Health may be defined as a perfect state of equilibrium of body and mind, where all the physiological activities take place without impairment or disturbance.
Disease is a state of dis-ease, discomfort produced due to a loss of balance between body and mind.
Genesis of Ill-Health or
Aetiology of Disease.
Out of ignorance (avijja), one does not understand the impermanent nature of the body and the mind. One therefore constantly goes on reacting (sankhara) to the subtle contact (phassa) of matter with the mind, resulting in very subtle pleasant or unpleasant experiences or sensations (vedana), and generating craving or aversion (tanha).
This tanha causes disturbances in the balance of life, generating unrest or discomfort at a very subtle level. This is the beginning of ill-heath, or the origin of disease - which is not noticed by an ordinary person (putthujjana) whose mind is not properly trained.
This habit-pattern of blind reactions continues, and cravings and aversions multiply, turning into clinging (upadana), which makes the process of becoming (bhava) continue. As this cycle of becoming, the cycle of existence, keeps rotating, so all the miseries of life continue to be experienced, including disease, old-age and death.
Examples in the Culakammavibhanga Sutta, one of the Buddha's discourses, explain how those who harm others will sow the seeds of future misery at the mental and physical level, and those not harming others will enjoy sound health.
Today, everyone in the present world is full of ignorance (avijja) about the true impermanent nature of existence, and hence living foolishly, constantly living with blind reactions and creating mental and physical disturbances. Therefore, everyone falls ill now and then.
The apparent causes of illness may be:

1. Physical causes
2. Accidental causes
3. Mental causes.
Mental causes may manifest as:
a) Purely mental illness of various grades from Neurosis to Psychosis. This may be stimulative or depressive.
b) Psychosomatic illness affecting one or more organs or any physiological systems of the body.
Another way of looking at the origin of disease is that it is the result (Vipaka) of Kammas, either past or present.
Present Kammas may be:
1. taking improper food
2. use of intoxicants
3. exposure to extremes of climate
4. prolonged physical or mental strain
5. inadequate rest
6. tensions, worries etc.
The Buddha classified sick persons in three ways in the Anguttara Nikaya and Paññati of Abhidhamma:
1. A sick person who is certain of regaining health in due time, even though he does not take any medicine or treatment.
2. A sick person who is certain of failing to make a recovery, and dying from the illness, no matter to what extent he may take medicines or treatment.
3. A sick person who will recover if he takes the right medicine and treatment, but who will fail to recover and die, if he fails to take the right medicine and treatment.
It is extremely difficult for us to decide which kind of sick person a patient is.
Therefore, all types of sick persons should be given right attendance, proper treatment and expert care.
Symptomatology.
Whatever the cause or causes of illness, disease is a feeling of discomfort (unpleasant, gross, solidified sensations), in any part of the body, or the whole body. Disease produces impairment of the working of one or more physiological systems of the body. This gives rise to various different types of symptoms and signs, needing either simple or complicated investigative procedures.
Treatment.
The Buddha, described as the greatest healer of beings (Mahabhisaka), advised the Middle Path as the right way of living.
Therefore, whenever necessary, i.e. whenever disease disturbs daily work, or hampers your meditation, take the medication of whatever "pathy" you have faith in.
However, one has to learn to endure distressful conditions, in spite of treatment, knowing the law of change, of impermanence. So, howsoever slight or grave physical pain may be, it should not become mental pain or grief or mental suffering. One has to learn this. This requires mental training.
In any situation, one should try to maintain equanimity, the balance of the mind. In the case of disease, tranquillity and equipoise of mind will help and hasten healing.
It should be very clear that Vipassana is not for curing illness. Vipassana meditation is a science to experience the reality about oneself, culminating in the realization of Absolute Truth, which is beyond mental-material phenomena. It is a process of purification of the mind. As the mind is cleansed of defilements, various somatic or bodily manifestations of disease, due to defilements in
the psyche, disappear or are alleviated as a by-product.
Vipassana is a path, establishing oneself in equanimity on the basis of physical, bodily sensations, and knowing by direct experience (panna), the impermanent nature (anicca) of these sensations, the impermanent nature of the universe, and the impermanent nature of existence. This equanimity will always help in the vicissitudes of life; during trying times, in the serious suffering of ill health, in life-threatening situations. Even at the moment of death, equanimity and understanding anicca are bound to help, to maintain peace and remain fearless and fully conscious when leaving this life.
Vipassana is not a remedy for disease, yet it is a "cure-all", cutting off the cycle of birth and death, the cycle of suffering. Vipassana is the noble way to real peace, the real happiness of nibbana.
Goenkaji's teacher, Sayagyi U Ba Khin, in his research work at IMC Rangoon, noticed that very stubborn diseases, progressive, crippling, degenerative conditions, or incurable ailments have vanished as side-effects of the practice of Vipassana. This has been well documented in his booklet "Real Values of Vipassana Meditation."
As mentioned earlier, ordinary ignorant persons, not knowing the true nature of impermanence (anicca) of suffering (dukkha), keep rolling in suffering, thus multiplying suffering (dukkha samudaya). A wise person, knowing anicca at a personal, direct, experiential level, makes this suffering a tool, develops equanimity, and ultimately achieves the end of suffering (dukkha nirodha).
Case Histories.
1. A woman of about seventy, well established in Vipassana meditation and practising more than two hours daily, experienced severe pain in the chest and other symptoms. The clinical diagnosis was heart attack, and this was confirmed by ECG as myocardinal infarction. The pain was such that she felt that her life was threatened, that death was near, and she wondered what to do. She decided to take refuge in Dhamma, and started meditating with awareness of anicca, with sati sampajanna.
The doctor and others present thought that she had become unconscious. Suddenly, the room become quiet and peaceful, and all present felt the atmosphere of peace. After some time, she came out of deep meditation. She said she felt that ill-will and hatred had left her, and that she felt full of love and compassion, peace and goodwill.
Here, the death-heralding pain of a heart attack, the unpleasant sensation (dukkha vedena) was made a tool to come out of suffering successfully, as she established herself in dukkha-nirodha-gamini-patipada.
2. A middle aged woman was travelling by air, when suddenly the weather became stormy and the plane started wobbling. The passengers were afraid they would die, and started to panic, shouting and crying etc. This woman, a serious meditator, realized the gravity of the situation, but did not generate feelings of insecurity and started silently meditating.
After a while the storm passed away and no-one was hurt. In such an extremely perilous situation, she could maintain inner peace with experience of anicca and equanimity.
3. A middle-aged man was severely burnt on his fingers by accidentally holding a very hot iron hammer. Blisters appeared. His hands were treated with cold water immersion and he also started meditating. After a few hours the excruciating pain subsided and the next day the blisters disappeared as if nothing had happened. The doctor attending thought this injury would take ten to fifteen days to subside, but within twenty-four hours no trace of the burn injury remained. After about ten to twelve days, the burnt skin, which was unnoticeable, started to peel off, as a reminder of the burns.
4. A man with a typical case of heart-attack started meditating. He was very restless and in severe agony, but kept on trying for about two days without giving up. After that, the symptoms started subsiding and the mind could remain with the breath, which was his object of concentration.
Experts examined him on the fourth day, and an ECG showed an attack of coronary thrombosis. On physical examination, the cardiologist said no medicine was necessary. Repeated check-ups were made by various cardiologists, and ECGs were done every three months. All gave the same result as the first. He fully recovered after a six-month rest, and was advised to forget about the attack. He did not have to take any medicines, and could lead a life as he had lived prior to the attack, doing his normal work.
5. In a case of unknown aetiology, a middle-aged male, a good meditator, developed loss of muscle power. Experts diagnosed it as a progressive, crippling, paralysing disease. After two months of treatment and six months of rest, full recovery took place. He continued to meditate during the illness. Experts then said no medication was necessary and he could live a normal life.
Practising Vipassana Meditation is a right way of living, in illness and in health. ¦