Medicine and Surgery In Ancient India

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About the Author

Prof. K. H. Krishnamurthy (b.128), B.sc. (Hons.), M.sc., Ph.d., FBS has worked in the Universities of Gujarat, Mysore, Tamilnadu and Pondicherry and retired (1986) after 30 years of distinguished service in the Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry. Even after retirement, he is busily engaged in several academic assignments and projects. His professional positions had been as a Convenor, Faculty of history of Medicine; a UGC Emeritus Scholar, JIPMER; a Fellow in Ayurveda, FRLHT. He is a distinguished Sanskritist and Linguist, has received many Honours and Awards and has authoured more than 100 research papers in National / International Journals. His many sided achievements are best revealed in the ranges achievement are best revealed in the ranges (4) and the number (30) of his books. The ranges are Brain and Language (his doctoral work), Writing on Advanced aspects of modern Science in Kannada and Sanskrit, General works and on Medicinal Plants/ Ayurveda.

Preface

It is now well recognised and documented that Hindus in ancient times had developed and perfected different branches of Knowledge including different branches of science and various technology streams. Hindus had a unique way of treading a subject in a holistic, integral manner. Another feature of all Hindu thought it to go to the deepest layers, raise some fundamental questions and seek the answers at a basal level.

A long, fruitful, happy, bountiful, exuberant, and zestful life was a part of the world view that the ancient people of Bharat developed. They did not reject the importance of the gross physical, material aspect of life. (Surely, they considered issues beyond material aspects and developed strong foundations of spirituality). That the Hindus did not discord the physical and material aspects of life, but treated the same with the due consideration is reflected in the Vedic, Upanishadic literature and also in the other scriptures. People who went to live for hundred full years with prosperity, and good health and in good vigor require several tools, implements, gadgets, technologies etc. This cannot be achieved without having a sound understanding of the natural physical principles. Thus the science and technology in ancient India developed in different fields such as astronomy, mathematics, botany, zoology, agriculture, architecture, medicine and surgery and so on.

In health care and medicinal systems Hindus developed a holistic approach involving the physical, mental. Intellectual and spiritual aspects of personality. In fact, the contemporary modern / western medicine is trying to see the effect of mind on body and vice verse only recently. The holistic approach to health and medicine of ancient Hindus can possibly be of immense to modern man, stuck with innumerable psychosomatic ailments.

Generally the western systems of knowledge are dissective / compartmentalised as against the Indian systems which are integrative and holistic. The traditional health care in India was inclusive of the life style (achara), thought process (vichara) and dietetics (aahara). The treatment part comprised of counseling, medicinal application, surgery and so on.

There are several treatises of traditional medicinal systems of India. The samhitas of Bela, Charaka and Sushruta are available in English and several Indian languages. The available books are highly scholastic and highly technical and definitely beyond the reach of common man. As a result, many people do not know the treasure of knowledge available in our tradition.

For example, the many of the surgical instruments used even today, are the ones that Sushruta described. Sushruta observed how birds and beats derive mechanical advantage and catch / kill their prey and designed the surgical instruments. The circulation of blood, its function, and its role as link between the foetus and the mother all are described in Bela Samhita. (The circulation of blood is attributed to W. Harvey of 17th century, a fact that Bela described the same several centuries earlier). There are clear descriptions of the methods of construction of hospitals, care of children, responsibilities of surgeon, geriatrics, sexology, knowledge using anaesthetics, embryology, pharmacology, drug administration and so on in the ayurvedic treatises.

In fact, when the British came to India they were surprised at the practice of vaccination, plastic surgery in India. A detailed account can be found in Sri Dharmapalas Science and Technology in India in 18th century. During the colonization of India, a trend was set by the British in a systematic manner, to discord all traditional systems of knowledge in India and to look at traditional practices with contempt. Unfortunately, this trend continued further after independence. This resulted in the neglect of all the traditional knowledge systems, practices and indigenous science and technology systems of India. This is manifested in various policies and programmes of government including monetary allocation, as well as the attitude of the people.

Recently, the traditional systems of India including yoga and herbal medicine are gaining momentum in different parts of the world, especially in the west. Perhaps, as a corollary similar trend is emerging in India. There is a growing need to educate Indians about the importance of the traditional systems of medicine and health care.

Yugayatri plants to take up research in various aspects Indian culture and to make it more relevant and adaptable to the contemporary Indian society. YUGAYATRI plants to create working group for research, training, mass communication, policy advocacy and allied activities.

Prof. K. H. Krishnamurthy, a retired professor of biochemistry form JIPMER, is Sanskrit scholar, and a linguist, a scholar who has several books and publication to his credit has authored this book. Prof. K. H. Krishnamurthy has presented this work essentially to a community who do not have access to Sanskrit literature and are not qualified in Ayurveda.

During the course of development of this book several people have put in their services. Sri Prasun Kumar Misra of Samskrita Bharati has spent significant time in collating the information and coordination. Vidwan Janardhana Hegde and Dr. H.R. Viswas of Samskrita Bharati, Sri. G. R. Santhosh of Yugayatri have put in their efforts in coordination, proof reading and in discussions.

It is hoped that the book will generate interest in the traditional systems of Indian knowledge, in a broad cross section of our society.

Introduction Rudiments of the knowledge of medicine are traceable from Rg. Veda onwards i.e. 10,000 years back. However its actual systematization and compilation can be said to have commenced from the much later Samhita period of 7,000 years ago. It was then that analogous works in other branches of knowledge as in Bhrugu Samhita etc. were attempted. Science of medicine of Ayurveda actually means a knowledge of the span of living, its good maintenance, all round excellence and possible extension beyond the usual limit. It is much more than merely curing illness. This started as an Upaveda of Atharvaveda. Some authorities however trace it Rg. Veda as later Charana Vyutha text indicates.

This is an art needing much practiced skill as well as humane considerations. Simultaneously this is also a science a rational, validated, authoritative and systematized knowledge. There are two major traditions in this knowledge. They are: Kaya Chikitsa the science of medical treatment specially of the body and Shalya Chikitsa or surgery. Very soon however the expanding knowledge got standardized into eight branches resulting in an Astanga Ayurveda. These branches are Shalya, surgery in general; Shalakya, supraclvicular surgery, mainly head and neck surgery above the shoulder; Kaya chikitsa, medical treatment of the body; Bhuta Vidya, management of mental diseases; Kaumarya Bhrtya, pacdiatrics; Agada Tantra toxicology; Rasayana, elxirisation and finally, Vaji Karana, virlification or counseling on sex and geriatrics, Such a standardization continues even today. Atri is regarded to be the progenitor of Kaya Chikitsa and Dhanvantary, of surgery, both earlier than Ramayana period.

The literature on Ayurveda are of these categories:

I. The classical works, mainly, the Samhitas of Charaka, Sushruta, Kashyapa, Bhela and the like. Among the later texts Vagbhta has attained such a fame that he forms one of the Vriddha Trayi the three elders viz. Charaka. Sushruta and Vagbhata. The rest of the Sanskrit texts include principally the medieval compositions such as those of Bhava Prakasha, Madhava Nidana and Rasaratna Samucchaya, that together constitute the laghu thrayi or the minor three.

II. The second category of works includes lexicons or the famous Nighantus. Their objective is to present the materia medica of their contemporary times. This starts from Dhanwantary Nighantu of the classical times of the mediaeval period and stretches up to Shodala Nighantu, the most recent.

III. The third category of words includes an effective and an impressive range of books mainly in English and by modern authors, these attempt in general correlating the ancient Ayurveda to the contemporary medicine

Out of the extensive information available on Ayurveda we select below only a very few stray points to highlight issues and to stimulate the interested reader in greater probing. In most cases, the original Sanskrit passages are themselves quoted as an evidence of the authority for the statements made here and also highlight the vigour and the power of the original authors. The English translations given, attempt to bring this out as well. Apart from proper translation the many implications meant therein are also included within brackets at appropriate places.

Historically, though surgery had developed to a great extent in ancient Ayurveda, it declined from the period of Buddha onwards because of emphasis on non-violence to the extent of a banning on dissection. Hence the contents of present day Ayurveda are essentially of Kaya Chikitsa and its materia medica. The development of knowledge and its practice as medicine had reached a zenith much before the times of Buddha, while the Greek civlization and its a chievments in medicine are principally post Buddhistic i.e. after 620 BC. The historians of western (modern) medicine trace its origin to this Greek civilisation.

A speciality of Ayurveda in comparison with modern medicine is that it distinguishes itself in being holistic, integrative rather than analytical and totally ethical. Besides, it gives a prime position to soul or Atma. Control of senses is an essential component of medical treatment in Ayurveda. Charaka declares "diseaselessness springs from Jitendriyatva conquest of senses". An important corollary of this notion is that Ayurveda treats mind as an organ of the soul and is best used that way. It is only recently that the contemporary western medicine started realizing the importance of "mind" it is here that Ayurveda is unique.

The origin of diseases is always traced to prajna aparaadha or willful transgression of pragna of sound wisdom and the know-how which a person mostly possesses already. The best cure and advise is therefore Nidana parivarjana or the giving up of the known causes behind a good living or sadvritta and proper seasonal and daily regimes of ahara, vihara and vichara viz., in dietetics, behaviour and indulgence and thinking as well as attitudes. This is the sum of the factors that regulates a man's living.

Tridosa and Triguna-The Basis of Ayurveda

Herbal medicine and health care products are becoming more the popular currently. Ayurveda should not be compared with the contemporary medical practices. It should be treated as a indigenous knowledge system, which more fundamental in its approach. Medical treatment of the body for health, happiness, ailments, longivity, rejuvenescence and elixirisation to confer natural immunity and Kaya Kalpa, transmutation to excellence is all termed Kaya Chikitsa Ancient medical system of Ayurveda is not merely flourishing well now a days but is also offering new holistic and integral approach to health care.

Ayur (span of life) veda (the knowing thereof) is more than a mere medical system of treating illness. It is a knowledge of the span living given to an individual, to extend it, to render it healthy, happy, salutary and Ojasvi, exuberatingly execellent. Diseases are accidents brought about by pragna aparaadha willful transgression of the laws of living, which confer svasthya or health. Its speciality is that it recognizes self or soul as integral to living and mind is but an organ of it, bet employed so, lest the mind would lead one astray. This is jitendriyatva, conquest of the sense-the surest way to never get a disease.

Disease are of two categories, mental and somatic. Mind has three qualities, satva, the innate, positive and working for tranquility; rajas, the colouring, of a person in all ways by an over riding passion and dynamism and tamas, the darkness, negative, dull passive and inert. Both rajas and tamas are causative of disease; satva ensures health. The best way to promote satva is to follow dharma and its dictates. Ayurveda is thus basically ethical where achara rasayana i e., actually conducting oneself in dharma and not merely preaching about it is the best elixir. It is not that treatment is merely councelling thus. There do occur medha janana plants for promotion of mental brilliance, tranquilisers, pain killers and the like. But the thrust is in counseling. Modern medicine can learn much here.

To understand somatic diseases as Ayurveda conceives, conceives we should know its two siddhantas or theories of body constitution. Tridosa theory states that the body is made up of three dosas. (from root dush meaning to pollute). The operative principles (without which body does not exist) are called doshas since they become apparent only when they are in excess or deficient and thus cause a non-equanimity which is a disease. In equanimity they just work on harmoniously, the state of health, Medications are measures to decrease them if in excess and increase. These are Vata, from va mobility, being its principle (vz., neuromuscular and endocrinological functions) ; Pitta is from tap heat formation, referring to all chemical activity, mostly exothermic. Shleshma is from shlish-cling, connoting all local, physical activity of adhesion. Neither in health nor disease, the body can cross them. Dosas (3), dhatus, the constituents (7, blood, bone etc.) and malas, the impurities (sweat, urine etc.) are the 3factors of significance. A stone has a dhatu but neither a dosha nor a mala whose formation or non-formation is impressively and uniquely developed with the theory of rasa or taste, the first contact the body has towards a drug as crucial. Hence food and drugs have much in common, justifying the modern concept of nutritional medicine.

These three doshas regulate the body. It is thus a somatic theory. The other theory is that of the three gunas of satva, rajas and tamas. Together they contribute to the other theory of concurring to the mind and are hence of value in mental diseases.

Contents

1	Introduction	1
	Tridosha &Triguna- the basis of Ayurveda	4
2	Medical services-Hospital organization Paediatrics	7
	Care of the wounded	8
3	Surgery	10
	Types of surgical Instruments	12
	types of operations	15
	Characteristcs of a good surgeon	16
	Plastic surgery	16
	Surgical procedure	17
	Surgical Instruments	19
	Yantram	19
	Ethical responsibility of a surgeon	28
4	Medical education	28
	General principle	29
	Need for practical experience	30
	Quality of student and oath taking	31
5	Anatomy	32
	I. Dissection	32
	II. Marmas	33
6	Mind, Mental health and yoga	34
7	Physiology	35
8	Embryology	36
9	Pharmacology	37
10	Administration of Drugs	38
11	Blood circulation	39
12	Plants in Ayurveda	40
	A. Food plants	41
	B. Edible Oils	44
	C. Medicinal Plants of Ayurveda	48
	1. Aamalaka	49
	2. Harad or Haritaki	56
	3. Sringavera	61