India is a country known for its unity in diversity, for the existence of various cultures, dynasties, religions and languages. But Ancient India’s contribution to the world has also been immense in various fields, one such field being the field of Medicine. The achievements of India in this field are not very comprehensively known to the world even today. One of the reasons could be that the ancient Indian medical information was written in Sanskrit which was comprehended only by Sanskrit scholars. Secondly, medical knowledge was closely guarded among the physicians (Vaidyas) and their families. Sharing this knowledge or writing books to preserve them for posterity did not appeal to them.
Towards the close of the 18th Century pioneering efforts by Sir William Jones and H. T. Colebrooke with an interest in Sanskrit studies led to the founding of the Asiatic society of Bengal whose journal made available a large volume of Sanskrit literature with English translations. A few more scholars from the West created an interest in the study of Sanskrit literature. Since the renaissance, this discovery of Sanskrit literature was considered to be one of the most significant events in the history of language studies and culture. Sanskrit Medical classics were discovered and translated only much later after initial interests in Literature and History. But this did not awaken much interest and it was only in the 20th century that translations of the Great Medical classics were easily available to the Western World. Even then there continued to be an obsession in the Western World about the origin of scientific medicine being in Greece.
The term Ayurveda is derived from the term ‘Ayuh’ meaning life and ‘Veda’ meaning to attain or to know. Thus Ayurveda is the science of knowing the means through which life can be prolonged. There are four Vedas or sacred books in India, the Rigveda, Samveda, Yajurveda and Atharvaveda. Thus Ayurveda was not exactly a Veda but is an Upanga or arm of the Atharvaveda and was raised to the level of a Veda to give the science of medicine its importance and sanctity. Since the Vedas are believed to be composed by the Gods and passed on to the ancient Rishis or sages by word of mouth, the Science of Medicine too must be a Divine Revelation to the sages. There are two versions, with the medical school tracing its origins to Sage Bharadhwaja and the surgical school tracing it to Dhanvantari. Both of them are stated to have received it from Indra, the King of Gods.
According to Charaka who is considered the Father of Medicine, Brahma the Creator revealed Ayurveda to the Lord of Creatures Prajapathi who then gave it to Ashvini Kumaras the divine twins who were the healer of the Gods. They passed it to Indra the King of Gods who revealed to Sage Bharadwaja in the form of three Aphorisms, the causes (Hetu), the Symptoms (Linga) and the remedies (Aushada) of the diseases. Bharadwaja in turn revealed it to Atreya who taught it orally to six disciples Agnivesha, Bhela, Jatukarna, Parashara, Haritha and Kshirapani. All the six disciples then compiled treatises on it. Dhanvantari is said to have revealed it to Sushruta a historical physician from the 6th century BCE.
In the Rig Veda texts occasional references are made to diseases and their cures. In Atharva Veda, medicines are seen to be an amalgam of magic, religion and removal of spirits. Diseases caused by evil deeds, possession of evil spirits, anger of certain Gods and sorcery of enemies were cured by Vedic medicines. The Atharva Veda which is a book of incantations and spells dealt with the treatment of the disease by advising offerings, rites, homas or rituals, penances, fasting and mantras. These were further supplemented by amulets and other devices to ward off witchcraft. Slowly the practise of medicine with medicinal herbs began to increase and this marks the beginning of rational treatment as against magico-religious medicines of the Vedic times.
Post Vedic Medicine
Following the Atharva Veda for a couple of centuries medicine seems have been confined to Sarpa Vidya and Bhuta Vidya. During the 6th century BCE, Buddhism and Jainism were established. Hinduism gave rise to six systems of thought-Samkhya, Nyaya, Yoga, Vaisesika, Mimamsa and Vedanta. Around this time were the famous physicians Sushruta and Charaka. There were three Samhitas the Charaka Samhita, Bhela Samhita and Sushruta Samhita, these three groups form the main sources of classical medicine.
The Charaka Samhita is said to be the most comprehensive document of ancient Indian medicine compiled by the great physician Charaka. It consists of 120 chapters consisting of 8 sections and made up of treatises, monographs and lessons. It defines the meaning and uses of Ayurveda calling it the Science of life. The body is explained to be a modification of the five elements water, fire, air, earth and ether. These modifications are referred to as Dhatus (flesh, blood or marrow) and the way they act on the food eaten. Doshas (principles) are Vata (Movement), Pita (Transformation) and Kapha (stability). As long as the Dhatus are in equilibrium, the body functions well. Any disturbance in this equilibrium causes disease. Diet was considered of paramount importance along with control of mind and conduct. Fundamentals and basic principles of Ayurveda are first explained here. The eight sections deals with different topics like anatomy, pathology, embryology etc. It gave a rational analysis to the cause and cure of the disease, introduced clinical examination methods and explained the synthesis between physician, medicines or diet, nurse and patient.
Charaka’s medical theories were based on the Nyaya Vaisesika systems of philosophy and stated that there are three special means for diagnosis ie instructions, perception and inference. He said that medical practitioners should hold discussions with other medical men. Such discussion removes doubts and strengthens convictions. Debates and discussions were held regularly with great skill.
The concepts of metabolism, immunity and digestion were first explained by Charaka. He explained genetics and the factors that determine the gender of the child.
Bhela Samhita was written by Bhelacharya and he was one of the six disciples of Atreya. The manuscript was recently discovered in 1880 in a palace library in Tanjore and many parts were missing or undecipherable.
It describes diseases that occur in different regions of the country which he said depended on the diet, habits, working conditions etc of the people of that region.
This Samhita was written by Sushruta a famous physician from 6th century BCE. It consists of 184 chapters and is divided into two parts, The Purva Tantra and Uttara Tantra.
The Purva Tantra gives the signs and symptoms of important surgical diseases, obstetrics, geriatrics, anatomy, embryology, nature of poisons and their removal.
The Uttara tantra gives account of various diseases of the ear, eye, head and nose and solutions to complications that may arise out of surgery.
Sushruta described eight types of surgical procedures and he devised several methods of practising them like incision and excision on leather bags and vegetables filled with mud of different densities, hairy skin of animals for learning scraping, using lotus stalks and veins of dead animals to learn puncturing etc. He found out about bones, their classification, injuries and treatment. Urinary stones, fistulae etc and their removal, treatment of war injuries, fractures, dislocations, skin diseases. Cataract surgery and plastic surgery are also discussed here. Sushruta was called ‘The Father of Surgery’. He described more than 300 surgical procedures with 120 surgical instruments. He used wine to dull the pain as an anaesthetic. With the help of a dead body he also studied the anatomy of a body in detail. Some of his explanations in the Sushruta Samhita is worth reproducing-
On Removal of Cataract from the eye-
“It was a bright morning. The surgeon sat on a bench which was as high as his knees. The patient sat opposite on the ground so that the doctor was at a comfortable height for doing the operation on the patient’s eye. After having taken bath and food, the patient had been tied so that he could not move during the operation. The doctor warmed the patient’s eye with the breath of his mouth. He rubbed the closed eye of the patient with his thumb and then asked the patient to look at his knees. The patient’s head was held firmly. The doctor held the lancet between his fore finger, middle finger and thumb and introduced it into the patient’s eye towards the pupil, half a finger’s breadth from the black of the eye and a quarter of a finger’s breadth from the outer corner of the eye. He moved the lancet gracefully back and forth and upward. There was a small sound and a drop of water came out. The doctor spoke a few words to comfort the patient and moistened the eye with milk. He scratched the pupil with the tip of the lancet without hurting and then drove the ‘slime’ towards the nose. The patient got rid of the slime by drawing it into his nose. It was a matter of joy for the patient that he could see objects through his operated eye and the doctor drew the lancet out slowly. He then laid cotton soaked in fat on the wound and the patient lay still with the operated eye bandaged. It was the patients left eye and the doctor used his right hand for the operation.’’
On Study of Anatomy using a dead body-
“For these purposes, a perfectly preserved body must be used. It should be the body of a person who is not very old and did not die of poison or severe disease. After the intestines have been cleaned, the body must be wrapped in bast (the inner bark of trees), grass or hemp and placed in a cage (for protection against animals). The cage should be placed in a carefully concealed pot in a river with fairly gentle current and the body left to soften. After seven days the body is to be removed from the water and with a brush of grassroots, hair and bamboo it should be brushed off a layer at a time. When this is done the eye can observe every large or small outer or inner part of the body beginning with the skin, as each part is laid bare by the brushing’’.
Sushruta’s operation of rhinoplasty or the restoration of a mutilated nose by plastic surgery was amazing and it attracted people from all over the country as cutting of the nose and ears was the most common punishment in the kingdoms of those days.
This manuscript was named after a British Intelligence Officer Hamilton Bower who obtained the manuscript from a local inhabitant in 1890. The manuscript is made up of birch bark leaves in seven parts and the text is written in the Gupta Brahmi script in Prakrit and Sanskrit indicating it to be from the Gupta era(4th to 6th centuries). Indologist Hoemle translated it and edited it when it was handed to him by Bower. It is now placed at Bodleian Library Oxford. It was said to be most probably written by four Buddhist monks of that period.
Most of the manuscripts contain details of medicines and herbs, snakebites, Ayurveda and is a very important treatise on ancient Indian medicines. Jivaka’s work is also said to be contained in the Bower Manuscript.
Born in Bihar, Jivaka was said to be the illegitimate son of King Bimbisara of Magadha. He is said to have studied medicine at Taxila University under the famous teacher Atreya for seven years and is said to have had brilliant powers of deduction and observation. He was appointed as the personal physician to Lord Buddha and also to the royal family. He used herbal remedies for healing of wounds, abdominal surgery for obstruction in the intestines and use of purgatives for constipation.
Nagarjuna was an ancient philosopher (150-250BCE) and a Buddhist monk though he was born in a Brahmin family in Guntur, Andhra Pradesh. He was an accomplished teacher and scholar and became the Abbott or head of Nalanda University. He was associated with the Madhyamik School of Buddhism and was called Bodhisattva Nagarjuna. He was an alchemist who worked extensively with mercury advocating it as an alternative cure to herbal medicines. He was a practitioner of Ayurveda and his descriptions of the circulatory system and blood tissue among other discoveries reflected his acumen and intelligence. He contributed immensely to working on the therapeutic value of Bhasmas or specially treated minerals and wrote treatises on Rasayana Alchemy.
Vagbhata was a disciple of Charaka and wrote a number of books on Ayurveda. Sushruta, Charaka and Vagbhata are considered to be the Trinity of Ayurvedic knowledge. He stressed on personal hygiene as being important to good health. He elaborated on the role of contaminated water and pollution affecting health. He worked on the formulae and prepared a number of antidotes which are used even today like asafoetida churna etc.
Madhava-Kara or Madhava was a famous Ayurvedic physician who wrote books on the diseases, symptoms and causes. He was the son of a disciple of Vagbhata. He was said to be the best diagnostician and pathologist of his time. He systematically wrote five methods for evaluation of diseases and wrote about the importance of diagnosis in finding a cure for the disease.
The achievements of the ancient medical practitioners in the absence of so called scientific knowledge as is available today is one of the most amazing factors in the discoveries in the field of medicine of ancient India. With the advent of Western Medicine and later scientific discoveries, Ayurveda is now practised hand in hand with other forms of medicine. But the mind boggling and astonishing facts of discovery in the field of medicine and surgery in Ancient India will never cease to astonish people the world over and the immense debt that has to be paid to these Great Masters should always be remembered when considering the great history of Ancient India.