Development Of Medical Science In Ancient India - Sumit Banik
An exalted standard of medical knowledge was prevalent in ancient india.The present day archaeological evidences of Mohenjodaro and Harappa presents the high civilization in matters of sanitation and hygiene. An analysis of the material in the Vedas reveals that all the four Vedas are full of references regarding various aspects of medicine. The Atharva veda is deemed to be an Encyclopaedia for medicinal knowledge and the Ayurveda (the science of life) is considered as Upa Veda ( Supplementary subject) of the Atharva Veda. Medical science was surprising advanced in ancient India. Specifically these advances were seen in the areas of medicine , plastic surgery , extraction of cataracts , dental surgery etc. These are not just tall claims. There is documentary evidence to prove the existence of these practices.
Though the dawn of historical period in india is counted from the 7th century B.C. But historical facts are found to be definite only after the 5th century B.C. The history of science and technology in India as per the presaent day Archaeological evidences, begins with the Indus Valley Civilization. This period is usually called the pre-vedic period.The excavations at Harappa and Mohenjodaro bear Ample evidences to the proficiency reached by the people of the Indus valley civilization in matters of sanitation and hygiene. Excavations of the harappan sites have brought to light several therapeutic substances like Shilajit , remedies for Diabetes and Rheumatism etc. It was announced in Journal Nature in April 2006 that the oldest evidence in human history for the Drilling Of Tooth in vivo , that is , in a living person , was found in Mehrgarh around 7000 B.C. This drilling of tooth involved curing tooth-related disorders with drills operated by skilled bead craftsmen. This is the glaring example of proto-dentistry. They were also conversant with the medical sciences and used various herbs and drugs to treat diseases. The people of Indus Valley Civilization practiced Trephination which is kind of medical intervention making a burr hole in the skull to treat migraines and mental disorders. The evidences of Trephination have been found at Lothal, Kalibangan and Burzahom.
The earliest sources of our knowledge of Indian Philosophy and Medicine are the four Vedas, the sacred books of knowledge belonging to the period of 1500 to 800 B.C. Ayurveda is considered to be the upa-veda or supplementary subject of Atharva Veda. An analysis of the material in the Vedas reveals that all the four Vedas are replete with references to various aspects of medicine.The medical lore contained in the Atharva Veda is not inconsiderable.There they appear among 731 hymns , charms and incantations. At the time of Atharva Veda there were physicians and an elaborate Pharmacopoeia for treating the diseases.The praise of the Atharwan as the physician par excellence , superior to all medicines prescribed by other physicians , implies the existence of Two systems of medicine side by side.
(1 )The system of charms prescribed by the Atharwan ( priest physician) ,
(2) The system of drugs prescribed by ordinary medical practitioners.
The Panchagavyas ( five products of the cow ) , honey and fats are described as a suitable vehicle (anupana) for the remedies. In X : 2 : 1-33, a hymn entitled “ The wonderful structures of man ” , in which the several parts of the skeleton are carefully enumerated. In II.33 allmost all the important organs of the body are enumerated.In X : 8 : 43 , a reference is made to lotus with nine gates. IN I : 17 : 3 , the comparison of the heart to a lotus is described as :
“ Thou sira of the lower part remains ,
Thou of the upper part remains ;
So thou of the middle part ,
So thou small , so thou big dhamani . “
With regards to this verse , S.N.Dasgupta says “ a knowledge of the distinction between Veins and Arteries , in the modern sense of terms , was known at that time “. The division of Dhamanis , Siras and Snayus seems to have been based on their relative fineness , the thicker canals were called Dhamanis , the finer ones were called Siras , and the still finer ones Snayus. The flow of certain fluids in the body , described in X : 2 : 11 ,
“ who stored in him floods moving in all diverse directions and formed to flow in rivers pink , rosy red , and coppery dark running in all ways in a man , upward and downward ………..” .
The intimate relation between the heart and the brain seems to have been dimly apprehended.
Atharva veda I :12 :3 mentions five classes of diseases.
- Atharvanic people recognized a threefold classification of all diseases those produced by wind , water and fire , later developments in Ayurveda , considered the threefold classification of all diseases as to the three Doshas Viz. vata , pitta and kapha.
- Diseases produced by possession by demons and evil spirits.
- Diseases due to worms.
- Diseases due to Sorcery ( the use of magic powers derived from evil spirits).
- Kshetraja ( hereditary ) diseases.
Krimi ( organism ) were explained in detail in the Vedas. In Atharva veda II :31 : 2 , the organisms were classified inti Drishya (macro) and Adrishya (micro) , which were in water , earth , sky , houses. Mainly Atharva veda I:28:4 to XIX:66:1 , about 98 Varities of krimis and krimi janya vyadhis ( diseases produced by bacteria , worms , insects ) and treatment for different bacteria manifested diseases were explained.
Atharva veda XIII:1:32 hymn reveals that “ the rising sun is prayed to destroy the infective organisms .” This connotes the ultra violet rays present in the sunlight was known to the Atharvanic people. Here it is stated that pathogenic bacteria live mostly during darkness and die during sunrise. Atharva veda stated herbal remedies like Ajashringi (IV:32:2) Prishni parni (II:25:2) Apamarga (IV:18:8) etc. as anti-bacterial and Shankha (IV:10:3), Pratisar(VIII:5:8) etc. Manidharana as preventive (protection from bacteria).There is abundant literature available for the eatiology , diagnosis , diferential diagnosis , complications, management of Takma (fever). Atharva veda speaks clearly about the different types of kasa (pulmonary) diseases(I:12:3 , V:22:10) and also explained its management ( VI:105: 1-3).
Atharva veda vividly explained the Rajayakshma in the name of jayanya ( VII:76:5) , Pampa ( v:22:12) and discusses very elaborately about two main causative factors , varities and complications.
Causes :
- The disease is communicable from diseased persons to others through roga jeevanu ( tuberculus bacillus )
- Loss of semen , due to excessive sexual intercourse.
Varities :
- Akshath – without any ulceration in phupphusa (lungs)
- Sukshath – ulceration in phupphusa (lungs)
Complications :
It effects the Asthi (bones), amsa (shoulder blade) ,mamsa (muscle) , virya (semen) and leads to the body emaciation.
A bovine type of tuberculosis is recognized and to eradicate it , mamsa-ghrita doopanam of cowsheds is suggested. This disease is communicable from husband to wife is evident from the fact that the males are predominantly effected (98%) because of vyavayam (sexual intercourse) where in millions and trillions of spermatozoa represents nascent amino acids which otherwise would have been usefull to body for protection are lost resulting the disease due to debilitating immunity.
Atharva veda , iv:9:3 , speaks Kamala (jaundice) as
- Harima – due to yellowish discolouration of skin.
- Haritha – due to loss of blood which leads to aneamia.
The following hymns reveals the three types of treatment of kamala :
- Both shall go up towards the sun , thy heart-burn and thy yellowness (I:22:1).
- With the colour of red bull , with that we enclose thee, for full length of life, that this man be free from defeats, and become not yellow (I:22:3).
- Those whose divinity is the redone , the cows that are red form after form (i.e. limb after limb) , vigor after vigor , with them we enclose thee (I:22:3).
These hymns reveals :
- Surya chikitsa ( treatment with the sun rays);
Transferring the diseases to the sun. if the patient exposes to the sun rays , the yellowish skin colour may change due to the ultra violet rays (vit.d) of the sun.
- Treatment with red colours cow’s milk ;
It removes the yellowness and develops the haemoglobin.
- Oushadha chikitsa (IV:9:3)
- Anjana mani
- Jangidi mani
these manis eliminate the yellowness ofd the body.
Kushtha (leprosy and allied skin disorders) is explained in Atharva veda (I:23,24) as kilasa and palitha.kilasa is the name of white leprosy. It resulted in the appearance of grey (palitha) and white (shvetha) spots all over the body.the aetiology of kushtha is stated in I:23:4. It effects the asthi(bone tissue) , mamsa(muscle tissue), meda(adipose tissue) etc. Asikni , Nakthajata , shyama , brahma are the herbs mentioned for its treatment (I:23:1).
Mutra krichra is mentioned in II:3 very elaborately. The most delicate operation described is the probing of the urethra which was prescribed to relieve of patient suffering from the retension of urine. Atharva veda II,III ;speaks the kshetriya ( hereditary) diseases (the diseases able to passed down from one generation to another through the parents) and also their treatment.
Jivaka was the personal physician of the Haryanka king Bimbisara. He lived in Rajagriha , Present day Rajgir , in 5th century BCE. Sometimes described as the “Medicine King” , he figures prominently in legendary accounts in Asia as a model healer. When king bimbisara suffered from an anal fistula , he called upon the help of jivaka. After curing the king of his fistula , jivaka was appointed by the king as his personal physician and as a personal physician to the Buddha. Jivaka was depicted healing a misplacement of intestines , performing an operation of trepanning on a patient , removing an intracranial mass and performing nose surgery. In the Dharmaguptaka Vinaya , he healed a disease of the head by treating the patient with ghee through the nose. In the pali texts he is depicted as performing laparotomy , removing post-traumatic volvulus and a cesarean section on patients under some form of anaesthesia. Jivaka treated another setthi , this time with a brain condition. After having performed brain surgery , he told the patient to lie still on the right side for seven years and on the left side for another seven years. In another case described in the Mulasarvastibada texts, king Bimbisara lent jivaka to king Pradyota , the king of Ujjayini ,to heal his jaundice.
Although there may have been several different systems of medicine in ancient India , the texts and traditions of only one of these – Ayurveda ( literally , knowledge for longevity) –have come down to us.the Charaka Samhita and Sushruta Samhita are its earliest surviving texts. There is little evidence to prove the claim made by the Ayurveda tradition that its root lie in the veda. Although vedic texts do contain ideas related to healing and medicine , these do not match those of Ayurveda. Neither is there any indication that Ayurveda owed anything to Greek medicine , not a single Greek loan word can be identified in its terminology. Debiprasad chattopadhyaya argues that the medical literature represents part of a “Secular” , i.e; non-religious empirical tradition that, at some point of time , came to be brahmanized. On the other hand , Kenneth G. Zysk (1991) holds that the roots of Ayurveda lie in the milieu of the Buddhist monasteries of early historical India , and that medical knowledge and the practice of monks gradually spread beyond the confines of the monasteries. It is interesting to note the interweaving of philosophical ideas , for instance, those of Samkhya, Yoga ,and Vaisheshika , in the medical texts.
The Charaka Samhita contains several chronological layers. The origins of the work may go back to the 3rd or 2nd century BCE. The Bower Manuscript contains passages very similar to those in the Charaka Samhita and indicates that Charaka was considered a medical authority by the early 5th century CE. The name charaka occurs in colophons at the end of each chapter of the book. The main body of the text presents itself as containing knowledge received by Agnivesha from his teacher , a sage named Atreya. It seems that the medical system described in the work was known as the system of Agnivesha and that Charaka simply edited Agniveshas text. In the 4th or 5th century CE , the text seems to have been edited again by a person named Dridhabala.
The Charaka Samhita is divided into 120 chapters arranged in 8 sections. The Sutra section deals with pharmacology , food, certain diseases and their treatment ,doctors and quacks, and various philosophical issues. The second ( Nidana) section deals with the causes of eight important diseases. The third ( Vimana) section deals with the issues such as taste, nutrition , pathology and medical studies. The fourth ( Sharira) deals with anatomy , embryology ,and philosophy. Then there are sections dealing with diagnosis and prognosis ( Indiriya) , therapy (chikitsa) , pharmacy ( kalpa) , and a further discussion of therapy in general (siddhi).
The Shusrata Samhita too has several chronological layers.the original text which basically dealt with surgery, may have been composed in the late centuries BCE. , But it was added to and edited over several centuries till about the 5th century CE. Commentaries on the work mention the name of an editor named Nagarjuna. The text as it has come down to us consists of six sections. The first (Sutra) section deals with issues such as the origin and parts of medicine , a doctors training, therapeutic substances , food , surgery , the treatment of wounds , and the extraction of splinters. The second (Nidana) section deals with symptoms of diseases , their pathology, prognosis , and surgery. The third ( Sharira ) deals with embryology , anatomy , and philosophy. Chikitsa deals with therapy , Kalpa with poisons. The Uttara section deals with eyes,teeth,childrens care, and diseases attributed to demons, etc.
The concepts of dosha ( humours) , dhatu (body tissues) ,and mala (waste products) are central to Ayurveda. Three semi-liquid substances or doshas – vata (wind) , pitta ( bile, choler) , and kapha/shleshman ( phlegm) – are supposed to circulate in the body. The vata is supposed to be localized mostly in the large intestine, the pitta in the navel, and the kapha in the chest. The three doshas interact with the seven basic elements of the body – chyle(the pulp to which food is reduced in the stomach) , blood, flesh fat , bone , marrow, and semen and with waste products produced by the body. Body fluids are are visualized as carried around the body through innumerable ducts, pipes,and tubes. Sushurata uses interesting similes to explain the function of the network of ducts – he describes it as similar to veins on a leaf , providing nutrition to all parts of the body through contraction and dilation, just as a garden or field is irrigated by water carrying canals. Digestion is seen as the central process of bodily function
Diseases are believed to be caused either by an inordinate build-up of one of the doshas in its location or by its movement into another area of the body. They are divided into those that can be cured , those that can only be alleviated , and those for which there is no cure. They are linked to other factors includinf lapse of judgement , the suppression of natural urges , karma, and the influence of dempns. The discussion of epidemics mentions their connection with bad water, rats and mosquitoes. Methods of medical diagnosis include direct perception and inference. Sushruta states that touching , looking and questioning are the three methods that a doctor should use while examining a patient , but adds that he should use all og his five senses. Ayurveda prescribes various kinds of therapies including dietary regulation , massage, enemas , ointments, bloodletting, and surgery. It emphasizes moderation , including in eating , exercise and medication.
The Sushrata Samhita describes surgery as the most useful branch of medical knowledge and gives information on surgical techniques and practices in ancient india. The author discusses the training of a surgeon and gives a detailed description of his tools. There are descriptions of surgical procedures such as the dislodging of the eye lens for the removal of cataract , cutting for a stone in the bladder, removing splinters and arrows, and suturing. The text also refers briefly to plastic surgery – a flap from the skin being grafted to repair a severed nose (rhinoplasty) and the repair of torn earlobes. It also discusses how corpses can be used to study human anatomy.
Other important ancient Ayurveda texts include Vagbhata’s Ashtangahridaya ( Heart of medicine) , a comprehensive and systematic presentation of Ayurvedic medical knowledge , which may belong to c. 600 CE. Another important work called the Ashtangasamgraha ( Tome on medicine) is ascribed to the same author. Other ancient Ayurvedic treatises include Kashyapa’s compendium , which mainly deals with the diseases of women and children. It may belong to the 7th century , although some parts may be based on older material. The 14th century Sharngadhara Samhita offers a brief but succinct account of Ayurveda. Its recipes are still used by the ayurvedic pharmaceutical industry. Mention may also be made of developments in veterinary science. The Hastyayurveda of Palakapya is a work consisting of 160 chapters. It deals with the diagnosis and treatment of the major diseases of elephants through medication and surgery.
The ideas of Ayurveda had an impact outside the subcontinent as well. The major texts became accessible to other regions and cultures via translations into languiages such as Arabic , Persian and Tibetan. There is evidence that Ayurvedic ideas influenced Botanical science in Europe as well. Ayurveda is an ancient system of Indian medicine which has continued into our own times as one of several traditional alternatives to the Allopathic tradition of modern medicine.
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