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Education in Ancient India c10.s1: Medical Education

Education in Ancient India c10.s1

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Medical Education

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Early Progress: Medical science is no doubt of hoary antiquity in India. The Vedic literature refers to the healing feats of Aśvins, who though originally human beings, were later deified by a grateful posterity. This science was fairly well developed by the 4th century B. C., for the Greeks, who had accompanied Alexander the Great, were very well impressed by the skill of Indian doctors in curing the cases of serpent bite. The Jātakas refer to the medical students at Taxila performing operations for cranial abscesses and intestinal displacement.

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Some general Features : Medical education was usually imparted by private teachers. There was a ritual at the admission of students which will be described in Appendix 1, E. The student had to be well grounded in Sanskrit, for most of the books on medicine were written in that language. Learning by rote was condemned ; Suśruta compares a person having only a verbal knowledge of the medical texts to a donkey conscious of the heaviness but not of the quality of the burden it carries. Specialisation was encouraged ; students were expected to master the different branches of learning from different experts.¹ Practical training in surgery and pharmacy and constant discussion of abstruse points among the students and teachers were some of the important features of the training.²

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¹ Suśruta, Sūtrasthāna, IV. 4. 4-8

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² Charaka. Vimānasthāna, 8. 4

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Training in Surgery :—We can get a fairly good idea of the training in surgery from our sources. The beginners were taught how to hold and use the surgical instruments by practising upon pumpkins, cucumbers, water melons, etc., under the teacher's directions. Puncturing was demonstrated on the veins of dead animals, the manner of holding the probe on dry Alābu fruits, scarification on stretched pieces of leather covered with hair, sewing on thin pieces of cloth or skin, application of bandages on stuffed human figures and the use of caustics on soft pieces of flesh.³ The novice was then gradually initiated in real cases and allowed to extract darts, cleanse wounds, and use the knife in piercing and cutting diseased parts of the body. How surgical wounds are to be made to dry up was also demonstrated. Practice in the administration of emetics, purges and enemas was given to all. Suśruta emphasises on the importance of dissection for perfecting the student's knowledge, and points out that mere book learning cannot give a clear idea of the actual internal constitution of the human body. Corpses used to be decomposed in water and students were then required to dissect them and visualise the nature of skin, muscles, arteries, bones, internal organs, etc.¹ Anatomical knowledge that was thus imparted was fairly high when compared with the contemporary standards elsewhere. Unfortunately in the course of time the dissection of human body went out of vogue, causing a setback to the progress of the medical science.

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³ Suśruta, Sūtrasthāna, Chap. 9

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⁴ Mil. Pan., Vol. II, 254-5

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¹ Suśruta, Śarīrasthāna, 5.49.

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Arrangements for Practical Training—Students received practical training in surgery and medicine, usually through private practice of their teachers. In some cases hospitals were attached to colleges. In great cities like Pāṭaliputra there existed big charitable hospitals, which must have afforded good opportunities for training medical students. Indian hospitals were well organised, for Hindu doctors were invited by the Abbaside Khalifas to supervise their own hospitals in the 8th century A D. It is to be regretted that Fa Hsien should not have given us detailed information of the hospitals, which he had seen at Pāṭaliputra. If he had done this, we would have probably known a good deal about the hospital management and medical education during the 5th century A.D.

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Duration of the Course and Examination :—The exact duration of the medical course is not known. Charaka and Suśruta do not enlighten us on the point. In the days of the Buddha, the medical course at Taxila was fairly long; for his physician Jīvaka was permitted to go home very reluctantly by his teacher, though he had spent seven years at that University. Charaka observes that no one can obtain a real all round efficiency in Āyurveda; this would also suggest a very long course. We may well presume that the student had to spend at least eight years, before he could get mastery in the subject. The completion of the course was followed by an examination. This is implied by the observation of Charaka¹ and Suśruta² that it is the king's fault, if incompetent doctors practise the medical profession. Śukra also prohibits a person to practise as a doctor without possessing the king's license.³ None of our authorities however discloses the conditions under which the royal permission was granted under efficient administration. Very probably it must have been given to students who were certified to have finished their course either by superintendents of state hospitals, principals of colleges or famous private practitioners.

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¹ Sūtrasthāna, 29.8

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² Sūtrasthāna, III. 52; X. 3

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³ I. 804

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High ideals placed before the Medicoes : The convocation address before the medical graduates exhorted them to follow a very high ideal of professional conduct.⁴ They must relieve distress in all quarters. They must strive for the welfare of all humanity. They must not desert a patient, even when their own life was in danger. They must continue study and research throughout their life.

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⁴ See Appendix III

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Achievements in the Medical Science : The above advice seems to have been followed in a very large number of cases. India continued to be famous for its medical skill throughout the ancient period. Her doctors could perform surgical operations for cataract, hydrocele, abscesses, extraction of dead embryos, etc.¹ They were in demand in Mesopotamia and Arabia for guiding and training the physicians there. Khalifa Harun sent several scholars to India to study Hindu medicine and pharmacology and induced about 20 doctors to come to Baghdad to become chief medical officers of state hospitals and to translate Sanskrit medical work into Arabic. Most celebrated among them was Manakā (Māṇikya), who was originally invited to cure an ailment of Sultan Harun, which defied the skill of Arabian physicians. He succeeded in his treatment and was later induced to become the director of state hospitals and translate the work of Suśruta into Arabic.² Arabic system

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¹ Sītā apprehended that Rāvaṇa might kill and dissect her limb by limb like a surgeon extracting a dead embryo; cf.

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² S. K. Nadvi. *Arab aur Bharat ke sambandha*, pp. 103-23; Alberuni, Introduction, p. XXXI. Saleh bin Bahala and Dahan (Dhanvantari ?) were two of the famous colleagues of Manaka, who accompanied him to Baghdad.

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तस्मिन्ननागच्छति लोकनाथे गर्भस्थजन्तोरिव शल्यकृन्तः ।
नूनं ममांगान्यचिरादनार्यः शस्त्रैः सितैश्छेत्स्यति मानवेन्द्रः ॥
*Rāmāyaṇa*, V. 28. 6

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Non-discovery of anaesthetics and sterilisation processes was standing in the way of progress. Wine was administered as a partial anaesthetic. The *Bhojaprabandha* refers to an anaesthetic called *mohanichūrṇa*: but since it is mentioned in connection with a miraculous cure effected by the divine physicians Aśvins, we may doubt its general knowledge or use.

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cf.

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ततस्तावपि राजानं मोहचूर्णेन मोहयित्वा शिरःकपालमादाय तत्करोटिकापुटे स्थितं शफरकुलं गृहीत्वा कस्मिंश्चिद्भाजने निक्षिप्य संधान-करण्या कपालं यथावदारचय्य संजीविन्‍या च तं जीवयित्वा तस्मै तददर्शयताम् ॥
*Bhojaprabandha*, after v. 318

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of medicine owes a great deal to the Ayurvedic system.

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Medical Education in Later Times :—Training in the medical profession was fairly efficient in India down to the 10th century A. D. Ayurvedic doctors were keeping themselves in touch with the discoveries and developments taking place elsewhere, and also experimenting upon new preparations as better medicines for ailments and diseases. The use of mercury, opium and metallic preparations was introduced into the pharmacopeia in the medieval times. Discontinuance of dissection and consequent decline in surgery however gave a setback to the system. Owing to the prevalence of stricter notions of ceremonial purity, the touch of the corpse became a taboo and dissection was consequently given up. This became fatal to progress in surgery, the practice of which gradually died down. The medical profession began to be held in low esteem as the doctor had to deal with filthy diseases and touch dying patients. In the earlier period famous doctors like Aśvins and Dhanvantari were deified; now the followers of the profession began to be regarded as defilers of the company at a dinner table.¹ Purāṇas state that medicine became the profession of the descendants of the illegitimate son born to sage Gālava from his maid-servant Ambā.² Occasionally we no doubt come across grants of villages given to doctors by kings; there can be however no doubt that society as a whole looked down upon the medical profession, which could not but have told upon its efficiency and progress.¹

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¹ Manu, III. 152.

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² Some of the Smṛtis also e. g. B. D. S., I. 8. 9. assign the medical profession to the children of a mixed caste sprung from the union of a Brahmana father and Vaishya mother.

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¹ An incidental observation in the Mitāksharā would show that the medical course was finished in four instead of eight years during the 12th century A. D.; of:— अन्तेवासी गुरोग्रहे कृतकालं वर्षचतुष्टयमायुर्वेदशिल्पशिक्षार्थं त्वद्गृहे वसामीति। On Yāj. II. 184.

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Veterinary Education :—The veterinary science had been developed in India fairly early. Śālihotra is its traditional founder and two of the Pāṇḍava heroes, Nakula and Sahadeva are said to have been experts in it. In the 3rd century B. C. veterinary doctors were fairly common; Asoka could find them in necessary numbers to man his hospitals for animals throughout the country. The army authorities used to employ them in army to treat the ailments of horses and elephants (*Arthaśāstra*, II. 30-2). There were special books also dealing with these subjects.² We however do not come across any veterinary schools or colleges, nor do we possess any information as to how veterinary doctors were trained. Probably army authorities used to organise their own schools to meet their own needs. In villages the profession may have been hereditary in some farmers' families, which may have occasionally taken some outsiders also to be trained as apprentices.

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² Aśvavaidyaka of Jayadatta, Aśvachikitsā of Nakula and Hastyāyurveda of Pālakāpya (published in A.S. series) are the important works on the veterinary science. Some of these works in their present form are not later than c. 800 A.D., but they had their precursors, now unfortunately lost.

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