Are monks allowed to have prescriptions? What did the Buddha say of medicine?

Providing the services of a medical practitioner or pharmacist to lay people is not allowed for monks according to DN2:

"Whereas some contemplatives & brahmans, living off food given in faith, maintain themselves by wrong livelihood, by such "animal" arts as: promising gifts to deities in return for favors; fulfilling such promises; demonology; reciting spells in earth houses [see earth skills, above]; inducing virility and impotence; preparing sites for construction; consecrating sites for construction; giving ceremonial mouthwashes and ceremonial baths; offering sacrificial fires; administering emetics, purges, purges from above, purges from below, head-purges; ear-oil, eye-drops, treatments through the nose, ointments, and counter-ointments; practicing eye-surgery [or: extractive surgery], general surgery, pediatrics; administering root-medicines and binding medicinal herbs — he abstains from wrong livelihood, from "animal" arts such as these. This, too, is part of his virtue."

Monks can use medicine for their own use, according to "The Bhikkhus' Rules: A Guide for Laypeople" by Bhikkhu Ariyesako:

MEDICINES OR TONICS

We have dealt above with food and fruit juice. There is now the category of 'tonic-medicines' (sattaahakaalika). These can be consumed at any time but cannot be stored longer than seven days (after they are offered).

These tonic-medicines were originally regulated when Venerable Pilindavaccha's great feats of psychic power made him so famous that he received many offerings of the five 'tonics.' Even though he distributed these among other monks there was so much that the excess had to be stored away and their dwellings were overrun by rats. Visiting lay people criticized the monks for "storing up goods in abundance like a king." The Buddha therefore set down this rule:

"Keeping any of the five tonics — ghee, fresh butter, oil, honey, or sugar/molasses — for more than seven days is [an offence of Confession with Forfeiture.] (Summarized Nis. Paac. 23; BMC p.242) ◊ There are various translations and interpretations about these 'tonic- medicines' — according to different Communities and different countries. Some places consider only liquids allowable while a few communities will drink only plain water in the afternoon. Some communities will not accept re-offered tonic-medicines (after the seven days period is over), some will under certain circumstances. Therefore lay devotees need to enquire about the practice of their local Community and follow that way.[94]

Some contemporary observations:

"The five medicines — ghee, navaniita.m, oil, honey, and suga — were allowed by the Buddha to be consumed by 'sick' monks at any time of the day or night. According to the Mahaavagga, these five were 'agreed upon as medicines and, although they served as nutriment for people, were not considered as substantial food.' The degree of infirmity required before a monk is allowed to consume these [tonic-]medicines is a controversial point... It seems that feeling rundown or feeling tired after physical exertion would be sufficient cause to be able to make use of the Five Medicines."(AB)

"The main effectiveness of these medicines seems to be in their nutritional value. They do not have medicinal value as commonly understood today, for example, relieving pain or as an antiseptic. However, as nutriment they would help to maintain bodily strength and assist in recuperation while, since they are so rich, would not be a substitute for normal food." (HS ch.10)

Also, if the tonic-medicine is mixed with a tiny amount of food then it would be acceptable according to this allowance:

"...if sugar has a little flour mixed with it simply to make it firmer — as sometimes happens in sugar cubes and blocks of palm sugar — it is still classed as a tonic as it is still regarded simply as 'sugar.'" (BMC p.238-9) If the flour is for more food-like reasons then it would be counted as food. See also Mixing Edibles above.

LIFETIME MEDICINES

The fourth category of edibles (see The Four Sorts of Edibles) is that of Lifetime Medicines (yaavajiivika). which includes what we generally think of as medicines.

The basic principle set down by the Buddha about all medicines is in this reflection:

"Properly considering medicinal requisites for curing the sick, I use them: simply to ward off any pains of illness that have arisen, and for the maximum freedom from disease." [OP p. 47; (Paali: M. I, 10; A. III, 387)] In the beginning, the basic (herbal) medicines allowed by the Buddha were those pickled in urine. Later, nearly all other types came to be considered allowable.[95] (See the separate allowance above for 'tonic-medicines.')

Medicines that may be consumed without time limitation are called yaavajiivika. The Texts mention different sorts of herbal medicines such as: plant roots, e.g., ginger, turmeric, sweet flag, etc.; decoctions, such as of the neem or nux-vomica; tree-leaves, such as neem-leaves, tulsi or holy basil; fruits, such as long peppers, myrobalan, wormwood; resins, such as asafoetida; salts, such as sea-salt, rock salt, etc. Any other medicine or herbs similar to these that is not reckoned to be food is included under this 'lifetime' category.[96]

◊ Modern western medicines are usually included — using the Great Standards — under this category and therefore can be taken at any time of the day and kept as long as necessary.

In "Ministering to the Sick and the Terminally Ill", Lily de Silva quotes the Buddha as exhorting monks to care for and look after other monks:

"He who attends on the sick attends on me," declared the Buddha, exhorting his disciples on the importance of ministering to the sick. This famous statement was made by the Blessed One when he discovered a monk lying in his soiled robes, desperately ill with an acute attack of dysentery. With the help of Ananda, the Buddha washed and cleaned the sick monk in warm water. On this occasion he reminded the monks that they have neither parents nor relatives to look after them, so they must look after one another. If the teacher is ill, it is the bounden duty of the pupil to look after him, and if the pupil is ill it is the teacher's duty to look after the sick pupil. If a teacher or a pupil is not available it is the responsibility of the community to look after the sick (Vin.i,301ff.).

On another occasion the Buddha discovered a monk whose body was covered with sores, his robe sticking to the body with pus oozing from the sores. Unable to look after him, his fellow monks had abandoned him. On discovering this monk, the Buddha boiled water and washed the monk with his own hands, then cleaned and dried his robes. When the monk felt comforted the Buddha preached to him and he became an arahant, soon after which he passed away (DhpA.i,319). Thus the Buddha not only advocated the importance of looking after the sick, he also set a noble example by himself ministering to those who were so ill that they were even considered repulsive by others.