Ancient Science of Life, Vol No. XI No.3 & 4, January – April 1992, Pages 106 - 113

THE MANY FACES OF *

G. J. MEULENBELD

De Zwaan 11, 9781 JX Bedum, The Netherlands *Speech delivered during the opening session of the Third International Congress of IASTAM, held at Bombay from 04 – 07 January, 1990.

Received: 14 July 1990 Accepted: 9 December 1991

ABSTRACT: The erudite author makes an attempt in this article to trace the historical developments of Ayurveda. He also identifies the divergent views which made their appearance on the scene, thus highlighting the flexibility and adaptability of the system to ever changing circumstances.

When one reads medical texts from is an arduous one. One way of facilitating various periods, one cannot but be struck by this insight is, in my view, the comparison a remarkable continuity of thought and of Ayurveda with other medical systems. practice on the one hand, and equally The most suitable counterpart of Ayurveda remarkable changes on the other. Just as for comparative purposes in Greek striking is the contrast between a tendency medicine, which resembles it in many towards consensus, and a tendency towards respects, being based on a humoral theory divergences in opinion. and having a long history.

Since numerous authors, especially in our The beginnings of Ayurveda as a medical own times, have emphasized the unchanging system are more obscure than those of aspects of Ayurveda, it seems natural to Greek medicine. Indian medical literature study the other side of the coin as well. does not start with writings that are comparable with those of the Hippocratic To start with, I want to be clear about my corpus, which consists of a large number of point of departure in the study of Ayurveda treatises, embodying very diverse points of and its literature. Ayurveda is in my view a view and theories. In contrast to this, the medical system that, having gradually Indian literature begins with two evolved on Indian soil, is intimately comprehensive treatises, the connected with Indian culture as a whole. I bearing the names of Caraka and Susruta. take much interest in the way in which Fortunately, these treatises belong to Ayurveda came into being, how it different schools, which results in numerous developed, changed, and maintained itself, divergences of opinion between the two, and adapting again and again to altered in different attitudes towards medicine as a circumstances. The task of trying to gain science. The Carakasamhita, which deals some insight into these historical processes mainly with internal medicine. The

Pages 106 - 113 Susrutasamhita, conversely, is less developments. Far more significant were preoccupied with philosophy, being a Tantrism and Saivism, both closely treatise that belongs to the surgical school, connected with alchemy and iatrochemistry. and surgeons are known to be, in ancient From the twelveth to thirteenth century India no less than in our own days, less onwards, Indian medical literature shows prone to philosophical speculations than that a varying amount of elements derived other medical specialists. from alchemy were used, resulting in all kinds of mixtures, the components of which The relationship between medicines and are not always compatible. Among the non philosophy thus proves to vary from early Hindu authors, the Jainas composed medical times onwards. It is worth considering if treatises adapted to their creed. These works thus relationship may not be a secondary are said to be based on texts belonging to the development, like it was in ancient Greece, Jaina canon, but do not, however, deviate where medicine developed as an considerably from the common stock of independent art, separate from philosophy. ayurvedic literature, except for their material The Caraka- and Susrutasamhita contain medica, which had to conform to Jaina numerous passages that seem to indicate that tenets. It is even hard to distinguish treatises philosophical concepts did not fit in well by Buddhist authors from those by their with medical doctrines. The Carakasamhita hindu colleagues, with the exception of also clearly shows the eclectic attitude invocation of figures from the Buddhist towards philosophical systems that is typical pantheon. of physicians in general. The of Susruta even advocates explicitly this In general, the role of religion in medical eclectic and tolerant attitude towards widely literature varies considerably. The diverging world views (Sarirasthana 1.11). Carakasamhita is a good example of a Later, in the age of the great commentators, treatise in which religion is conspicuously the scene has evidently changed. Authors, present, as is philosophy. Some later works in particular some of them, like incorporate verses of entire chapters on Cakrapanidatta for example, devoted much disorders regarded as the fruits of evil energy to the interpretation of the classical actions committed in previous lives, but this texts in agreement with philosophical never became a marked feature, which is doctrines that had become authoritative. A understandable since disorders of this type one sided picture of post-classical literature are not amenable to medical treatment. would emerge by giving this trend too much Exceptions do occur, however. A treatise, weight. A large part of the later literature called Virasimhavaloka, composed towards conveys the impression that medical in the end of the fourteenth century, deals philosophy. Other parts of its reflect the extensively with this subject. Mantras, and great diversity of philosophical and religious in later texts also yantras, occur regularly, thought in various periods of Indian history. though not frequently, except in works of A remarkable feature is, for example, the Tantric inspiration, such as Narayana’s almost complete lack of impact of the - Tantrasarasamgraha. Magical element system on medicine. One single text, the show a similar distribution and are found in anonymous Ayurvedasutra, testifies to an particular in Tantric works, as well as in individual effort to integrate Yoga and specialized treatises such as Nagarjuna;s Ayurveda; this remained an exception and Kaksaputa. As to astrology, its relation with did not have any influence on subsequent medicine is not a close one, although in a

Pages 106 - 113 few exceptional texts, like the already There were numerous differences of opinion mentioned Virasimhavaloka, it is given on practical points, especially on the details ample scope. In more recent times, we can of the preparations of compound medicines. observe that during the revival of Ayurveda in the nineteenth century, much thought was Apart from all these early disagreements in given to the integration of Ayurveda, the formative period of Ayurveda, the philosophy, and religion. This is striking number of differences between the views feature of the extensive commentary on the expressed in Caraka and Susrutasamhita is Carakasamhita by Gangadhra Kaviraj, the considerable, many of these even being greatest representative of this movement. irreconcilable. It is therefore no surprise The most recent literature does not show this that, in the course of time, just as in the tendency any longer, being characterized by Graeco-Roman world, there was an a secularization of Ayurveda. increasing need to construct a more unitary system of medicine. The demand was met After this digression on the vicissitudes of by Vagbhata, who probably lived in north the relationship between medicine on the western India about A. D. 600. The work he one hand, and philosophy and religion on composed, the Astangahrdayasamhita, the other, I shall turn to medicine proper. although based in large measure on the Taking a closer look at the samhitas of samhitas of Caraka and Susruta, heralds a Caraka and Susruta, we notice efforts new era by introducing a consistent system towards a coherent body of medical theory of medicine, with the added advantage of without this aim being completely achieved, being couched in elegant Sanskrit verse. In which is a fortunate state of affairs for the spite of the importance of the subject, the medical historian. Besides their construction of Vagbhata’s treatise and the inconsistencies, a fascinating aspect of these motivation behind his choices, have not yet samhitas is their preservation of a been studied in details, although much considerable number of old theories, which informations on this tissue can be found in a are still referred to, though these are refuted book by Prof. P. V. Sharma, called by the authoritative teachers who figure Vagbhatativecana. An extremely interesting prominently in them. The available topic is the influence of Vagbhata and the evidence point to a great diversity of views subsequent fate of his work. As opposed to in the period anterior to the establishment of what one would expect, his treatise was not the classical samhitas. In this it must have generally welcomed and accepted, and only resembled the formative period of Greek became authoritative and very popular in medicine. Regrettably, this pre-classical certain parts of India, especially in the south. period has left us no complete texts or large A remarkably large number of authors from fragments of these, but nevertheless, the India’s Dravidian-speaking areas have references found in the samhitas themselves, extensively drawn upon Vagbhata’s the quotations and all sorts of remarks in the Samhitas in composing or compiling their commentaries, and a few fragments of early won medical treatises. A few examples are texts, show that this diversity was a reality. the Prahitasamhita, Srinivasa’s Disagreements and clashes of opinion Cikitsatilaka, and works on material medica occurred on a large number of issues, both such as the Astanganighantu, theoretical and practical. A much debated Madanadinighantu, and Abhidhanamanjari. theoretical issue, for example, was whether Characteristic of Vagbhata’s fate is that, to or not blood was to be regarded as a dosa. this day, his work has not been translated

Pages 106 - 113 into English, whereas, on the other hand, the treatment, but the majority of the physicians Tibetans rendered it into their own language had to choose a therapeutic manual since the at an early date. samhitas of Caraka and Susruta were evidently not often used for that purpose. To be sure, Vagbhata was the first author to Collections of prescriptions and formulas, present a new system of medicine, but also containing sundry rules with respect to shortly afterwards attempts in the same treatment, had circulated among direction were made by others. One of these practitioners since early times. Some early was Ravigupta. Yet, in spite of its merits, examples, like the Bower Manuscript and his Siddhasara, which was much more the Yogasataka, have been preserved. concise than Vagbhata’s work, did not Characteristic of these therapeutic manuals succeed in finding a wide audience. The or compendia is that their contents have Tibetans, again, took notice of it and been taken from a wide variety of sources, translated this Siddhasara. thus reflecting a rich medical literature, most of which has irretrievably been lost, due to A Bengal author who lived a couple of the very success of some of these new centuries after Vagbhata was more manuals. One such work was compiled by successful, especially in northern India. His the author of the Madhavanidana, but in name was Madhava. His system of contrast to his compendium on pathology, it pathology, the Rugviniscaya, usually called evidently did not appeal to most of his Madhavanidana, evidently gained the upper colleagues and was almost forgotten. hand within a short time. In contrast to the Vrnda’s Siddhayoga, probably dating from treatises by Vagbhata and Ravigupta, about A. D. 900, acquired higher repute, yet Madhava’s work is a compilation of verses was eclipsed by Cakrapanidatta’s taken from earlier sources, more often from Cikilasamgraha bout two centuries later. A Caraka and Susruta than from Vagbhata and large number of this type of treatises were Ravigupta. The cornerstone of his success compiled or composed in later times, and up may have been his systematic and eclectic to the present day, all of them adapting or mind, manifest in his treatise. borrowing from a great variety of sources.

From the beginning of the second A new branch of Ayurveda suddenly millennium after Christ onwards, the appears in the thirteenth and fourteenth ayurvedic literature can therefore be divided centuries. This branch, called nadisastra, is into two main streams, dominated either by concerned with diagnostics and Madhava’s system of pathology or by prognostication by means of the Vagbhata’s system. A third part of this examination of the pulse. The abrupt literature, quite considerable in its extent, appearance of this procedure, present for the and very interesting too, consists of works first time in the Sarngadharasamhita, poses by authors who were obviously dissatisfied a still unsolved problem to medical with both, and therefore attempted to historians because of the obscurity of its improve on them or to develop ideas of their origins. The medical literature posterior to own. Sarngadhara shows that feeling the pulse was accepted as one of the standard In the field of therapy the situation was elements in the examination of a patient, yet completely different. Those who followed I feel that nadisastra did not become fully Vagbhata could employ his ways of integrated with Ayurveda, since most

Pages 106 - 113 treatises contain only few verses on the sciences is characteristic of the history of subject, while, on the other hand, a separate Indian medicine, since it is absent from class of monographs on pulse lore came into western humoral medicine until the times of existence. The reasons for this development Paracelsus. Study of the Indian sources can only be conjectured. Pulse lore many reveals that it was a gradual process. have been experienced as an extraneous Moreover, the amount of fusion between the element, its practice may have been left to two sciences varies considerably in different specialists, or the obstacle may have been authors. Those who held on to Vagbhata’s that its main concern was with prognosis. teachings were generally averse to the new The same process can be observed with ways of treatment. regard to the aristas, the signs foreboding death. The early samhitas deal at large with The Processes which led to the blending of this subject, which a separate type of texts medicine and alchemy remain obscure. The appears, monographs on signs announcing same applies to the origins of alchemy itself. death, often bearing the title of Kalajnana. We do not know where it came from, and when and where it began to develop on Besides the examination of the pulse, Indian soil. However that may be, it is a several other procedures were added to the very old science in the Indian civilization, as already recognized traditional ones in the it is elsewhere. examination of a patient. The inspection of the urine, called mutrapariksa, not Alchemy produced its own body of literature completely unknown in the early samhitas, consisting of a substantial number of texts. became more widespread, and a new It is partly very technical, but several of element was introduced, the tailabindu these texts contain medical sections, method. abounding in recipes, which are also found in medical treatises of the mixed type I have These developments that can be deduced referred to. For that reason the rasasastra from the medical literature only a glimpse of literature cannot be neglected by the medical the changes that took place in the course of historian. Going through it, the absence of time in the practice of Ayurveda. Other medical theory is striking. The dosas are, facets of the process of transformation of however, frequently mentioned, and the Ayurveda are the decline of surgery and, names of diseases are the same as in closely bound up with it, of anatomical Ayurveda. A noteworthy feature is that knowledge. Surgical procedures like blood most of the formulas are employed against a – letting and cauterization fell into disuse. vast array of disorders, although one also Appreciable losses can also be observed in comes across more specific ones. Another the field of the botanical knowledge of notable feature is the accent on rasayana, physicians. the science of longevity, on vajikarana, aphrodisiacs, and even on the acquisition of A major change, already referred to, came an incorruptible body, not subject to decay. about by the blending of Ayurveda and It is surprising that iatrochemistry, i.e. rasasastra, medicine and alchemy, a alchemy applied to medicine, was so easily conspicuous feature since the times of incorporated in Ayurveda, because in many Cakrapanidatta and Vangasena, and ways it conflicts with it. The developments becoming more marked since Sarngadhara. sketched so far may have been purely This blending of two originally separate internal, without influences from outside,

Pages 106 - 113 but contacts with other cultures may also borrowing of drugs from Islamic medicine have contributed. was not restriction to the first centuries of contact between the two systems, by was a The culture that had a definite influences on continuing process. Some treatises Ayurveda was that of Islam. The Muslims composed as late as the nineteenth century is brought with them their own system of full of them, such as, for example, medicine, derived from the Greeks. Both Krsnarama’s Siddhabhesajamanimala. Very systems interacted and borrowed from each rare, on the other, are diseases, or simply other. Remarkable is the absence of changes names of diseases, which are borrowed from in the theory. The borrowing that can be Islamic medicine. An example is detected are restricted to the practice of munnatakhyaroga, a venereal diseases medicine. A number of drugs used by the described in Sankara’s Vaidyavinoda, hakims were adopted by the Indian vaidyas composed in the seventeenth century. and remained part of their material medica, while the reverse process took place as well. The contracts between Ayurveda and These developments have not been studied western medicine began in the sixteenth in detail. The texts edited so far convey the century. In the same period a new diseases impression that it was more widespread in appears in Indian medical sources, namely northern than in southern India, and that the phirangaroga, i.e. syphilis. Some followers of Vagbhata were rather immune Europeans who resided in India developed a to it. One of the contributions of Islamic keen interest in Indian medicine and its medicine was probably the introduction of a material medica. Famous examples are a new type of medicinal preparation, called Dutchman, van Rheede tot Drakenstein, and arka, a word of Arabic origin. The term a Portugese doctor, Garcia da Orta. In that arka, which designates a preparation made way Indian drugs became known to the by means of a still, appears for the first time western world. The westerners, from their about A. D. 1200 in the ayurvedic literature, side, introduced new plants into India, of in the writings of Sodhala. Later, at a so far European and South – American origin, undertermined date, arkas became the several of which were of medicinal value. subject of a monograph, entitled As a result new drugs were incorporated in Arkaprakasa, and attributed to a the Indian pharmacopoeia. An interest mythological figure, Ravana. A large process, not yet sufficiently studied, is the number of substances derived from Islamic utilization, since these times, of newly medicine are mentioned in this work. Aras, introduced medicinal plants under old however, never became a commonly used names, while the originally employed type of pharmaceutical preparation, and botanical species passed into oblivion. remained rare in the ayurvedic literature. These processes form part of a development An isolated phenomenon is the composition that went on during the centuries, and that is, of works in Sanskrit on Islamic medicine. for example, still clearly visible in a The reverse process, including translations, nineteenth-century work, the was probably more extensive. Examples of Saligramanighantubhusana¸ belonging to a works on Islamic medicine in Sanskrit are very large medical encyclopedia, the two treatises by Mahadeva, the Brhannighanturatnakara. Hikmatprakasa and Hikmatpradipa, written in the eighteenth century, both abounding in Besides these changes in the material Arabic and Persian medical terms. The medica, we can observed influences of

Pages 106 - 113 western medicine on the Indian system of Bengal, born in 1789, and a very prolific nosology. New diseases, derived from author. The most characteristic feature of western medicine, being to crop up in an the medical literature of the nineteenth increasing number in Sanskrit medical texts century consists, however, of essentially the dating from the eighteenth and nineteenth same type of syncretism that was already centuries. A good example from the present in preceding centuries, but eighteenth century is Govindadasa’s reinforced bow by the influx of elements Bhaisajyaratnavah, while the same trend is from western medicine. These foreign represented in the nineteenth century by influences became still more pronounced as works like Krsnarama’s a result of the professionalization of Siddhabhesajamanimala and Binod Lal Ayurveda and its consequences, such as the Sen’s Ayurvedavinjana. The latter treatise establishment of Ayurvedic Colleges. These has also adopted numerous notions from developments, beginning in the nineteenth western anatomy and physiology. century and going on in the present one, led to a gradual transformation of Ayurveda, The nineteenth century is the age of the and gave it a new face, the features of which revival of Ayurveda and its cannot easily be delineated on the basis of professionalization. Hand in hand with this the contemporary medical literature. revival went a process of resecularization of Ayurveda, as rightly stressed by Charles Besides, there is a shortage of studies on the Leslie. An interesting question is therefore actual practice of Ayurveda, the texts used which type of Ayurveda was revived, and, by the practitioners, and the curricula of the related to this, which type was being Ayurvedic Colleges. A distinct element of practiced in that period, especially in the new face of Ayurveda appears to be a northern India, and, more in particular, in renewed and sustained pursuit of a unitary Bengal, where the movement of revival theory, with a strong emphasis on the originated and from where it spread. In doctrine of the three dosa, unfortunately practice, Ayurveda was undoubtedly of the without making clear which parts of the syncretic type just sketched, whereas the elaborate and complex theory are still revivalist ideology asserted firmly that adhered to, and on which texts the modern Ayurveda had declined due to foreign views are based. Some parts of the old influences, thus creating the necessity of a heritage, in particular those connected with return to the ancient texts. An ambiguous religion and magic, are disavowed, and other situation developed, which is reflected in the parts, especially those dealing with literature of the period. On the one hand one nosography, are, for better or worse, made to observes a renewed interest in the classical agree with western medicine. Studies on samhita, which were repeatedly printed, contemporary ways of treatment often while, on the other, there was no break with described that ayurvedic and western drugs the preceding period to be seen in the works are used side by side, but purer types of compiled or composed in the nineteenth ayurvedic therapy are not yet completely century. The renewed interest in the extinct. classical medical treatises emerges, for example, from the very elaborate Sanskrit The available information on the actual commentary on the Carakasamhita, written situation shows clearly that Ayurveda is by probably the most eminent representative going through a period of far-reaching of the revival, Gangadhara, a resident of changes. Whatever the future may have in

Pages 106 - 113 store, I am convinced that the rich heritage long history of Ayurveda give evidence of of Ayurveda will not easily be obliterated its flexibility and adaptability to ever and disappear from Indian soil, because the changing circumstances.

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