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Volume I : Move Towards Holistic Health
Appendix 1 : The Medical Heritage of India
N. H. Keswani
"On, East is East and
West is West, and never the twain shall meet", has
been disproved in this astronautical age. The closer we
come to each other in the present century, the more we
realize our common ancestry, our common heritage, the
common fountainhead of our cultures, and the identity of
our aims, aspirations and experiences as one man in one
world. Shades of Wendell Wilkie? No! It is the spirit of
scientific inquiry of this century. We no more live in
ivory towers and no more recognize any international
boundaries or intellectual barriers.
Medicine is as old as mankind; and the science of
medicine, like any other form of knowledge, is better
appreciated from the records of its evolution. A student
of medicine cannot afford to lose sight of the
discoveries of the ancient and their hypotheses that may
appear to be erroneous today, were, nevertheless, the
foundation of most of the scientific discoveries that we
cherish today.
The primitive man, nay even the lower animals,
instinctively found treatment for all their ailments and
injuries. As the mind of man matured, the archaic
medicine became a combination of religious, magical and
empirical views and practices. Thus, in the ancient
civilizations, extending from the Indus tp the Nile,
where religiou formed an important part of their daily
life, disease was considered as a punishment from the
heavenly bodies, the spirtis, the demons and the witches.
This led to the creation of various gods, demigods and
mythical heroes, who probably had an earthly existence;
and the powers to protect the people against evil and
cure their ills were attributed to them.
The antiquity of achievements of the Hindus in analytical
and creative thought is universally acknowledged. But
skepticism still persists in many a mind with regard to
our achievements in the natural sciences in ancient
times, even when it is conceded that the genius of any
race is indivisible and its accomplishments in any field
of human endeavour are closely related to its spirit of
analytical thinking and creative activity. This
skepticism is partly due to the fact that the sacred
lore, which also encompasses the Indian scientific
thought, was transmitted from man to man, and finally
when it was put down on parchment, the self-renouncing
sages dedicated all their works to their ancient
predecessors, whether mortal, mythological or immortal.
Establishing the chronologyof our ancient and medieval
texts has been beset with difficulties - at times
insurmountable. The only way, therefore, left to us to
ascertain the period in which a particular text was
originally composed, is the internal evidence available
in the text itself and its various commentaries written
during later periods. This varies with the different
scholars. These, at times, have been governed by
consideration other than the objective approach based on
sound philological principles.
Another factor which has proved to be a stumbling block
in our efforts to establish the truth of the statements
in biological sciences, made by our ancients, is the
total absence of illustrative material in our ancient
biological texts. Howsoever factual the description
mentioned in the text, it is acknowledge on all sides
that "one picture is worth a million words". It
is more so when one is discussing the biological and
medical sciences. Efforts have been made overa a period
of years to probe into the physical evidences from the
past which could throw some light on the science of
medicine and the art of surgery, as practiced in India in
that remote antiquity, and propogated by our ancestors.
There is some evidence available regarding the knowledge
of anatomy during the chalcolitic (Copper Age) period,
and the health conditions prevalent in prehistoric times,
from which one can surmise the kind of medicine practised
during that remote period in the history of India.
Many centuries before the advent of the Aryans into the
Indus Valley, civilization flourished in this region, as
evidenced by the excavations in Mohen- Jo-Daro in Sind,
Harappa and other minor sites, which was closely related
to the civilization of Elam, Sumer, and Crete. In the
absence of any literary records of that period, one can
only deduce from the archeological findings the kind of
medicine the Indus Valley people practised in the fourth
millennium B.C. Like other civilizations of the same
period, their medicine must have been a combination of
magical, religious and empirical practices. A few
substances have been found in the ruins which form a part
of the Ayurvedic pharmacopoeia even today and were
probably used as drugs during those times. The public
health facilities found in the ruins of the Indus Valley
cities far surpass those found in the ruins of other
ancient civilizations and indicate the high level of
their achievement in the field of health and medicine.
When the Aryans entered the Indus Valley, they brought
with them their gods and medical knowlwdge too. But,
there is definite evidence to show that many elements of
the Indus Valley culture were taken over and assimilated
by them. The chief sources of the Aryan culture and
medicine are the four Vedas. These are said to
have been originally revealed by the creator, Brahma to
the sages some six thousand years before Christian era,
according to Indian traditions. The Western scholars,
barring a few, believe that the oldest Vedas, was
compiled during the second millennium B.C. The Rig
Veda is considered by most of the scholars as the
orginal source of Hindu medicine, and is comprised of
hymns and prayers addressed to different deities whose
medical and surgical skills are also extolled . The Sama
Veda and the Yajur Veda are closely related to
the Rig Veda and contain many hymns derived from
the latter. These cinsist of collections of sacrificial
prayers and ritual texts. But, the Atharva Veda
which was composed at a later date, is replete with
prayers, incantations spells and charms to protect people
against all kinds of disease and natural disasters. It is
to this Veda and to the practices provided by
another later work of the Atharva Veda, the
Kaushika Sutra, that we are indebted for our
knowledge of medicine during the Vedic period. The
texts of the Vedas were later organized into
encyclopedic Samhitas, and commentaries were
written and attached to each of these texts. Even in
these purely religious texts we find a reflection of
anatomical, physiological, pathological, psychological
and therapeutic views which are rational even though they
may have some symbolic orgin. Therein, side by side with
the magico religious formulae, empirical and rational
elements are evident, which show that the Vedic
people knwe the sings and symptoms of the diseases and
their treatment with drugs, and performed many a surgical
procedure with skill and ingenuity. During the later Vedic
and the Puranic periods much of the medical
history got involved more and more with the mythological
figures. The seers and sages, who might have had an
earthly existence and contributed to the advancement of
medicine during the early Vedic period, were
raised to the status of divine beings. To sift and sort
out the real from the mere creation of the mind of man,
is a task that will have to await further historical
evidence. Since the extant work available point out the
contribution which the mortals as well as the immortals
made to the science of medicine, mythology, like that of
the ancient Greeks and Romans has become an integral part
of ancient Hindu medical history.
The word Ayurveda (in Sanskrit Ayu means life and Veda
means to know) which means the knowledge of life or the
knowledge by which the nature of life is understood and
thus life prolonged, does not figure in the Vedic
texts. The traditional Vedic medicine, that must
have flourished for several centuries, was handed down
orally from the master ot the pupil, and it is only at a
much later stage that the traditional Hindu medicine was
named Ayurveda. It may be noted that the anceints
anticipated our attitude towards the practice of medicine
and they did not name it as a science of therapy or cure,
but as science which pervades all knowledge of the life.
The origin of the healing art, as in other ancient
civilizations, was traced back tomthe creator, brahma who
became the fountain of all knowledge contained in the
next of Ayur Veda. During the period of rational
medicine which began around 600 B.C., the Ayur Veda
became intimately associated with the Atharva Veda,
and later it was raised to the status of the original Vedas,
thus confirming on it necessary authority and sanctity.
Brahma, the first teacher of the universe, according to
Hindu mythology, originally composed the Ayurvedic texts
in 100,000 hymns divided into one thousand
chapters," but, realizing the fact that it would be
beyond the comprehension of the mre man, He abridged it
and divided it into eight parts with medicine (Kayachikitsa),
and surgery (Shalya Tantra) as the main subjects.
Having propounded the science of healing, Brahma
propagated this knowledge through Daksha Prajapati,
who taught the science to the legendary Ashwini Kumars,
the celestial physicians to the gods. The Ashwinis appear
to the Vedas also under the names of Dasra and
Nasatya. It may be pointed out that these and many other
names of the Vedic gods appear in the documents
found in the excavation in Boghaz Koyi in Cappadocia,
northwest Mesopotamia. It is, therefore, believed that
the Mitanian kings used to worship the Vedic gods as
early as 1600 B.C. The Ashwins imparted the science of
medicine to Indra, considered chief of the gods in
heaven, who, in turn, is said to be the first god to hand
over this knowledge to his mortal protagonists. According
to the popular school of medicine represented by Charaka,
the first mortal who received this science from god Indra
was Bharadwaja. He then imparted it to Atreya and other
great sages of whom Agnivesha seems to have been the
first to compose the text of Ayurveda. Charaka in
his text claims to have reproduced the actual words of
his master, Atreya.
However, according to the old Dhanvantari School of
Surgery, represented by the celebrated surgeon Sushruta,
Indra favoured Dhanvantari with the entire knowledge of Ayurveda.
Dhanvantari, who warded off death, disease and decay from
the celestials, appeared in the form of Divodasa, the
king of Kashi (modern Benares or Varanasi). On being
approached by a group of sages who were moved by the
human suffering, Dhanvantari agreed to admit them to his
hermitage and delivered to them the science of healing.
The sages selected Sushruta to be their spokesman who it
is believed recorded the very words of Dhanvantari
himself. but the South of India, like the South anywhere,
has its own traditions; and it credits the sage Agastya,
with the dissemination of the knowledge of Ayurveda
during ancient times. It is unfortunate that the Ayur
Veda is no more available in its orginal form, but the
most of its contents are revealed to us by the Samhitas
or the encyclopedic work of Charaka and Sushruta. These
texts were originally written about 1000 B.C., and are
sonsidered the most authentic and renowned
representatives of the orginal Ayur Veda. They contain
all the information regarding the status of medicine in
the ancinet times. They, on the whole, have similar
contents, analogous divisions, and corresponding
theoretical and practical data; except for the fact that
the Sushruta Samhita is richer in the field of surgery.
These Samhitas contain an abundance of material in an
extremely condensed form, and have a rational approach.
The exception being the use of magic and the mantras (the
holy incantations) in cases of delirium, in demoniac
possessions, in some diseases of children, and in the
ceremonies connected with birth. The state of health and
of disease is explained on the basis of interplay of the
constituent elements of the body, the general and
alimentary regimen, and the influences of time and
season.
Charaka, in his writings, has a combined role of a
moralist, philosopher and above all a physician; whereas,
Sushruta has tried to cast off whatever shackles of
priestly domination remained at his time, and created an
atmosphere of independent thinking and investigations,
which later characterized the Greek medicine.
The Sushruta Samhita is acknowledged as one of the
greatest of its kind in Sanskrit literature; and,
is especially important from the surgical point of view
(Sarton). The glory of first changing the art of surgery
into a practical science, during the remote antiquity,
must go to Sushruta, the author of the orginal Sushruta
Samhita. In its revised and redacted version this
original Samhita has been passed on to posterity
by Nagarjuna (second century B.C.) in the form of the
present Sushruta Samhita.
The Science of medicine received the greatest support
and stimulus in India during the Buddhist period. The
Buddha (563-477 B.B.), himself, was a votary of medicine
and regularly attended on the sick disciples in his camp.
When the Buddha declared tht this is the noble truth of
suffering that "to be born is to suffer, to die is
to suffer, and to fall sick is to suffer", his
followers considered tending to the sick to be one of
their religious obligations. The practice of surgery
received the greatest setback in the later Buddhist
period, and surgery completely receded into the
background, since Buddhism put a stop to animal
sacrifices and prohibited dissection. Yet, Jivaka (sixth
century B.C.), the personal physician to the Buddha,
practised surgery with success, and is known to have
performed cranial surgery on many occasions. I-tsing, a
Chinese traveller to India in the seventh century, quotes
from a Sutra (text) on medicine, which, according
to him, was preached by the Buddha himself (Takakusu).
The old Buddhist text of Mahavagga, belonging to
the Mahayana sect of fourth century B.C., deals
with the practice of medicine, as prevalent in those
days. It is in no way different from the Ayurvedic
medicine of the period, and speaks of Tridosha
(three humours or elements), various drugs of the Ayurvedic
materia medica, inclusive of nasal remedies, eye
ointments, and asafoetida, formentations, and even
laparotomy. Charaka is believed by some scholars to have
been the court-physician of a Buddhist king. Kanishka
(first century), whose wife he attended on as
obstetrician during her difficult delivery. Nagarjuna
(second century B.C.), the famous physician and
alchemist, who revised the Sushruta Samhita was
also a Buddhist, and the Samhitas of the Vagbhattas
show traces of Buddhist influence in them. The famous
Bower Manuscript found in a Buddhist stupa in Kashgar,
and written in Indian Gupta script, probably by a
travelling Hindu scholar-physician about 450, has several
references to the Buddha as Bhagava and Tathagata. The
later Mahayana Buddhists even raised one of the Bodhisattva
Mahasattvas to the status of a god of medicine, the Bhaishajyaguru,
who is China and Tibet is known as "Bhuguru"
and in Japan even today is worshipped a Yakusha
Niyorai. The ancient Ayurveda which travelled with
the Buddhism everywhere, thus, flourished in the Buddhist
viharas (monasteries), and they became the hub of medical
education also. Hiuen Tsang (Yunan Chwang) and I-tsing,
two ancient travellers from China, who stayed for years
in India to study religion, philosophy and medicine
during the seventh century, give an excellent account of
these monasteries (Beal).
After the dealth of the Buddha, his son Rahul, and later
his famous disciple Emperor Ashoka (died 232 B.C.),
established charitable hospitals for animals and men. In
the fourth century another Biddhist king, Buddhadassa of
Ceylon (Shri Lanka), himself a physician, wrote a medical
text Saratthasamgaha, and maintained physicians
for both his troups as well as elephants and horses, and
erected hospitals throughout his country (Mahavamso).
With the spread of Buddhism to the Asian countries, the
science of Ayurveda also travelled far and wide,
and found a congenial soil in these countries. Even to
this day, the acient Ayurveda, in the garb of
indigenous medicine, is being taught and practised in
their native schools of medicine. More than 2,000 years
ago, the Hindu culture and civilization reached
Indonesia, and Ayurveda became the medicine of the
Islands. Bali has preserved the rich Ayurvedic
theory and practice. More than 250 medical texts in
palm-leaf (lontar, in Indonesian) manuscripts are known
to exist in the land including Ushada (in
Sanskrit, Aushadha means medicine) and Trinadi (in
Sanskrit, three channels). The medicine of Tibet,
untouched by wars until the Chinese occupation of this
land, is based on Ayurveda Several Sanskrit texts
that were translated into Tibetan, including the Rgvud
Bzhi (Four Tantras), whose original Sanskrit text is now
lost, have preserved the rich heritage of the Indian
medicine in Tibet. The Chakpori Medical College at Lhasa
was one of the oldest instututions of its kind. From
Tibet, Ayurveda travelled to Monogolia and distant
Northeast Siberia; and all the Buddhist monasteries in
these areas became great centres of medical learning. The
medical college of the Kumbum monastery in Sinking
attained special renown, as it was the birthplace of
Tson-kha-pa, the founder of the yellow sect. It has in
its possession a vast array of charts illustrating
ancient Hindu medical texts. Another famous Mongolian
medical college was at the Yung-Ho-Kung monastery, a
monument to a great era ib Peking, where once the Mongol
students from Urga, Kiakhta and Kobdo, the Buryats from
the the Baikal Lake, the Kalmuks from the Volga, the
Manchus from Tsi-tsi-Khar, the Tanguts from Koko-nor, and
the Tibetans from Lhasa, repaired for medical training.
One of the most famous physicians from these Mongolian
medical schools, known for his Ayurvedic practice and
success in this theraphy during the recent times in
Leningard, was a Siberian, n.N. Badmaev. he counted
among his patients, some of the prominent Communist
leaders, Bukhrin and Rykov, the famous writer Alexei
Tolstoy, and even Joseph Stalin (Lokesh Chandra). With
the gradual revival of the Brahmanism during the later
Buddhist period the Elder Vagbhatta of Sind (second
century B.C.). attempted to bring about reconciliation
between the texts of Charaka and Sushruta in his text
called the Ashtanga Samgraha. Later on, one of his
descendents the Younger Vaghbhatta (? eighth century)
wrote the Ashtangahridya Samhita , a lucid and versified
presentation of the whole Ayurveda, with special
reference to surgey as dealt with in the Sushruta
Samhita, from which he had borrowed extensively. The
wroks of Sushruta, Charaka and the Elder Vagbhatta later
came to be recognized as authoritative texts of Ayurveda,
and the three texts were reverently called Virddha
Trayi, the "Triad of Ancients". The medical
literature during the early medieval peroid (500-1200)
became entirely receptive and passie. One work that
deserves mention is that of Madhavacharya (eighth
century) whose Nidana, leterally meaning pathology,
occupied such an undisputed position of authority in
Ayurveda for many centuries to come, that is was later
ranked equal with the above "Triad of
Ancients". As a matter of fact, there is a popular
Sanskrit quote among the practitioners of Ayurveda,
which states, "Madhava is unrivalled in
pathology, Vagbhatta in principles Sushruta in
surgery, and Charaka in therapy". This Madhava or Madhavakara,
son of Indukara, made further advance in the enumeration
and description of diseases, and listed them in 79
chapters (Nidhanas) under their causes, symptoms and
complications. He devoted a special chapter to smallpox
(Masurika) which was classified as only a minor disease
by the earlier writers.
The Nidana of Madhava remained as standrad textbook for a
long time to come, and is quoted profusely by the
sixteenth century author Bhava Mishra in his Bhiva
Prakasha, which was later translated into Arabic under
various titles of Nidan, Badan and Yedan. The
style of presentation in Nidana, which was a great
improvement on the texts of Charaka and Sushruta, shows
that it must have been composed for the guidance of
students and practitioners of medicine; and that during
the Puranic period, before the Arabs conquered Sind and
the northern India, the training of physicians must have
been very systematic and thorough.
The last revival of the orthodox school of Ayurveda in
the sixteenth century, was mainly due the eminent
physicians like Bhava Mishra, who practised and taught
medicine in Kashi (modern Benares, Varanasi) and is
considered by the later authors as "a jewel of a
physician and the master of the Text". Bhava Mishra
summarized the theory and practice of medicine as
enunciated by all the well-known previous medical
writers, in his universally acclaimed text Bhava
Prakasha (1558-59). This text is the first to mention
syphilis (Firanga roga, literally meaning the Portuguese
disease, since the Portuguese first introduced in into
India) and discusses in detail its various stages and
treatment.
The Arabs had contacts with India much before the birth
of Islam, since the Indian products trekked along the
trade routes passing through the Arabian countries.
During the spread of Buddhism into Northwestern Asia, the
Indian scholars travelled through Persia and Arab
countires, which brought them still closer to Indain
culture. Many words of Indain origin like kafoor (karapura
in Sanskrit; comphor) and Zanjabil (Shringavera in
Sanskrit; ginger) appear in the Koran. There is a
tradition current among the Muslims in India that Adam
descended from Paradise onto the Indian soil and received
his first revelation in India. Some Indian scholar are
believed to have been in the company of Prophet Mohammed
himself, and it is reported that during the
Prophets time a famous medical school flourished in
Senna, in Southern Arabia, whose Principal Harith bin
Kaladah had acquired his knowledge in India (Lassen). It
is recorded that many Hindus were settled in Mesopotamia
during the early part of the Umayyad regime, and
when Sind was conquered by the Arabs in 636-37, and
annexed to the Umayyad Empire many Arabs also
settled there. The superiority of the Hindu civilisation
astonished the Arabs, and the sublimity of the Hindu
philosophy and the richness and versatility of their
intellect were a strange revelation to them. Thus started
a great influx of Indian men, materials and manuscripts
in science and medicine into West Asia. The court of
Baghdad extended its patronage to the Hindu scholars, and
the second Abbasid Khalifa al-Mansoor (753-744)
received emissaries from Sind, including Hindus pandits
who presented him with two Indian books on astronomy.
These were later translated into Arabic by al-Fazari,
and also by Yaqub ibn Tariq. Another influx of the
Hindu learning into Arabia took place during the regin of
Khalifa Harun al Rashid (786-814), under the influence o
f the Barmecides who had attained the highest
position in the Abbasid court. These Barmecides were the
descendants of the high priests (Pramukh, Arabhicised
into Barmak) of the Buddhist temple at Balkh and had,
therefore a special interest in Indian sciences. They
encouraged the translation of Indian texts into Arabic,
and appointed many Indians to run the Royal Barmecides
Hospital in Baghdad. One of the first Indian physicians
appointed was Manka (Manikya), a successful
physician and a philosopher of saintly character, who had
a profound knowledge of Persian and Sanskrit
languages. The other was Ibn Dhan (a descendant of
Dhana, Dhanvantari or Dhanapati), who was
appointed the Director of the Royal Hospital by Yahya,
the Barmecid. Both these scholars translated several
Indian medical texts into Persian or Arabic. Another
famous Hindu practitioner in Baghdad during the reign if
Harun was Saleh bin Bhela (Shali, son of Bhela),
who seems to have cured Ibrahim, a cousin of the Khalifa,
after Haruns personal physician Gabriel, an expert
in Greek medicine, had declared Inrahim dead!
Among the various Sanskrit texts that were rendered into
Arabic during the Abbasid period, the following
medical works in Arabic were commonly used by the Arabs
until the end of the ninth century; the Charaka Samhita
known as Sharak in Arabic; the Sushruta Samhita as
Sasrad and Susrud; the Ashtangahridaya
rendered into Arabic by Ibn Dhan, was Astankar, Astagar
and Asankar; and the Nidana of Madhava as Nidan, Badan
and Yedan. The Siddhayoga also translated by Ibn
Dhan, was known as Sindhastaq or Sindhahan;
and there was a treatise on womens diseases written
in the eighth century by an Indain woman whose name
appears as Rusa in Arabic texts.
With the coming of the Muslim conquerors to India, from
the tenth century onwards, corruption grdually began to
creep into the letter of the ancient Hindu texts. The
glories of Ayurveda were on a rapid decline, and the
Hindu medicine slipped down many grades for want of
patronage from the rulers. Due to the peculiar aversion
of the Brahmins to contact with blood, pus and the
corpse, during the post-Buddhist and Muslim period,
surgery was allowed to pass into the hands of lower
classes, until bleeding was left to the barbers,
bone-setting to the herdsmen and the application of
blisters to anyone!
The medicine in India during the later medieval period
was thus dominated by the Persian and Arabic influences
which produced an amalgam of the Greek or Unani
medicine, as it passed through the hands of the Persians
and Ayurveda of the Hindus. The pattern of medical
practice changed throughout the country from the days of
Muslim dominance until the arrival of the Europeans on
this subcontient.
Although there was an attempt at the revival of the
ancient systems of medicine in India during Emperor
Akbars time(1555-1605), and the Unani and Ayurvedic
sysyems were being amalgamated, no real advance was made
in the field of medicine similar to what was happening
then in the West. The only significant achievement of
this period of Indian medicine was the translation
achievement of this period of Indain medicine was the
translation of most of the medical texts written in
Arabic into Persian, since Persian happened to be the
court language of the period. By the time of Emepror
Alamgirs rule (1658-1707), all the Arabic texts
that were being used by the Unani school of
medicine were available in Persian also. During the later
part of the nineteenth century most of these texts were
again translated into Urdu, the language of the Muslim
population in particular, in Northern India.
The so-called modern medicine was introduced into India
by the Portugeses in the sixteenth century when
Albuquerque (died 1515) conquered Goa in 1510, and
founded the Royal Hospital, which was later handed over
by the Portugese to the Jeuits in 1591. The Jesuits
managed this institution remarkably well and in 1703
introduced a rudimentary form of medical training at the
hospital with Capriano Valadares as its Master. In 1842,
this was converted into School of Medicine and Surgery.
Although the Portuguese first brought the modern medicine
to India, it was the French and the British who later
established and consolidated the modern medical system in
India.
This succinct summary shows the hoary, glorious past of
Ayurveda, its achievements and contribution to the
civilization of the world, the inroads that other systems
of medicine made into the body of Ayurveda, its
progressive decline, its efforts at survival, and its
ambitions today to contribute again to the restoration of
health, rehabilitation of patients, prevention of disease
and promotion of health. Ayurveda is still today a living
science, since millions of people in India are being
treated according to this system. A system that has
survived through the centuries, cannot be lightly
dismissed as being unscientific. Therefore, let us go
back and take a look at the salient features of the
ancient Ayurvedic system and study the content of its
curriculum prescribed for a student of medicine in
ancient times.
The curriculum for the training of a physician was
comprehensive. The entire subject of medicine was divided
into eight main fields, and the science of Ayurveda was
therefore, known as the "eight-limited" (Ashtanga
Ayurveda). The eight branches were (1)
Kayachikitsa or internal medicine, which included
principles of physiology and pathology; (2)
Shalyachikitsa or surgery, including anatomy; (3) Shalakyachikitsa
or eye, ear, nose and throat diseases; (4) Kaumarabhritya
or pediatrics including obstetrics and embroyology; (5) Bhutavidya
or demonology, which included psychotherapy and analysis
of dreams, etc; (6) Agada Tantra or toxicology;
(7) Rasayana or rejuvenation with reference to
geriatrics; and (8) Vajikarna or virilification
and use of aphrodisiacs Apart from these fields of
medical science, the medical student was expected to know
ten arts that were considered indispensable in the
preparation and application of his curative measures, and
in his undertaking of the clinical and experimental work.
These ten arts were: distillation, operative skills,
cooking, horticulture, mentallurgy, sugar manufacture,
phrmacy, analysis and separation of minerals, compounding
of metals, and preparation of alkalis. The curriculum, in
general, had a clinical bias, and the basic medical
sciences were not taught as distinct disciplines, as is
being done in the modern schools of medicine. Proper
emphasis on teaching of anatomy, physiology, pathology,
microbiology and pharmacology was, however, laid during
the teaching of relevant clinical subjects. For example,
anatomy was included in the teaching of surgery;
embryology formed a part of training in pediatric and
obstetrics; and, the knowledge of physiology and
pathology was interwoven in the teaching of all the
clinical disciplines, particularly the internal medicine.
Sushruta laid great stress on direct at personal
observation of anatomy of the body by a surgeon and gave
details of dissection (Avagharshana). He directs
that "Any one desirous of acquiring a thorough
knowledge of anatomy should prepare a dead body and
carefully observe (by dissecting it) and examine its
different parts. For, a thorough knowledge can only be
acquired by comparing the account given in various texts
with personal observation". The dead body selected
for dissection, he advised, should not be of a person who
had lived up to 100 years , that is, not too old, nor of
one who had died of any protracted disease or of
poisoning. The excrements were first removed from the
intrestines, the body was covered entirely with a sheath
of grass, hemp or rope, then securely placed in a cage so
that it was not a prey to the animals or fish, and
finally left to decompose in the still waters of a
solitary pool. After seven days, when the body was
thoroughly decomposed, the student was instructed to
scrape off the decomposed skin, etc., with a whisk made
out of grass roots, hair, or strips of split bamboo, and
carefully observe with his own eyes all the different
organs, external and internal, beginning with the skin.
Charaka also emphasized that a physician who knows the
anatomical enumeration of the body, together with the
description of all its members, is never a victim of
ignorance. It appears from the methods employed for
dissection, during the ancient times, that the details
and the minuate of most of the organs were not know, nor
were they needed then. However, the topographic
description of the various organs, bones, joints,
muscles, ligaments and nerves had been given with a fair
amount of accuracy. As the method of dissection was not
perfect enough to provide a precise knowledge of the
regional anatomy, the medical scholars surmounted this
difficulty by designating vital points, called the
marmas, on the surface of the body; and warned the
physician to approach these points with extreme caution
and care. During the later times, the discontinuation of
dissection due to the prevalence of stricter notions of
purity, when touching a corpse became a taboo, proved
fatal to the progress of surgery. Even the profession of
physician, which during the early period of Hindu history
was deified, began to be held in low esteem, and the
doctor was considered as a defiler of the company at the
dinner table! (Manu Smriti).
The detailed description of the marmas and the
effects of injury at these viatal points, as observed by
the ancient Hindus, right from the Rig Vedic
times, give a good insight into their ideas, regarding
the functions of various neurovascular elements and other
important structures that lie close or deep to those
marmas. The heart and the pelvic regions have been
conisdered as among the most vital places of the body;
and the "life-breaths" and all the special
senses are said to depend on the head. The marmas are the
sites where important vessels, nerves, tendons, muscles,
joints, bony points and organs are situated at varying
depth. A superfical or deep injury at these points on the
body, gives rise to certain symptomatology; and as a
corollary to these symptoms and sings the ancients
hypothesized the functions of the structures lying in
close proximity to these points.
There are 107 such points marked on the body, 11 in each
extremity, 12 in the thorax and abdomen, 14 in the back,
and 37 in the head, face and neck region. The marmas are
classified according to the damage caused by the injury.
The injury to some of these marmas is fatal immediately.
These are called sadyah-pranahara marmas. Injury
to others results in death after some time. These are
designated Kalantara-pranahara marmas. The injury
with foreign bodies lodged at some of the marmas
does not cause much damage, until attempts are made to
dislodge the foreign body, which may then result in
severe hemorrhage and consequent death. These marmas are
called vishal-yaghna. The marmas where injury
causes permanent loss of a limb or its activity are
called vaikalyakara (deforming or maiming) marmas.
The remaining marmas, when injured, cause intense pain
and are called rujakara marmas
It may not be out of place to illustrate some of the
marmas and the effects of injury to them to grasp the
idea how the ancients inferred the function of various
structures and organs from the study of the marmas.
It is recorded that the bilateral injury to the vitapa
marma, which lies between the scrotum and the groin
on each side, results in loss of sexual activity in the
male. By inference, therefore, the ancients knew the
function of the vas deferens which is situated at this
point. The injury to hridaya marma, it is stated
in the medical Samhitas, causes death immediately,
since this is the point just above the pit of the stomach
between the two breasts where the heart lies. The injury
to stanamula marma which is situated immediately
below each breast, it is emphasized, fills the thoracic
cavity, with the deranged kapha (phlegm) and gives
rise to cough difficulty in breathing, and death. In the
neck region, the change in the voice to hoarsences and
dumbness, sometimes accompained by the loss of taste, was
observed to occur if the injury was inflicted on nila or
manya marmas; which are situated respectively anterior
and posterior to the larynx (kanthanadi). In the
head, an injury to the simanta marma, which are situated
at the juncitions of the sutures of the calvaria, results
in mental excitement, fear, loss of intellect and
ultimate death.
The Indian medical scholars considered the human body as
a conglomeration of the modified five elements (panchmahabhuta),
which are prithvi (earth), ap (water),
tejas (light, fire or heat), vayu (air or
motive force), and akasha (space, vacuum or
either). The five elements in various proportions combine
to form seven basic tissues (dhatus) which uphold
the body. These tissues are rasa (plasma), rakta
(blood), mamsa (flesh), medas (fat), asthi
(bone), majja (marrow), and Shukra (semen).
The decrease and increase in the basic tissues (dhatus)
in the body causes deteriorating changes in it. Rasa, for
example, if decreased causes heart disease, trembling, a
feeling of emptiness and thirst; and its increase causes
nausea and salivation. The quintessence of all these
elements is called the ojas (vitality) or bala
(power), which governs the functions of all the external
and internal organs of the body. Ojas is described
as an oily, white, cold, soft fluid that permeates the
whole body. It is demolished by injury, grief,
exhaustion, hunger, etc., and its derangement is
manifested in three stages, the worst of them leading to
death. From all the attributes characteristics of ojas it
appears this term was appiled to the tissue fluid in the
body.
The Ayurvedic theory of tridosha or tridhatu
meaning three elements or humors, namely vayu or vata
(air), pitta (bile), and kopha (phlegm), on
which the whole of physiology and pathology of the
ancient Hindus was based, has been misunderstood by many
scholars to mean literally the elements of air, bile and
phlegm. The ancients used these terms in a very broad
sense, with variable meanings depending on the context in
which they were used. The term vayu or vata, for example,
comprehends all phenomenon of motion that come under the
function of life, the cell development in general, and
the functions of the central nervous system in
particular. Pitta does not essentially mean bile alone,
but signifies the functions of metabolism and
thermogenesis, including digestion and the formation of
blood, various secretions and exretions (mala), which are
either the means of the endproduct of tissue combustion.
The term Kapha does not mean mere phlegm, but is
used primarily to imply functions of cooling,
preservation and thermo-taxis or heart regulation; and
secondarily to denote the process of production of
protective fluids like mucus, synovial fluid, etc. The
imbalance of these elements (dhatus) beyond normal
variations was considered to cause bodily disfunction and
disturbance.
The personality of an individual would depend on the
predominance of the above three humors. For example,
those with predominant vata are usually alert, varacious,
atheist, lovers of music, witty, and enjoy sports, and
are, in general, extroverts. They can also be unstable,
disaffectionate, thin, tall, weak, miserable creatures
with trembling voice. The persons with predominance of
pitta on the other hand are cultured, clean, intelligent,
prudent but coward individuals. They do not easily fall
in love with nature or with opposite sex. These
individuals perspire much, have brown hair on the head,
very little hair on the body and become prematurely grey,
etc. The kapha type of individuals are intelligent,
trustworthy, faithful, truthful, patient and grateful.
They are vey fertile, with high forehead and thick dark
hair etc.
The functions of vital organs like liver (yakrit),
spleen (pitha), heart (hridaya), and brain
(mastishka) were explained on the basis of the
flow and exchange of the tissue elements in the body. The
heart was considered as the chief receptacle of the three
most important fluids of the body, rasa (plasma), rakta
(blood), and ojas (tissue fluid). The plasma which is
considered as the end-product of digestion of food, is
according to them, converted into blood in the liver and
spleen, from where it goes as arterial blood to the
heart. The heart, in turn, gives rise to many vessels and
ducts, which carry the blood, the lymph, as well as the
nervous impulses. The various terms for the blood and
lymphatic vessels and ducts arising from the heart were
used indiscriminately, although some of the authorities
feel that the terms vata-vaha, pitta-vaha, kapha-vaha
and rakta-vaha should be identified with the
nervous cords, venous, lymphatic and arterial channels
respectively. The Ayurvedic scholars did not distinctly
delineate venous from arterial system, nor was pulmonary
system well understood by them, although they did speak
of two kinds of blood, the red and the blue. Charaka,
some authors claim has clearly described the systemic
circulation, in his staement that "from the great
center (the heart) emanate vessels which carry blood into
all parts of the body -- an element that nourishes life
of all animals, and without which life would be extinet.
It is that element which goes to nourish the fetus in the
uterus, and which flowing into body returns to the
mothers heart". (Sen). The ancient
medical texts describe many dusts or canals (srotas).
Among them they assign two each for breathing, for
ingestion of food, and for drinking water; and two each
for carrying each of the various materials like chyle,
blood, flesh, fat, urine, feces, sperms and ova (Jolly).
Although right (? kloma) and left phupphusa
lungs have been mentioned in various texts in different
contexts, their function as respiratory organ has not
been clearly stated. The word Chest (uras)
has been used instead, whenever the respiratory movements
are described. The trachea, along with its dusts, has
been clearly mentioned as one of the ducts (srotas)
close to the heart, which forms with it the root of all
dusts that carry the "life-breaths"
(pranavaha).
The nutritive power of various foods, the ancients
believed, depends on various qualities (gunas) of
food susbtances; and the taste (rasa) was
considered the most important of these qualities. The
different varieties of taste, according to them, are
sweet, sour, saline, pungent, bitter and astringent. This
quality of food depends upon the preponderance of
different basic elements (bhutas) which go to form
each article of food, and each modality of taste is
responsible for producing different physiological
effects. The other qualities of the food are heavy or
light, cold or hot, wet or dry, mild or sharp, soild or
fluid, soft or hard, smooth or rough, etc. The digestion
of food is done by "digestive fire" (pachakagni).
the food is brought through the agency of one of
"life-breaths" or motive forces (vayu)
called prana, to the stomach (amashaya), where it
is churned into liquid from. Another motive force called
samana, stirs another "fire" and digests the
food, converting it into chyle (rasa) and
excretions (mala). When the food is half-digested,
it passes out into the beginning of the small intestine
where it meets with the biliary secretions (pitta).
Finally, the food comes down towards the last part of the
intestine where it is dried up by another
"fire" and converted into a compact mass, which
is voided as feces.
The digested food material in turn, is converted into
several tissues (dhatus) by process of
"cooking" (paka) through the agencies of
five different types of "elemental fires" (bhutagnis)
and seven tissue fires" (dhatvagnis) which
respectively act on the constituent elements (bhutas)
of the food, or on the various tissues (dhatus)
like the plasma, blood, flesh, fat, bone-marrow and
semen.
The products of metabolism are of two varieties. The part
of the food substances (prasada) which nourishes
as sustains the body, and the remaining portion that is
converted into various excretions (malas), which
also include some secretions. The waste products among
the excretions (malas), when present in the body
in normal quantity, do not damage; but if they increase
or decrease in quantity they cause derangement in the
body and can ultimately destroy it. The by-product or the
waste materials (malas) of the digested food are
the feces and urine; of plasma is the mucus; of blood is
the bile; of flesh are the excretions of eye, ear, nose,
skin-pores and genitals; of fat is the sweat; of bones
are the nails and the hair; and of marrow are the oily
secretions of eyes and skin.
"Vayu is the support for the function of the
body. It has five forms: prana, udana, samana,
vyana and apana. It stimulates all the senses, and
carries all the sense impressions to the mind. It holds
together the various elements of the body in proper
proportion; and maintains the cohesive unity of the body
as a whole. It is the promoter of speech; basis of sound
and touch; it is the origin of joy and enthusiasm; the
kindler of fire (agni) the drier of the elements which
cause derangement (doshas); and expulser of the
waste products. It divides the microscopic (sukshama)
and the macroscopic (sthula) channels of the body.
It is the maker of the embryonic form, and stands as an
evidence of existence of life when not excited".
(Charaka Samhita, 1.12.7).
Vayu or Vata, as Charaka has explained
above, was the term applied to the motive forces in the
body, particularly the nervous impulses. Functionally
these motive forces are classified as:
- Udana which
acts in the region of the throat, causes
vocalisation and is responsible for speech, music
etc. The derangement of this
"life-breath" is responsible for the
disorders which occur in the region of the neck
and head (shalakya).
- Prana, located
in the region of the heart, propels the food from
mouth into the gastrointestinal tract. The
derangement of prana is responsible for asthma,
hiccup and similar disorders.
- Samana, which
resides in the gastrointestinal tract, carries
out the digestive functions and coverts the food
substance into various elements. If samana is
deranged, there is poor digestion, dearrhoea and
edema of the body.
- Apana,
situated in the pelvic region, is the driving
force for defecation, micturition, ejaculation,
menstruation and parturition. The disturbance of
this "life-breath" gives rise to
dangerous diorders of the rectum, urinary
bladder, reproductive system, and suprisingly to
diabetes!
- Vyana, which
pervades the whole body, causes the flow of the
tissue fluids, lymph and blood, the secretion of
sweat,and the various movements of the eyes. The
later authors consider all motility in the
various organs within the body under the overall
control of vyana, and therefore, its derangement
afflicts the whole body. With the simultaneous
derangement of all the above five
"life-breaths" (vayus) the men
ceases to exist (Bhava Prakasha).
The brain (mastishka)
as different from the head (shiras) has been
mentioned even in the Atharva Veda (X. 26.8.26).
The heart, in the early texts, was the centre of manasa
(mind); but Bhela, who is as old as Charaka, considered
the brain to be the centre of mind, which he said is
"the highest of all senses and has its seat between
the head and the palate. The brain knows all the sense
objects and all the tastes which come near it". The
Bhela Samhita distinguishes between manasa (mind)
which is recorded as the cause of all cognition, with its
seat in the brain; the chitta (consciousness) as the
cause of all activities, feelings and judgement, with its
seat in the heart; and buddhi (intellect) which is
considered as a special function of the chitta
(consciousness).
Sushruta, even though he does not attach significance to
the brain, however, considers head as the centre of all
special senses and describes certain cranial nerves
connected with specific sensory functions. he describes
two nerves lower down the back of the ear (vidhura),
which, if cut, produce deafness; a pair of nerves (phana)
situated inside the two nostrils, which if cut, cause
anosmia; a pair of nerves below the outer end of the
eye-brow, near the external corner of the eyeball (apanga)
which, if cut, cause total blindness.
The five special senses, and sense perception have been
well described in the medical Samhitas. The five special
senses mentioned are vision, hearing, smell, taste and
touch. The five elements (bhutas) pervade all
these senses, but one of these elements predomintes in
each of the senses. For example, earth predominates in
the sense of smell, water in taste, light or fire in
vision, air in touch, and ether in hearing. The Sushruta
Samhita states: "Ten nerves maintain the
functions of the body by carrying impulses of sound,
touch, vision, taste, smell, respiration, sighing,
yawning, hunger, laughing, speech and crying. A pair of
nerves each responds to sound, touch, vision, taste, and
smell. Yet with other two man speaks with two makes
sound, with two he goes asleep and with two be wakes up. Stimulation
of two of them causes lacrimation, of other two causes
lactation in the female and ejaculation in the male
(?)." (3.9.4)
Charaka states that : "The memory is caused by the
following eight: impressions, their similarities and
dissimilarities, co-oedination of the mind, practice,
consciousness, concentration, repetition of sight,
hearing or perception (as tasting and smelling)
(4.1.117-118).... The man sleeps when sense organs cease
to operate, being tired by the fatigue of the mind".
(1.21.35).
The later Tantric School considered cerebrum as the seat
of soul, and the spinal cord as the centre for vital
functions of the body. The whole of the nervous system,
according to this School, is divided into various
plexuses (Chakras), which extend from the root of the
vertebral column upwards into the cranial cavity. These
centres (Chakras) are inter-connected by and give rise to
numerous nerves which are approximately 72,000 in number.
These centres control the physical and mental activity of
the body; and are located at the points on the body deep
to which, according to modern concepts of neurology,
different autonomic ganglia and plexuses are situated.
The functional significance of these plexuses also
corresponds, to some extent, with our modern concepts.
The Indian scholars have tried to correlate the natural
phenomenon with the powers attributed to various gods in
the Hindu pantheon, who in turn, have been associated
with various centres (Chaakras) within the nervous
system. The centres have symbolic names, and from sacral
region cranialward, they are (1) the muladhraa chakra,
corresponding to the sacral plexus, which is associated
with the autonomic functions of the pelvic organs
including the genitals, (2) The svadhisthana
chakra, corresponds to the hypogastric plexus, (3) the manipura
chakra to the epigastric plexus, (4) the anahata
chakra to the cardiac and pulmonary plexuses, and (5) the
vishuddha charkra to the various plexuses in the
neck. (6) The ajna chakra which corresponds to the
hypothalamo-hypophyseal axis in its action, is situated
between the eyebrows. (7) The highest sahasra padma
chakra (thousand-petalled lotous) is situated inside
the cranial cavity, and is concerned with the special
senses of hearing, touch, sight, smell and taste, and
sleep, or the absence of all these. It is also concerned
with all the higher functions, and with emotions, memory,
etc.
The practice of Kundalini yoga, a special
technique of breathing and physical exercises, which goes
back to primitive pre-Aryan antiquity, is aimed at
establishing these centres within consciousness and thus
bringing them into active play.
The science of embryology was matter of considerable
speculation and controversy in the various schools of
philosophy and medicine. One entire Upanished has
been devoted to the speculations with regard to the
formation and development of the human embryo (Keswani
1962, 1965). This Garbha Upanishad, literally a
brief treatise on embryo, is considered to be of greater
antiquity than the rest of the Upanishads of the class to
which Garbhopanishad belongs. There are ample
references to the development of the human embryo in the Vedas
themselves. It is suprising to read in them and the
various medical texts, the ideas of the ancient Hindus
regarding the biological evolution, reproduction,
generation, preformation and spontaneous regeneration,
which at a first glance appear to be borrowed from a
modern text on embryology!
The derangement of three humors (tridosha) was the
basis of pathogenesis of all the disease. On this basis,
sushruta divided all the diseases into 1120 types,
whereas Charaka considered them to be innumerable. the
disease so caused is called a nija disease, as compared
to the conditions caused by external factors, called
agantuka, which include mental afflictions. An other
classification, based on the etiological factors, divided
the diseases into seven categories: (1) the hereditary
conditions caused by the diseases ferm cells (adibalapravratta);
(2) the cogenital disease (janmabala-pravratta);
(3) diseases dur to disturbance of humors (doshabalapravratta);
(4) injuries and wounds (Sanghatabalapravratta);
(5) seasonal diseases caused by change in weather (kalabalapravratta);
(6) diseaes due to the divine will (daivabalapravratta);
and (7) the natural conditions, like hunger (svabhavabalapravratta).
In the field of materia the properties of drugs and foods
were investigated. The drugs were described by a
terminology, which when transliterated, does not fail, in
many instances, to give correct insight into their
therapeutic uses. The drugs of the Hindu materia medica,
have found a prominent place in the Hippocratic and Arab
medicine. The Ayurvedic works of the later period have
incorporated, in their own materia medica, some of the
foreign drugs which were found by them to have valuable
therapeutic properties, like rhubarb, opium, jamaica,
sarsa, etc. (Bhava Prakasha)
The diagnosis, it was enjoined, was to be made by the
five senses supplemented by interrogation. The basis of
diagnosis was built on (1) cause (nidana), (2)
premonitary indiciations (purvarupa), (3) symptoms
(rupa), (4) therapeutic tests (upashaya),
and (5) natural history of the development to the disease
(samprapti). Sushruta declares that "The
physician (bhishak), the drug (dravya), the
attendant or the nursing personnel (upashata), and
the patient (rogi) are the four pillars on which
rests the success of the treatment". And the
physician, with a profound understanding of the science
of medicine, was considered the first and the strongest
pillar of the therapy. The different methods of
treatment, based on the diagnosis of the case, were
outlined, and the drugs were classified into seventy-five
(75) types according to thier therapeutic effects. The
whole doctrine of medical care was considered to consist
of the following factors, which are to be kept in mind in
achieving successful results: (1) the organism (sharira),
(2)its maintenance (vritti), (3) cause of disease
(hetu), (4) nature of disease (vyadhi), (5)
action or treatment (karma), (6) effect or result
(karya), (7) time (kala), (8) agent or the
physician (karta), (9) the means and instruments (karana),
and (10) the final decision on the line of treatment (vidhi
vinishchaya).
The microbial origin of the disease, and the
infective nature of some, such as eruptive fevers,
leprosy, smallpox, tuberculosis, etc., have been clearly
indicated. Sushruta states that "All forms of
leprosy and some other skin conditions are not only due
the derangement of vaya, pitta and kapha but are also pf
parasitic origin. Various skin diseases, leprosy,
tuberculosis, fever, ophthalmic and epidemic diseases
borne by the air and water, are usually capable of
transmission form one man to another. He further states
in Uttara Tantra that "There are various fine
organisms which circulate in the blood and are invisible
to the naked ye; usually these look like round bodies of
cooper color and are without legs. They give rise to
vaious forms of skin disease, ect." (Sen).
In surgery the progress made by the ancient Hindus was
phenomenal indeed, and justifies the remark by Sir
William Hunter (1718-1783) that "Hindu medicine was
an independent developement. Arab medicine was founded on
translation form Sanskrit treatises, and in turn,
European medicine down to the seventh century, was based
upon the Latin version of the Arabian translation."
(Gordon). The traning of a surgeon was thorough and
methodical. The principles of surgery were based on well
established foundations. The student was demonstrated and
instructed to practise surgery on various objects, such
as cucumber, gourd, melon, all types of phantoms, and
strectched skins of animals with hair intact. The
students practised puncturing on distended bags, probing
on openings in worm-eaten wood or lotus root, extracting
teeth on dead animals, suturing on thick cloth or soft
leather, and bandaging on the limbs of manikins.
The surgical operations were classified by Sushruta into
eight categories: excision (bhedana), incision (chhedana),
scarification (lekhana), puncturing (vedhana),
probing (eshana), extraction (aharana),
evacuation and drainage (visravana), and suturing (sivana).
A variety of instruments and appliances is included in
the armamentarium of a surgeon. Sushruta grouped these
under teo types; yantra or blunt instruments numbering
101, and shastra or sharp instruments numbering 20. It
was impressed upon the physician that he must consider
his hand as the first, the best and the most important
instrument of all, as it is with its assistance that all
surgical operations are performed. It is enjoined that
the instruments should be made of the best steel, and
should be well-shaped, with sharp flawless edges, and
should be kept in a handsome portable case with a
separate compartment for each instrument. Fourteen types
of bandages (bandha or patta) with their specific uses
are described. The surgical operations on all parts of
the body have been given in detail, such as laparotomy,
craniotomy, caesarian section, forceps application,
plastic repair of the torn ear lobule,cheiloplasty,
rhinoplasty, excision of catract, tonsillectomy, excision
of laryngeal polyps, excision of anal fistulae, repair of
hernias and prolapse of rectum, lithotomy, amputation of
bones, reduction of dislocations, and many neurosurgical
procedures. Pre-operative preparation of skin with some
medicaments and dressing of wounds with medicated oil was
routingly done. Haemostasis was achieved by the use of
ice, caustics or actual cautery. Venesection and cupping
were in general use, and the poultices and formentations
formed a routine part of the treatment. The anaesthetics
were not unknown either. Medicated wines were liberally
used pre and post operatively to assuage pain. Sushruta
distinctly laid down that the wine should be used before
operation to produce insensibility to pain. Charaka
advised the use of wine to alleviate the pain of
operations. A drug called Sammohini (producer of
unconsciousness) was administered before, major
operations, and another drug, Sanjivani (the restorer of
life) was employed to resuscitate the unconscious after
operation or shock (Keswani, 1961, 1967 & 1971).
The science of obstetrics and gyneocology had progressed
well inspite of the fact that it was considered as a
distinct division of the original eight limbed Ayurveda.
The menstrual disturbances, the diseases of the female
genital tract and their treatment have been classified.
The clinical course and various stages of labour, the
management of puerperium, the miscarriage (makkalla)
and abortion of various types, and the difficult labour (mudhagarbha)
have been discussed in detail. The different mal
positions of the fetus at birth were well understood, and
the different methods of treatment by version,
embryotomy, caesarian section, etc.,are described. (Keswani
& Sharma, 1972).
The general care of the infant, the diseases peculiar to
children including nine types of conditions causing
convulsions in them, are described . Since the suddenness
with which a serious illness appears and disappears in
children can not be explained easly, and the innocent
children are most vulnerable to the evil influences of
the demons, the childrens diseases are particularly
attributed to the demoniac influences. Jumbha and
naigamesha are to such demons, described in the Atharva
Veda, who make children sick. Sushruta named nine
evil spirits (grahas) which torment the children.
The voluntary offences of the mother or wet-nurse are
blamed for the attack by these grahas which can be driven
out by medicine, baths, fumigation and special sacrifices
to propitiate the individual demon.
The diseases of the head (shiroroga), nervous
diseases (vatavyadhi), and other mental
afflication are well classified and their treatment is
given in detail. The various nervous disorders mentaioned
are convulsions (akshepaka), apoplectic fits (apatantraka),
hysteric fits (dauruna apatanka), sick-like
stiffness of the body (dandapatanaka), bow-like
body or tetanus (dhanushstambha), dorsal bending
(bhairayama), ventral bow-like bending of the body
(abhyantarayama), hemiplegia (pakshavadha),
total paralysis (ardita), lockjaw (hanugraha),
shiff neck (manyastambha), paralysis of the tongue
(jihavastambha), sciatica (gridhrasi), St.
Vitus Dance (kalayakhanja), paralysis
agitans (vepathu), etc. Fainting (murchha),
giddiness (bhramaroga), and apoplexy (sanyasa)
were treated with cooling agents and stimulants. Four
kinds of epilepsy (apasmara) were distinguished
and the treatment outlined. It is enjoined that once the
attack is over one should not reubuke the patient, but
should attempt to cheer his soul. Six kinds of madness (unmada)
were differentiated. The worst forms were attributed to
the demoniac influences and called bhutonamada
(possession). Along with the violent remedies suggested
it was also recommended, as in case of epileptics, that
the possessed one should be cheered with friendly talk. Sushruta
devoted one complete chapter to the analysis of dreams,
and he believed that a favourable or an unfavourable
termination of a disease could be predicted from the
messengers, omens and dreams.
Dietetics and hygiene formed as much a part of the
religious ritual as of medical practice of the ancient
Hindnus. Therefore, the dietetic regimen and the hygienic
principles were almost mandatory. A sensible physician is
advised to take into consideration first the regulation
of diet of the patient in all diseases, and then turn to
the treatment of the disease with drugs.
Could ancient Hindu medicine be called scientific? The
answer is certainly yes, for the time in which these Ayurvedic
texts were originally written. Science is not born only
within the four walls of a laboratory with bubbling vats,
eight-channel recorders and computers working round the
clock, as is the notion of our modern times. The Greeks
are given their unique place in history by the West, as
originators of all the arts and science cherished by the
modern civilization, because they evinced a spirit of
scientific inquiry and astute observation. Considering
the knowledge of the ancient Hindu in medical sciences,
as detailed in the above summary, one can not help but
conclude that they had a similar spirit of inquiry,
actuity of observation and sense of clinical acumen. It
has been an unfortunate custom of the Western historians,
until recent times, to look form an answer to the origin
of any scientific thought among the Greeks. That there
might have been some others before them who lit the torch
of science and handed it over to the Greeks to keep it
aglow, very few of us are disposed to enquire. There is
no denying to the fact today that the torch of learning
was handed down to the greeks by early Babilonians,
Egyptians, Persians, and most certainly, by the hindus,
as aknowledged even by the ancient historians and
philosopheres like solon (? 638-558 B.C.) and
Philostratus (third century B.C.). (Bjornstjerna).
It is surprising, therefore, to find many historians in
the West particularly perturbed by the "lack of
definite chronology in the study of ancient Indian
science and the difficulties in solving the
question of priorities. Captain Johnston-Saint (1929),
who felt strongly about Asia and India being totally
ignored by the Western historians of science, in his
address to the Royal Society of Arts in London declared
that "Asia can benevolently give but it does not
need to borrow. Its ideas and fantasies are as exuberant
as its vegetation... if we were to speak the truth we
must call Greece no the parent of our modern medicine,
but only its nurse". Julius Jolly, an authority on
Indian culture, during the early part of this century
commented, "Medicine can now be regarded as the
oldest of Indian sciences and has been proved to be the
science in which the Indians specialized first".1
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