside world -- a strange landscape, with English football and the Belgian Stock Exchange occupying the foreground). The cutting provides a fair example of the muddled thinking about which I wrote to you earlier. You will see from it that, whereas you and I (and presumably Mr. Coghlan too, who wrote the letter) seek food when we feel hungry, a cat seeks food when its stomach is empty: it does not feel anything at all. All its actions -- such, for example, as screeching and bolting when boiling water is poured on it -- take place simply as a result of a stimulus to its cybernetic brain. It would, it seems, be a great mistake to suppose that a scalded cat suffers pain. The cat is perfectly indifferent to what is going on since it feels nothing -- indeed this statement is excessive, since the cat does not even feel indifferent.

Actually, the 'cybernetic brain' is a considerable advance on Professor Jefferson, and is the subject of Dr. Ross Ashby's book Design for a Brain. The principles of cybernetics, of teleological or end-seeking or purposive behaviour (which can be expressed mathematically) are very instructive provided the proper order is observed -- consciousness or experience first, and the body, if at all, a bad second. But Ross Ashby and his disciple Coghlan follow the prevailing fashion of 'scientific common sense', and put the body first. The argument runs something like this. Our own experience, and the observed behaviour of others, is teleological (which is perfectly true); and since our experience or behaviour is entirely dependent upon the state of our nervous system (which is exactly half the truth, and therefore false), our nervous system (or brain) must therefore be a cybernetic machine. It is then the simplest thing in the world to assert that our experience or behaviour is teleological because our brain is a cybernetic machine (explicable, of course, in 'purely physiological terms' as Professor Jefferson would say) -- an assertion for which there is no independent evidence whatsoever. Confusion is then worse confounded by the unexplained addition of 'conscious intelligence and will', whose connexion with the cybernetic mechanism of the nervous system is left completely in the dark. However, enough of this.

I notice that at the top of the hospital notepaper there is the motto 'Árogya paramá lábhá'. Everybody naturally takes this to mean that bodily health is the highest gain, and it might seem to be a most appropriate motto for a hospital. But perhaps you would be interested to know what the Buddha has to say about it. The following passage is from Majjhima Nikáya Sutta 75 (M.i,508-10, in which the simile of the leper who scratches and roasts himself also appears). The Buddha is talking to Mágandiya, a Wanderer (paribbájaka -- follower of a certain traditional school of teaching):

Then the Auspicious One (Bhagavá) uttered these lines:
-- Good health is the highest gain,
nibbána is the highest pleasure,
and the eight-factored path is the one
that is peaceful and leads to the deathless.
(Árogya paramá lábhá nibbánam paramam sukham,
Atthangiko ca maggánam khemam amatagáminan ti.)
     When this was said, the Wanderer Mágandiya said to the Auspicious One: -- It is wonderful, Master Gotama, it is marvellous, Master Gotama, how well said it is by Master Gotama 'Good health is the highest gain, nibbána is the highest pleasure'. I, too, Master Gotama, have heard this saying handed down from teacher to pupil by Wanderers of old 'Good health is the highest gain, nibbána is the highest pleasure'. And Master Gotama agrees with this.
     -- But in this saying that you have heard, Mágandiya, handed down from teacher to pupil by Wanderers of old 'Good health is the highest gain, nibbána is the highest pleasure', what is that good health, what is that nibbána?
     When this was said, the Wanderer Mágandiya stroked his own limbs with his hand. -- This, Master Gotama, is that good health, this is that nibbána. At present, Master Gotama, I am in good health and have pleasure; there is nothing that afflicts me.
     -- Suppose, Mágandiya, there was a man blind from birth, who could see no forms either dark or light, no blue forms, no yellow forms, no red forms, no crimson forms, who could see neither even nor uneven, who could see no stars, who could see neither sun nor moon. And suppose he were to hear a man who could see, saying 'What a fine thing is a white cloth that is beautiful to look at, clean and spotless!', and were then to go in search of such cloth. And suppose some man were to deceive him with a coarse cloth stained with grease and soot, saying 'Here good man is a white cloth for you that is beautiful to look at, clean and spotless'. And suppose he were to accept it and put it on, and being pleased were to utter words of pleasure 'What a fine thing is a white cloth that is beautiful to look at, clean and spotless!' -- What do you think, Mágandiya, would that man blind from birth have accepted that coarse cloth stained with grease and soot and have put it on, and being pleased would he have uttered words of pleasure 'What a fine thing is a white cloth that is beautiful to look at, clean and spotless!' because he himself knew and saw this, or out of trust in the words of the man who could see?
     -- Certainly, Master Gotama, that man blind from birth would have accepted that coarse cloth stained with grease and soot and put it on, and being pleased would have uttered words of pleasure 'What a fine thing is a white cloth that is beautiful to look at, clean and spotless!' without himself knowing and seeing this, but out of trust in the words of the man who could see.
     -- Just so, Mágandiya, sectarian Wanderers are blind and sightless, and without knowing good health, without seeing nibbána, they still speak the line 'Good health is the highest gain, nibbána is the highest pleasure.' These lines, Mágandiya, 'Good health is the highest gain, nibbána is the highest pleasure, and the eight-factored path is the one that is peaceful and leads to the deathless' were spoken by Arahat Fully Awakened Ones (sammásambuddhá) of old; but now in the course of time they have been adopted by commoners (puthujjaná). This body, Mágandiya, is diseased, ulcered, wounded, painful, sick. And you say of this body that is diseased, ulcered, wounded, painful, sick, 'This, Master Gotama, is that good health, this is that nibbána.' You, Mágandiya, do not have that noble eye (ariyacakkhu) with which to know good health and to see nibbána.

In my letter to you containing the extract from Majjhima Nikáya Sutta 75, I translated one passage near the end as follows: 'This body, Mágandiya, is diseased, ulcered, wounded, painful, sick...' On second thought, I see that this is not quite what is meant. Please substitute the following:

'This body, Mágandiya, is a disease, an ulcer, a wound, a sore, an affliction. It is of this body, which is a disease, an ulcer, a wound, a sore, an affliction, that you say "This, Master Gotama, is that good health, this is that nibbána"...'




[L. 17]   6 July 1962

I have the impression[1] that there is a continuous, though variable, specific stimulation, which, though no doubt neutral in itself (it is, indeed, disagreeable when observed dispassionately), is a pressing invitation to sensual thoughts. I have never experienced anything like this before.

I wonder, therefore, if you would be good enough to send me a sedative to enable me to sleep at night, and also anything else that you think might be helpful. Sedatives, in the last analysis, are not a final cure for this condition, but they may help to make things easier. The cure is essentially a matter of raising the mind above the waist and keeping it there, but this treatment takes time and is hard work (as you may gather from my letter on drug-addiction).




[L. 18]   12 July 1962

Thank you for sending me the copy of Panminerva Medica.[1] The idea that diseases are useful as a means of adaptation to adverse circumstances, namely pathogenetic causes, would perhaps be valid if the only alternative, in such circumstances, to being sick (and surviving) were death -- though even so, as you suggest, the incurable cancer patient might need some persuading before accepting this principle. But why does Prof. Vacira assume that without pathogenetic processes we should die? Or to put the matter another way, since Prof. V. is clearly a firm believer in cause-and-effect he will consider that pathogenetic causes and pathogenetic processes are indissolubly linked -- where there is one there is the other. This being so, if he regards pathogenetic processes as 'indispensable' he must inevitably regard pathogenetic causes as equally necessary. Admitting that man will always encounter adverse circumstances, is it necessary to assume that they must be pathogenetic? There are pathogenetic causes only if they result in pathogenetic processes, and from this point of view pathogenetic processes serve no useful purpose whatsoever -- we should be far better off without them.

The Buddha tells us <D.26: iii,75> that in periods when the life-span of man is immensely long he suffers from but three diseases: wants, hunger, and old age -- none of which involves pathogenetic processes. Man falls from this state of grace when his behaviour deteriorates; until, gradually, he arrives at a state where his life-span is extremely short and he is afflicted by innumerable calamities. General improvement in behaviour reverses the process. It seems, then, that adverse circumstances become pathogenetic causes as a result of the immorality of mankind as a whole. But this connexion between the General Theory of Pathology and what we may call the General Theory of Morality remains hidden from the eyes of modern scientific philosophy.




[L. 19]   11 December 1962

My present situation is this. As you will remember, I first got this affliction (satyriasis?) last June, and I fear that it is still with me. During the first two months, certainly, it became much less acute, and I had hopes that it would altogether disappear. But for the last three and a half months I have noticed no further improvement. With an effort I can ignore it for a few days at a time, but it remains always in the background, ready to come forward on the slightest encouragement.

I find that, under the pressure of this affliction, I am oscillating between two poles. On the one hand, if I indulge the sensual images that offer themselves, my thought turns towards the state of a layman; if, on the other hand, I resist them, my thought turns towards suicide. Wife or knife, as one might say. For the time being, each extreme tends to be checked by the other, but the situation is obviously in unstable equilibrium. (Mental concentration, which affords relief, is difficult for me on account of my chronic digestive disorders, as you already know; and I cannot rely on it for support.) I view both these alternatives with distaste (though for different reasons); and I am a faintly nauseated, but otherwise apathetic, spectator of my oscillations between them. Sooner or later, however, unless my condition much improves, I may find myself choosing one or the other of these unsatisfactory alternatives; and a fresh attack of amoebiasis, which is always possible, might well precipitate a decision.

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Footnotes:

[14.a] For most people, of course, the question does not arise -- they are already fully devoted to seeking the means for gratification of their sensual desires and fulfillment of their worldly ambitions. [Back to text]















Editorial notes:

[15.1] a cutting:

Daily Telegraph and Morning Post, Thursday, March 15, 1962
MAN IS THE ONLY ANIMAL ABLE TO THINK AND FEEL

   Sirs -- In The Facts of Insect Life, Dr. Anthony Michaelis raises the problem of the relation of life and consciousness, i.e., awareness of individuals of their existence.
   Insects are automata reacting mechanically to stimulation of a cybernetic nervous system. They act by instinct. Instincts are chains of reactions to stimuli so linked that reaction to the first stimulus causes the organism to receive the second, the second the third, and so on until the goal is reached. The sequence of actions resulting is intelligent in the sense that it is directed to an end.
   Dr. Michaelis assumes the activities of mammals are not so explicable and 'vertebrates like the rat are conscious.'
   Consider a hunting cat. The first stimulus to its cybernetic brain is an empty stomach causing it to prowl to and fro. The next the rustling noises of its prey in the herbage as the animal accidentally comes within range. Its sonar direction finders swing the head to the direction of the sound, bringing the eyes to bear. Their registration of movement causes the pounce and capture. Grasping claws draw blood, smell provokes the bite, taste then plays its part and the prey is consumed.
   The process is repeated till a full stomach coupled with depletion of the brain's fuel brings things to a halt. The animal curls up and sleeps.
   Since conscious intelligence is not involved, instinct chains can be set in action by anything applying the appropriate stimulus at any point. Cats hunt rustling leaves blown by the wind or the glimpsed tips of their tails as avidly as real prey. In mammals the instinct-provoking object must apply the correct stimuli in the correct order to five perceptors: sound, sight, touch, smell, and taste. In nature this means instinct is in practice infallible.
Our own acts fall into three classes: (1) reflexes which do not reach consciousness; (2) reflexes of which we are conscious but which could equally well be the result of unconscious instinct; and (3) acts impossible to produce without the use of conscious intelligence and will.
   The majority fall into classes 1 and 2 and these we share with the animals. Class 3 activities are found only in Man. The inference? Man alone is conscious; Man alone thinks and feels.
Yours faithfully,
J. J. Coghlan                                                                                Hull
[Back to text]

[18.1] Panminerva Medica is a medical journal published in Turin. [Back to text]