Bathing Practices as a Religious and Medical Encounter: Water, Climate and Health Across Monsoon Asia

Abstract

This study explores the intersection between religious and medical bathing practices across Monsoon Asia, with particularly reference to āyurvedic and Buddhist traditions. While previous scholarship has emphasised the ritualistic and social dimensions of bathing in Brahmanical and Buddhist contexts, this article complements it with discussions of its medicinal and healing functions, as outlined in classical texts and displayed in material culture. The research highlights how bathing was considered essential for maintaining bodily balance—a concept analogous to humoral theory in Galenic medicine—across different climatic and environmental conditions, particularly during the monsoon season. The article further examines the transregional circulation and localisation of these practices, considering how diverse Asian cultures adapted Indic bathing traditions to their unique climatic and cultural contexts. Notably, the study addresses the complex interplay between religious doctrines, health and environmental factors, drawing connections between āyurvedic principles and Buddhist medical discourses. The findings suggest that while the notion of balance in bathing practices was widespread, its interpretation and implementation varied significantly across regions, reflecting local environmental and cultural influences. Through a comparative analysis of sources from South Asia, China and Southeast Asia, this article provides a nuanced understanding of how religio-medical bathing practices were shaped by and responded to the diverse climatic realities of Monsoon Asia.

1. Introduction: Bathing in Classical Āyurvedic Texts and the Question of Monsoon Asia

Scholars of Indic religions have traditionally approached bathing practices from a ritualistic point of view. Brahmanical texts on ablutions set out complex and lengthy procedures that involve various body postures, hand gestures, mantra utterances and offerings.1 Further ritualistic elements associated with bathing include mindfulness of cardinal directions, astrological alignments and the lunar calendar, as well as the symbolic re-enactment of social and cosmic hierarchies. Similarly, Buddhist texts on bathing show considerable concern with standardised practices, which besides ritual elements also focus on decorum and securing the approval of the laity (Heirman and Torck 2012). Thus, avoiding unpleasant smells and wearing clean robes projected an aura of respectability that was conducive to harmonic social interactions both within and outside the Saṅgha. Equally important to religious authors was the avoidance of improper behaviour that may occur while bathing, as the exposure of flesh and the possibility of intimacy may encourage the temporary forsaking of monastic vows. Thus, in both Brahmanism and Buddhism, complex rules and regulations are required to shape and facilitate the experience of bathing. In this article, my aim is to complement this approach by placing more emphasis on the medical and healing aspects of bathing. But there are some aspects of ritual that cannot be entirely left out. The ritualistic approach to bathing culminates in the concept of ritual purification, a holistic notion that encompasses both spiritual and bodily wellbeing. This partially overlaps with the medical narratives we are setting out to collect here. Concurrently, the objective is to see to what extent views about bathing and health can be discussed transregionally, following the circulation of Brahmanism and Buddhism across Asia in the premodern period (for a discussion of the chronology, see below). This is particularly important for Southeast Asia, which has traditionally been neglected due to the relative paucity of surviving textual sources. Let us clarify both objectives before moving on to a survey of primary sources connecting various regions.

Recently, a study of water in classical āyurvedic texts2 has shed more light on the multiscalar dimensions of bathing, including its healing aspects, in premodern South Asia (Angermeier 2020).3 The study highlights how bathing was intimately connected with the notion of balance. This is to be expected, as āyurvedic aetiology is akin to the humoral approach of Galenic medicine: disease results from an imbalance in one of the three doṣas (Zysk 2021). While diet was seen as the key instrument in facilitating this balance, bathing too could serve such a purpose. But the study also highlights how the notion of balance is in fact multiscalar and involves other realms beyond that of the body and its constituents, including environments and topographies as well as wider climatic and cosmological settings. For example, different kinds of water bodies are said to have different medical properties depending on the seasons, especially the monsoons and the winter months.4 As in mediaeval European medicine, the approach taken is a holistic one, inasmuch as the human is seen in connection with their context and as subject to a dynamic flux of forces. In classical āyurvedic texts, some of the main medical benefits of bathing are listed as energising the body and mind, removing sweat, removing dirt, awakening of the senses, improving one’s mood, enhancing manliness, purification of the blood, and pacification of the digestive fire.5 There are similar lists of benefits in Buddhist texts, which will be presented below.

In line with the objective of the present special issue, the main question here is whether and to what extent views about bathing as a health practice can be discussed from a transregional perspective. We are of course mindful to avoid a diffusionist model that takes India as the source of cultural practices, and Southeast Asia or East Asia as the recipients. Nevertheless, we take Indic practices as a starting point in order to show how multiple cultural “centres” and actors across Asia selected and adapted some of these materials to fit their own needs and agendas.6

Given that āyurvedic sources on bathing place emphasis on climate and the environment, one wonders if this could be the starting point for building a transregional framework, along with the traditional focus on the physical “humours”. It goes without saying that there is one major weather event that characterises the macroregion including India, Southeast Asia and parts of East Asia: monsoon rains and the cyclical environmental changes associated with them. The term Monsoon Asia has a longstanding, and perhaps controversial, historiographical pedigree, which after decades of neglect has recently made a comeback. The improved and more nuanced theoretical backdrop avoids the dangers of reducing highly diverse regions to a homogeneous and unrealistic whole.7 Rather, diversity is emphasised at the same time as a complex web of encounters, facilitated by monsoon and maritime connectivity. The high point of such connectivity networks is represented by the circulation of Indic religions roughly between 600 and 1300 CE.8

While it does make sense intuitively that bathing practices across Monsoon Asia would be somehow linked to each other, the ways in which they are linked defies initial assumptions. We would assume that the climates of India, Sri Lanka, Cambodia, Java and perhaps coastal China and even Southern Japan would expose people to similar sets of problems and pathogens related to water and bathing. My initial expectation was to find similar diseases linked to monsoon rain treated with similar emphasis in the available texts across these regions. For example, fungal infections or other skin conditions could be expected to figure prominently. However, as I progressed, I found that the texts were reluctant to offer straightforward accounts of aetiology, especially when it came to tallying directly with contemporary biomedical concepts of infection and disease. Also, I found that notions of humoral and elemental disharmony were far less homogenous than one might expect. A key issue here is the uneven distribution and typology of textual sources, which makes it difficult to compare practices, for example those in ancient Angkor with those of Hangzhou or Polonnaruwa. Nevertheless, I believe the evidence collected here allows for a first discussion of the health benefits of bathing in a transregional perspective. In this context, religious agents, texts and ideas played a key role in facilitating circulation, alignment as well as localisation (i.e., non-alignment) of practices. Generally speaking, I argue that the very notion of “balance” can be used as a starting point for a transregional discussion of bathing practices, and that environmental and climatic contexts formed an essential part of how this notion was locally interpreted. However, such a notion of balance cannot be seen as entirely detached from ritualistic purification. Separating the two would be artificial and anachronistic, given the holistic character of premodern healing traditions. This is particularly important for Southeast Asia, where the relative lack of medicalised narratives could result in the neglect of entire regions which have much to offer to the study of premodern bathing practices. If we are to build more compelling transregional studies in the future, an understanding of the multiscalar dimension of bathing will surely be a requirement.

2. Chinese Buddhist Sources on Bathing and Climatic/Seasonal Variations

Most of the available research on the transregional dimensions of bathing predictably focuses on Buddhist discourses and their reception in China up to and including the Song period, particularly in the context of monastic regulations (Vinaya) (see Kieschnick 2013). Crucially, such discourses have also found a material dimension in the Buddhist “bathhouse” or jantāghara. Archaeological remains of this important part of a Buddhist monastic complex can be found in South Asia and Sri Lanka.9 In China, in addition to the limited archaeological evidence, we have detailed descriptions of such bathhouses and even depictions in drawings of idealised monasteries.10 The most well-known drawings are those related to Daoxuan, in which the bathhouse is depicted as an annex building in the lower-right margin.11 As the extant buildings from South Asia illustrate, the bathhouse primarily functioned as a steam house, with water levels reaching just above the ankle and with water heating facilities to generate the desired temperature. As mentioned above, Buddhist texts were concerned with the social aspects of bathing and the avoidance of impropriety both within the order and in its relation with the laity.12 Apart from social concerns, Buddhist texts were also adamant that the hedonistic aspects of bathing, including the pursuit of cleanliness and beauty, should not constitute the main reason for bathing. In this context characterised by injunctions and prescriptions, one aspect that regulators could encourage was to seek baths for health purposes. In particular, the descriptions in Buddhist monastic codes (Vinaya) emphasise the usefulness of bathing against wind illnesses, which are associated with cold symptoms that can be alleviated through steam.13 This is parallel to the āyurvedic ideal of using water at different temperatures as a means of balancing the doṣas. However, in the context of Buddhist cross-cultural translations—of Sūtras as well as Vinaya—one typically discovers contrasting frameworks that can be hard to reconcile. For example, the Sūtra on Bathing the Saṅgha in the Bathhouse14 lists various health benefits of bathing, such as bringing the four elements into equilibrium, curing wind illnesses, removing cold and replenishing feverish “Qi”.15 It is clear that the mention of balancing of “the four elements” rather than “the three doṣas” or indeed of “Qi” cannot be just simplistically traced back to Indic medical theories. In cases like this, one can either posit that Buddhist medical discourses recognised both a system of humours and one of elemental balance, or one may talk about Chinese reformulations of aetiology in accordance with local medicine. A recent study considers the Fo yi jing (T793) and tangentially discusses such complex matters (Lin and Radich 2023, pp. 886–87). Be that as it may, these examples illustrate two points: (1) that medical concerns are quite central in Buddhist discourses on bathing (indeed, the Vinaya commentary Pinimu Jing, possibly translated towards the end of the fourth century, goes as far as stating that “bathing is for no other purpose than to rid the body of illnesses caused by wind and cold)16 and (2) that the transregional dimension of these discourses is often one of divergence and localisation, rather than homogenisation.

The next question is whether it is possible to link such cross-cultural exchanges to climate and the environment. Once again, we are not attempting to reduce “Monsoon Asia” to a homogeneous region. Discussions about differences and contrasts in environments may prove more enlightening. References to climate-related disease do occur in Buddhist sources. First of all, the mention of wind illness could suggest a link with cold temperatures or sudden temperature drops.17 Furthermore, seasonal change (ṛtupariṇāma) is explicitly listed in the texts among the possible causes of disease, along with seven other factors recognised in canonical sources.18 Some widely circulating Mahāyāna texts—such as the one devoted to the adventures of Sudhana and also depicted in murals in Central Java19—offer insights into the climate-related aspects of illness. Specifically, a key section lists which doṣas increase or decrease according to the seasons, linking the monsoon season with an increase in vāta or wind-related ailments.20 The monsoon season is particularly critical to health due to sudden changes from cooler moments following rainfall to moments of heat and very high humidity. This is in stark contrast to the summer months preceding the rain, in which temperatures are very high but are easier to cope with due to lower humidity. A passage in the Chinese rendering of the Saṃyuktāgama clearly defines this period of monsoon rain as both “hot and cold” (Sik 2016, p. 123 [T99.252c]) when discussing harm due to seasonal change.

While collecting passages on awareness of climatic impact on the body’s balance is rather straightforward, the task becomes more challenging when looking for texts that directly link seasonal health imbalances with the practice of bathing. Scholars working primarily on Chinese sources have identified a number of relevant passages, including non-scriptural sources. A Song inscription has been interpreted as referring to excessive sweat during hot months and the necessity of bathing in order to avoid falling ill (Kieschnick 2013, p. 25). This is mirrored by younger Vinaya passages that clearly stress the need for bathing in order to counteract the summer heat.21 Various discussions by Chinese and Japanese authors go into further detail regarding the frequency of bathing across different seasons. For example, one author encourages daily bathing in the summer and bathing every five days in the winter (Heirman and Torck 2012, p. 44). Another source speaks of a ten-day gap during the winter (Heirman and Torck 2012, p. 36).

In this context, there is one author whose works perfectly illustrate how such discussions took place on a transregional platform. Clearly, the different weather systems of India and China would represent a thorny issue for monks concerned with following monastic rules around bathing. So, it is not surprising that as early as the seventh century, the Buddhist pilgrim and traveller Yijing, who took the maritime route towards India, devoted ample space to this particular topic. Contrary to most discussions of Vinaya and cleanliness, which focus on decorum and ritual, Yijing stresses the medical and health benefits of bathing, with a remarkable attention to climatic differences across regions. His discussions are made all the more fascinating by a considerable acquaintance with both āyurvedic and Chinese systems of medicine. For example, we read: “The customs regarding taking baths in India are different from those in China. In India the climate is temperate with slight variations in different regions. There are flowers and fruits throughout the year, even in the twelfth month. Snow and ice are unknown, except for a thin layer of frost. Although the weather is hot at most times, the heat is never unbearable. Even in hot weather, people do not suffer from prickly heat, and in the cold season, their feet are not chapped. Because of this [moderate climate], the people take baths frequently and set store by bodily cleanliness. Every day they do not eat before having washed themselves. There are ponds full of water in all places, and the people consider it a meritorious deed to dig ponds […] At Nalanda Monastery there are more than ten large bathing pools, and every morning an instrument is sounded to call the monks to take baths”.22 When discussing the method of making a bathhouse, Yijing also explicitly states that “the heat of the stove should be adjusted to the season” (Kieschnick 2013, p. 109).

These known examples from transregional discussions of Buddhist bathing practices speak to an awareness of the interaction between health and climatic factors, including of differences across the macroregion we may call “Monsoon Asia”. However, the search for evidence becomes more challenging once we move out of the relatively abundant and well-researched Chinese sources. Can one integrate regions like Sri Lanka, Cambodia and Java within the tapestry of bathing narratives across Monsoon Asia?

3. Sri Lanka: From Monastic to Royal Dimensions of Bathing Practices

As we turn to evidence from Sri Lanka, it is useful to distinguish two major themes within discourses about bathing. One is the now-familiar theme of Buddhist monastic practices. The second major theme is a discussion of royal interventions and narratives, which are often informed by religious ideals. For example, there is evidence of royal patronage in the construction of bathing facilities in Lanka, acts which are also described in eulogistic passages in local chronicles. As can be expected, the amount and detail of the primary sources are less abundant than in the case of Chinese Buddhist discussions. Even more challenging is the detection of direct references to climatic and environmental factors. Some passages can however be readily identified and are referred to in this section. Another issue is the degree and character of the transregional dimension of these narratives. While in the case of Vinaya discussions or Yijing’s travelogues, that dimension was prominent, here it is less explicit. However, it can be teased out through comparison with allied materials from neighbouring regions. With these preliminary remarks in mind, we may now turn to presenting an overview of the available evidence.

First of all, evidence from Sri Lanka can be easily integrated within discussions about bathing and Buddhist monastic regulations. Surprisingly, due to the highly specialised nature of contemporary academic practices, it is generally rare for scholars of Chinese Vinayas to incorporate these sources.23 As we have already seen, one of Sri Lanka’s contributions to these discussions starts with material culture. Here we find actual evidence of mediaeval “saunas” known as jantāgharas, an integral part of Buddhist cleanliness practices. Furthermore, monastic architectural remains testify to sanitation facilities and septic tanks.24 It is very challenging to identify similar and co-eval structures on either the Indian subcontinent or indeed in Southeast Asia. Rather unique pieces of material evidence can be found in the so-called “sarcophagi” that can be found within some Ceylonese monastic complexes. These appear to date back to the ninth century. According to some scholars, the internal carvings of these structures, shaped in order to accommodate a person lying horizontally, could have been used for medicinal immersions. Some attempts have been made to identify descriptions of similar immersion pods within classic āyurvedic texts such as Caraka or Suśruta, as well as within Buddhist texts (Mueller-Dietz 1996, p. 50). To the best of my knowledge, the current consensus is this: while no specific description of these sarcophagi has been found, various textual passages referring to immersion therapy and the use of various unguents and herbs for healing purposes allow us to have some confidence that these pods were used for healing immersions. Unfortunately, the main Buddhist medicinal manual for this region, the 13th-century (?) Bhesajjamanjusa, does not seem to describe the structures (Liyanaratne 2002). I have so far only been able to identify passing references to bathing as a way to heal various ailments. But I have not encountered any detailed descriptions that also relate to seasonal or climatic variations. Once again, the Pāli Vinaya represents the main textual source here, as exemplified in particular by the Bhesajjakhandaka section (Sik 2016).

I think the most fascinating materials from the island come not from Buddhist sources but from sources related to the exercise of royal power. Such exercise was of course regularly expressed with the help of religious themes and notions.

Starting from material evidence, it is easy to notice that parts of the island are criss-crossed with a system of gutters, channels and tanks. Much of this infrastructure predates the fifteenth century (Abeywardana et al. 2023). Such a remarkable system of irrigation and water management is of course linked to the need to distribute and retain water in one of the regions which is hit most strongly by monsoon rainfall (even if the island can be divided into various subregions, some of which receive less rain). Tanks and ponds that may have been used for bathing also constitute part of this network. While it is always difficult to comment on the public dimension of bathing structures, some pools were clearly created as bathing facilities for royals or aristocrats. Like the ankle-height water level of the jantaghāra, some of the identified structures present stone seats. Others may also allow for a full immersion of the body.25 One set of written sources that can potentially throw light on the construction and maintenance of these pools is epigraphic documents. Indeed, it is possible to find reference to “baths” in the published volumes of Inscriptions of Ceylon for the period under review. But these passages are mainly concerned with regulating access to the baths and have little to say about their therapeutic use, let alone in accordance with seasonal change. One inscription states that “no tenants shall be allowed in any bath” attached to what could be a monastic infirmary.26

For more explicit passages, one needs to turn to royal chronicles such as the Cūlavaṃsa and the Mahāvaṃsa.27 These outline the alleged reasons for the construction of bathing facilities, with the intention of highlighting a ruler’s concern for the welfare of monastics. Most passages limit themselves to praising the generosity of the ruler, or listing the buildings and structures, either new or repaired. However, some can be more informative. One passage speaks of a ruler sponsoring “a fine bathing-house wholly of stone, a boundary wall and a garden which belonged to the bhikku community” (Geiger 1996, [reprint], section 78.83). This probably refers to a jantaghāra-style building. Another passage directly mentions seasonality and health: “For the bathing of the bhikkhus in the hot season, he had two charming ponds made there beneath hollow rocks” (Geiger 1996, section 79.5). This remark is in line with the āyurvedic and Vinaya injunctions presented above, namely to bathe more often during the hot months.

Another passage says: “in order to cleanse the outward impurity, that one might be able to bathe in great heat he had eight bath-houses of stone erected […], adorned with pillars, staircases and railings” (Geiger 1996, section 78.45). Once again, remarkable acts of patronage are justified by the wish to help the monastic community maintain health during the hot months.

Putting aside these rare instances addressing health concerns directly, a number of passages attest to the role of myth and poetical constructions of nature in relation to ideal rulership. While such themes are not the primary objective of the current investigation, these can be helpful where direct references to medicine are lacking. On the one hand, the chronicles are replete with anecdotes that involve bathing ponds within an idealised and idyllic natural environment. Royal power is thus constructed as a way to bring balance to nature, partly through the management of bathing facilities. In this balanced and benevolent natural “garden” (Shaw 2022), people are free from fear and danger.28 On the other hand, we find constructions of nature as dangerous and unpredictable. This is exemplified in the figure of the Nāgas, the powerful serpentine creatures that are traditionally associated with water bodies and the weather. While a number of sources construct royal power as well as ritual and religious means as capable of taming these creatures, it is harder to find direct references to bathing and health in this context. Some pools and tanks in Sri Lanka occasionally bear carvings of Nāgas.29 And Sanskrit manuals that deal specifically with taming the Nāgas do mention bathing, but this is usually addressed in the context of preparatory ritual purifications before engagement with the powerful creatures can begin. The only example I have been able to find comes from the Rājataraṅginī, a Sanskrit chronicle of the kings of Kashmir. One passage speaks of a Nāga king helping to cure the Queen’s eye illness. Water and immersions are included within the narrative as a way to access the Nāgas’ underwater realm (Hidas 2019, p. 28). While such narratives are not as pertinent as āyurvedic or Vinaya materials, they did circulate widely and may prove useful in regions where there is a paucity of extant literary sources. For example, the Nāgas are also part of the Indic myth of the churning of the ocean with Mount Meru. A result of this churning includes the distilling of amṛta or “nectar of immortality”. It is easy to see why discussions about amṛta could be relevant to the interpretation of bathing sites, for example involving the use of springs as healing waters. As we move our survey to mainland and insular Southeast Asia, it will be helpful to keep this in mind. However, in most cases, I have been able to identify at least a few textual passages that speak more directly to medical concerns.

4. Angkorian Step-Pools and Hilltop Springs

There is a remarkably extensive literature on water management and pool-like structures of the Khmer Empire (ca. the 9th century to the late 14th century) (Lustig et al. 2018). However, most archaeological studies—and indeed most epigraphic references—address first and foremost the preoccupation with agriculture and societal sustainability throughout the monsoon cycle. While bathing facilities are integrated within this wider water management network, one needs to look further to unveil the medicinal and therapeutic aspects of bathing. Where such aspects cannot be found, or remain otherwise implicit, one needs to explain why.

As expected, the vast majority of available structures—including art historical pieces and epigraphic references—address ritualistic concerns. Although it is possible to explore health-related themes on the basis of ritual, that should be done with considerable care. For example, an inscription mentions the bathing of images of Buddhist deities (Green 2014, p. 41). The sanctified water is then used to irrigate the surrounding fields. In this sense, one sees how a ritualised form of bathing is integrated within communal concerns with sustenance, balance and possibly wellbeing. The same notion is further stressed by epigraphic passages that enjoin the bathing of Buddha statues at times of danger or inauspicious astrological events (Green 2014, p. 83). Here too, one can at least identify a concern with communal wellbeing and the protection of the people. Where human bathing is addressed, this is often from the perspective of ritualistic purification, with various procedures accompanying the ablutions, from the uttering of mantras to the pouring of water, from facing certain directions to the use of ashes (Green 2014, p. 215ff.).

There is also some evidence that constructing and administering different bathing structures could have significant social implications. For example, the Bat Chum inscriptions distinguish between the so-called taṭāka (reservoir) and the parikhā (canal) structures, possibly indicating that the structures would be available to either Buddhist or Brahmanical officials. However, I failed to identify any clearly expressed healing or cathartic concerns in the inscriptions (Mertens 2005). As mentioned above, āyurvedic texts mention the specific medical characteristics of different water bodies, natural or constructed. Even if such connotations are typically related to drinking water, rather than for immersion, the discussions include the same kinds of canals and reservoirs mentioned in the inscriptions. Perhaps some ritual officiants would have been aware of such medical connotations, but these concerns are rarely addressed directly in Angkorian epigraphic texts. There is firm but limited evidence that āyurvedic medicine was known in Cambodia, since at least two inscriptions mention the classic Suśrutasaṃhitā.30

To narrow our search down, we can identify at least two places that stand out for their connection to bathing and ritual and may possibly be construed as having a healing dimension too. One is Neak Pean, within the Angkorian archaeological park. The other is Phnom Kulen, in the hills to the northwest of the Angkor Thom citadel. Neak Pean has long been linked to healing baths in popular culture and archaeo-tourism. Unfortunately, there appears to be little hard evidence to back up these intuitively appealing speculations. That is leaving aside the common identification of barays with the mythological “oceans of milk”, the distilling of the elixir of eternal life (amṛta) or indeed the presence of Nāga sculptures.

More specifically, the artistic symbolism of Neak Pean has been linked by scholars to the mythological lake Anavatapta, typically found in Buddhist cosmological narratives involving Mount Meru. Such narratives typically stress the association between the lake and the elixir of eternal life (amṛta). As Indic cosmologies travelled across Asia, we find depictions as well as descriptions of this lake as far away as China and Japan.31 There is some textual evidence that links the Anavatapta lake with medicinal concerns and healing. For example, a Chinese text on meditation sickness states that even remembering this lake can help recovery from disease.32 Other aspects of the artistic programme of the lake are images of Avalokiteśvara, who is known for his compassion and help towards devotees and is also like many other Buddhist figures linked to various health practices. Some scholars have also associated the four figures carved around the pond—an elephant, a lion, a man and a horse—with the four bodily elements (Stark 2022, p. 391). This is taken as potential evidence for a Khmer humoral system and for an architectural example of bathing as seeking balance among the bodily constituents. Although somewhat speculative, this suggestion deserves more attention in future studies. Unfortunately, inscriptions associated with the site fail to mention specifically medical themes or concerns. Stanza 170 of the Preah Khan inscription states that “Far out in [the lake] is an island whose charm lies in its artificial pond filled with a single body of water from sacred bathing-places. [The island] washes away the mud of sin from those who make contact with it; it is a boat for crossing beyond the ocean of worldly existences”.33 We do find here a mention of bathing linked with ritualistic purification, as is usual in this context, but no explicit medical terminology.

The situation is similar with Phnom Kulen (or Mahendraparvata), the forested hill to the Northwest of Angkor Thom. While most of the literature emphasises the role of the associated river in terms of water management and agriculture, it is clear that water on Phnom Kulen was invested with ritualistic and symbolic significance. If we read a contemporary fieldwork report, we immediately find observations of contemporary pilgrims involved in ritual bathing and purification. A local guide is reported as having explained that some of the pilgrims were likely showing their gratitude to the gods after recovering from an illness (Lefferts and Cort 2008, p. 291). Reports like this, or anthropological studies on spirit mediums (kru boramei) and their use of water for healing, are easy to find. Today, it is also common to find stalls selling herbal and animal-derived remedies in the vicinity of waterfalls. And there is at least one spring near the linga-decorated river which is considered sacred. To the best of my knowledge, the water from the spring is drunk and is not used for ablutions or immersions. Further into the mountain, we find a series of rock-cut shelters near the famous reclining Buddha statue. Some of these rock-cut shelters have tanks for the collection of water, and pilgrims have been known to drink this water as a blessing, as it is considered sacred. Unfortunately, mediaeval sources are quite silent on bathing practices on Phnom Kulen, with occasional discourses framed in purely ritualistic and religious terms.34

There is however one set of inscriptions issued under Jayavarman VII (ca. 1182–1281) that are more explicit on medical matters. These steles record the foundations of “houses of health” (ārogyaśālas) and explicitly mention āyurveda as a branch of knowledge, as well as the provision of medicines and the employment of physicians.35 A number of relevant structures have been identified around the Angkorian citadel (usually counted as four sites) and in the provinces of the former Khmer Empire, in what is now Northeastern Thailand (over twenty sites). It has been suggested that if any actual hospice facilities did exist, these could have been wooden structures. What currently remains are an enclosing wall, a central chapel (thought to house the Buddha of Healing) and an annexed building within the otherwise empty courtyards. Yet there is one more feature of these still largely mysterious “houses of health” that is relevant here: the step-pools regularly found on the outside of the wall perimeter, towards the northwest. These pools are a stable feature of Jayavarman’s “houses of health”.36 Given the explicit medicinal dimension of these sites (at least according to the inscriptions), one may at least assume that the pools would have been used for healing purposes. However, to what extent bathing was enjoined as a therapeutic practice is debatable. First of all, the inscriptions do not go into any detail on the uses of the pools. Secondly, allied Indic descriptions of “houses of health” from āyurvedic texts in Sanskrit do speak of the need for nearby water bodies, but mainly as a way of securing a stable provision of water (Wujastyk 2022, p. 12).

This leaves us with one final piece of evidence in terms of sources dating back to the Angkorian period: the notes and descriptions by Chinese diplomat Zhou Daguan (ca. mid-13th–mid-14th century). The visitor does devote various sections to health and medicine, including one on childbirth and one on illnesses. As the latter addresses bathing directly, it is worth quoting it here in its entirety:

“The people of this country are frequently ill, and can often cure themselves by immersing themselves in water and repeatedly washing their head. At the same time there are a lot of lepers—they are everywhere on the roads—and local people think nothing of sleeping and eating in their company. They sometimes say that disease occurs because of particular local conditions. It is also said that the king once contracted the disease so people are not troubled by it. In my humble opinion people contracted disease because they so often go into the water and bathe after making love. I have heard that local people always go and bathe as soon as their lovemaking is over. Out of every 10 people that contract dysentery, eight or nine die. They have people who sell medicines in the markets, as with us, but the medicines are not the same as the ones in China and they do not know what they are made of. There are also witchdoctors of some kind that give people their help”.37

Here, we encounter the kind of medicalised description we intended to emphasise. However, there are a number of issues. First of all, while there is a reference to bathing as a therapy, there is no mention of either Indic or Sinitic aetiology involving humours or elements. That would have made it easier to link this passage to transregional concerns. Whether or not “leprosy” is the right translation for the underlying Chinese is debatable, but there appears to be at the very least a reference to a condition that affects the skin. Skin issues are a common problem in tropical climates, which makes the topic relevant to a discussion of Monsoon Asia. The fact that Zhou Daguan acknowledges the unfamiliarity of Khmer medicines, and thus possibly the uniquely local materia medica, reminds one to view Monsoon Asia as a highly diverse zone, even if tightly interconnected. As for the mention of love making in the context of bathing, Caraka mentions it in Śarīrasthāna 8 (bathing before coitus and sprinkling the woman with cold water afterwards). Generally, there is an acknowledgement that water, especially perhaps in a tropical climate, could be the source of disease. Overall, this passage does prove valuable in linking Angkorian bathing practices to health and the wider tapestry of Monsoon Asian climates.

To sum up, in the case of Angkor, the few medicalised sources on bathing exhibit a localised character rather than a cosmopolitan one. Most of these sources address the importance of ritual purification. Why is this the case? First of all, one needs to address the issue of source typology. While South Asia has preserved a plethora of āyurvedic treatises, only epigraphic sources survive from pre-1400 CE Cambodia. These may refer to medical texts, but their main purpose is to record royal donations and generous acts of patronage. The first half of the inscriptions typically offers a poetic eulogy of the ruler and his lineage, while the second half lays out administrative details including boundaries, taxation and access regulations. There is little scope here to bring out medicalised discourses. On the other hand, religious narratives about purification fit very well, for they serve to legitimise the ruler’s power or praise the piety of religious figures. The Khmer evidence also poses the following question: what does “medicalised” mean in the context of the premodern world? Āyurvedic texts and Buddhist Vinayas express very specific and technical aspects of the effects of bathing on the human body, but these should not be seen in opposition to religious or ritual benefits. Within the holistic stance of premodern medicine, ritualistic purification and medical balance overlap, as exemplified at Neak Pean and other bathing sites.

5. Springs in East Java

The situation is somewhat similar in Nusantara (maritime Southeast Asia), where we find an overwhelming majority of references to ritualistic purification and fewer to medicalised discourses. There have been some attempts at linking water management infrastructure with the history of tropical diseases, particularly with regard to Majapahit’s capital (e.g., Miksic 1999). However, these attempts are still speculative, and there is a lack of consensus on the very form or extent of water management in ancient cities such as Trowulan. A more solid starting point in terms of material evidence is the sacred bathing facilities known as petirtaans, of which Jolotundo in Eastern Java is a key example. There are of course various bathing spots in Central Java as well, including Ratu Boko or Cabean Kunti.38 Some include hot springs like Candi Umbul or Candi Ngampon. Other places of interest for sacred bathing are Candi Gembirowati and Sengang Beji.39 However, the studies on the symbolism of eastern sites are possibly more advanced at the present stage. Jolotundo was constructed near a natural spring on the sides of a mountain, intended as a holy bathing site and closely connected with political discourses as well as agricultural needs. In order to understand any possible connections with health, one can turn to the carvings and decorations on its walls and the spring itself. Some of these architectural elements are now housed in museums but have been documented by scholars. As pointed out by a number of specialists, it appears that the main cosmogonic notion associated with the site is that of Mount Meru, which is symbolised both by the mountain itself and by sculpted heads around the spring, adorned with Nāgas. This is an indication that the waters of Jolotundo were linked to the concept of amṛta, nectar or the elixir of eternal life.40

There is little else at the site or in associated epigraphic material that could offer further insights into healing practices. The concept of amṛta does have medical connotations, but as usual, these are conceived as a side dimension to the more central idea of ritual purification, a religiously constructed concept in which physical health is subsumed within a holistic paradigm. But these early Javanese “SPAs”, with their cosmopolitan natural symbolism linked to Mount Meru, are not the only source of evidence.41

To gain further information, one needs to look at the relatively extensive literary works in Old Javanese, most notably kakawin poetry, as well as tutur religious literature. While there are indeed references to bathing, the overwhelming majority of these deal with idealised depictions of nature or with erotic scenes. Other passages refer to how bathing and cleanliness reflect a sense of decorum, respectability or even royalty. It is possible however to identify a common theme of bathing in order to restore one’s energy and feel refreshed after a fatiguing journey.42 Unsurprisingly, similar benefits are listed in both āyurvedic and Buddhist texts. Another theme potentially more relevant to medicine is that of toiletry and personal care. Some kakawin descriptions of washing either the body or one’s hair refer to powders, oils and ointments. One description identifies a particular kind of medicinal leaf and refers to powders and unguents in the context of a beautifying bath.43 More relevant to the present line of enquiry, a passage describes the collection of holy waters from various bathing places and links it with alchemical efficacy and methods, in a hyperbolic depiction of its power.44 The term used for alchemy is the Sanskritic term rasāyana, which thus carries a cosmopolitan connotation, at least on the surface. Its occurrence in a context that directly addresses bathing is suggestive of underlying notions of bathing as a process that affects the body in transformative ways. However, presently, I am unaware of any passage linking bathing to balancing either the humours or bodily elements. It is likely that more relevant material will be brought to light by scholars of Old Javanese in the future.45

This leaves us with religious sources. A later text directly refers to bathing as a way of removing sweat and dirt, which parallels āyurvedic and Buddhist discourses but has little medicinal value, inasmuch as the connection between hygiene and illness was not as clear in the premodern world as it is today.46 The religious hymns preserved in Bali are mainly concerned with religious and spiritual purification but occasionally include some information on holy water too.47 For example, one hymn concerned with bathing with ashes could be construed as implying that normal bathing with water might be beneficial for skin conditions (Goudriaan and Hooykaas 1971, p. 83). However, the reference to “skin” is reliant on a certain reading which is not uniform across the manuscripts. In cases like this, the risk of overreading is considerable.

A final source of information is anthropological studies on bathing in Javanese culture. To the best of my knowledge, the most relevant studies point to ritual bathing in connection to stage of life, such as a girl’s first menstruation or marriage. In this context, various unguents or substances may be involved in the ritual washing. Modern bathing practices in Bali are also linked with the pursuit of mental health.48 Even in cases where a medical dimension is more clearly detectable, it remains challenging to find allied materials in extant, pre-1400 CE literary sources. This remains, however, a promising field for further research.

In general, the narratives and bathing sites of Java offer close parallels with the Khmer ones. One point of divergence is the large body of ornate literature (kāvya) preserved in Old Javanese. These sources primarily address the erotic aspects of bathing and only secondarily touch upon medical and ritual themes around purification and health.

6. Conclusions

In this transregional overview of sources on the therapeutic aspects of bathing, we began by noticing common threads linking distant literary cultures. Buddhist texts and agents offer insights into the circulation of Indic ideas spelled out in parallel āyurvedic sources. Buddhist monastic texts are particularly keen on medicalised discourses as a way to emphasise that bathing is more than self-indulgence and sensuality. Thus, we could highlight (1) the view of bathing as helping balance the humours, especially wind, as well as helping with digestion and skin conditions, and (2) the concern with seasonal adjustments, mirrored by changes in the frequency and style of bathing. With the circulation of Buddhism, these views were debated by Chinese scholars and adapted to the local cultural and climatic contexts. Therefore, these materials are essential to complement the more common scholarly focus on the ritualistic and social aspects of bathing.

The next question was whether cultural zones that have preserved fewer or different literary sources could be included within this discussion. In the case of both mainland and insular Southeast Asia, we showed that bathing practices can be first approached under the rubric of “ritual purification”. The symbolism of amṛta then opens the door for discussion about bodily health. Both in the case of Angkorian and Old Javanese sources, we were also able to identify a few examples that speak more directly to the medicinal and therapeutic aspects of water use. These examples were usually of a localised character. This is due primarily to the uneven typology of the primary sources and to the specific political and literary purposes they serve. Of course, it is also possible that medicalised bathing took place in contexts for which we currently have no evidence. We should also be careful not to overemphasise the importance of bathing within medical regimens, as diet and other forms of therapy would have usually taken precedence. Although preliminary, the incorporation of these findings opens the door for further study, especially in the case of Old Javanese kakawin and tutur literature, which has hardly been studied from the perspective of the history of medicine. Although we could not identify clear references to monsoon climatology in the presented Southeast Asian texts, the symbolism of Mount Meru and its sacred lakes offers at least some insight into how climate and environments were integrated with discourses on water use and health benefits.

Ultimately, this study proposes looking beyond the fields of āyurvedic studies, Buddhist studies and Southeast Asian studies, suggesting ways in which different typologies of sources could be brought together to form coherent research agendas. This approach has hardly been attempted so far, despite considerable advances in all of these separate fields. In the future, along with further research on textual sources, we hope to include more archaeological and archaeo-medical materials to further enrich this dynamic picture.