Ancient texts blend two accounts regarding the death of Lord Buddha. Was it planned and desired by Buddha, or was it due to food poisoning or something completely different?
The Passing of Buddha
By Dr. Mettanando Bhikkhu, M.D.
The Mahaparinibbana Sutta, part of the Pali Tipitaka’s Long Discourses, stands as the most authoritative source of information on the death of Siddhartha Gautama (563-483 B.C. Written in a narrative style, it invites readers to trace the final days of Gautama, revered as the Lord Buddha, beginning a few months before his demise.
Yet, grasping the true events of Buddha’s end is no simple task. The Sutta reveals contrasting portrayals of Buddha, each alternating throughout the narrative.
According to the Mahaparinibbana Sutta, Buddha fell gravely ill after consuming a dish known as sukaramaddava, or “soft pork,” prepared by his generous host, Cunda Kammaraputta.
The dish’s intriguing name has captured scholarly attention, sparking extensive research into its ingredients. The Sutta not only details Buddha’s symptoms but also provides credible information about his health in the preceding four months— facts with significant medical implications.
The Sutta begins with King Ajatasattu’s intent to conquer the rival state of Vajji. Buddha had journeyed to Vajji to commence his final rainy season retreat, where he eventually succumbed to an illness marked by sudden, severe pain.
A Different Diagnosis of Buddha’s Passing
The text indicates that Buddha’s illness struck immediately after eating the sukaramaddava. With little known about the dish’s nature, pinpointing it as the direct cause of his illness is challenging.
However, the description suggests a rapid onset of discomfort.
While eating, Buddha sensed something amiss with the meal and requested it be buried. Shortly after, he experienced acute abdominal pain and rectal bleeding. It’s plausible that the discomfort began during the meal, prompting him to suspect something was off with the exotic dish. Out of compassion, he had it buried.
Could food poisoning be the culprit?
It seems unlikely.
The symptoms don’t align with typical food poisoning, which can be severe but rarely causes bloody diarrhea. Bacterial poisoning doesn’t manifest immediately but follows an incubation period ranging from a few hours to half a day, featuring diarrhea and vomiting but no bleeding.
Another possibility is chemical poisoning, which also manifests immediately. Yet, it’s uncommon for chemical food poisoning to cause severe intestinal bleeding. Only corrosive substances like strong acids can cause immediate clinical symptoms, leading to upper digestive tract bleeding, known as hematemesis, a symptom not mentioned in the Sutta.
Peptic ulcer disease can also be ruled out.
Though it might begin suddenly, it rarely involves fresh blood in the stool.
A bleeding gastric ulcer would likely produce blackened stools from a blood vessel injury. An ulcer higher in the digestive tract would probably cause blood vomiting rather than bloody diarrhea.
Given Buddha’s age and acceptance of a meal invitation, suggesting he felt as healthy as a man in his eighties could feel, we cannot dismiss the possibility of chronic diseases like cancer or tuberculosis or even a tropical infection like typhoid fever, prevalent in Buddha’s time.
Our life is a creation of our mind.
Gautama Buddha
A Possible Mesenteric Infarction
The mesentery, part of the intestinal wall connecting the entire intestinal tract to the abdominal cavity, is typically involved. An infarction in the mesenteric vessels usually results in tissue death in a large portion of the intestine, leading to the tearing of the intestinal wall. This often causes intense abdominal pain and bleeding, with patients usually dying from acute hemorrhage. This aligns with the Sutta’s account.
Later, when Buddha requests water from Ananda, indicating severe thirst, Ananda refuses, citing the absence of clean water and arguing that a large caravan had muddied a nearby stream. Yet, Buddha insists on having water regardless.
Here arises a question: Why didn’t Buddha fetch the water himself rather than pressuring an unwilling aide?
The answer is straightforward. Buddha was suffering from hypovolemic shock due to severe bleeding.
Retrospective Analysis
From the above diagnosis, it is almost certain that Buddha suffered a mesenteric infarction due to an occlusion of the superior mesenteric artery. This was the cause of the pain that nearly killed him a few months earlier during his last rainy season retreat.
As the disease progressed, the intestine’s mucosal lining detached, becoming the source of bleeding. Arteriosclerosis, the hardening of the vessel walls due to aging, was the cause of the arterial occlusion. This small blockage did not result in bloody diarrhea but manifested a symptom known as abdominal angina.
He experienced a second crisis while eating the sukaramaddava. The pain probably wasn’t intense initially but it made him feel that something was wrong.
Suspecting the dish, he asked the host to bury everything to prevent others from falling ill. Shortly after, Buddha realized his condition was serious, with rectal bleeding and worsening abdominal pain. Due to the bleeding, he went into shock. The severity of dehydration was so great that he could no longer endure and had to take shelter under a tree along the way.
Feeling thirsty and exhausted, he asked Ananda to fetch water despite knowing it was muddy. It was then that he collapsed, and his entourage took him to the nearest town, Kusi Nara.
The sutta makes it clear that Buddha did not anticipate his sudden illness; otherwise, he would not have accepted his host’s invitation. Kusi Nara was likely the nearest city where he could find a physician to attend to him.
Without proper treatment, a patient with mesenteric infarction can live from 10 to 20 hours. From the sutta, we know that Buddha died about 15 to 18 hours after the onset of the crisis. During this time, his attendants did their best to make him comfortable, for example, by warming the room where he was resting, dripping water into his mouth to quench his persistent thirst, or offering him medicinal preparations.
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About the Author
The author’s analysis inspired this article. Dr. Venerable Dr Mettanando Bhikkhu, M.D., practiced medicine before becoming a Buddhist monk. He later left monastic life, taught at universities, and managed social projects in Thailand. Mettanando – How the Buddha died.
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