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A Concise History of Science in India c8.s2: Āyurveda: The Special Treatises

A Concise History of Science in India c8.s2

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Contents

Āyurveda: The Special Treatises

Āyurvedic Saṃhitās

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*Āyurveda* had its origin in the healing art of the Vedic period. Its development as a comprehensive and rational medical system came in the succeeding centuries side by side with the flowering of the philosophies, arts and sciences in the golden age of Hindu civilization. Our knowledge of this ancient science comes mainly from the surviving written treatises, the oldest of which are the *saṃhitās* named after Bhela (or Bheḍa), Caraka and Suśruta. The first has reached us in a single and very incomplete manuscript but many independent references in other ancient works as well as the internal evidence put its authenticity and antiquity beyond reasonable doubt. It is very possibly the oldest medical treatise in existence. Nagnajit, an authority on toxicology, mentioned in the *Aitareya* and *Śatapatha Brāhmaṇas*, is also mentioned in this work as a contemporary living person.a This makes the original *Bhela Saṃhitā* a work of the period of the *Brāhmaṇas*. The work, as recent studies indicate, contains some valuable materials to fill up gaps in both the *Caraka* and *Suśruta Saṃhitās*; but on account of its fragmentary and mutilated character, it does not provide a full exposition of Āyurvedic medical knowledge.

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The other two works now available as later redactions, respectively by Dṛḍhabala (eighth or ninth century A.D.) and Nāgārjuna (*c.* third century A.D.), of earlier works belong entirely to a different category. Both are erudite and exhaustive compendiums, incorporating and codifying the theoretical and practical knowledge of medicine and its contributory arts and sciences available at the times. The *Caraka* and *Suśruta Saṃhitās* were followed in later centuries by more sophisticated treatises, commentaries and medical encyclopaedias (which were largely based on materials obtained from the two earlier works), but they have retained their place during two millennia as the two most complete and representative works on *Āyurveda*. Most of our present knowledge of the extent and depth of Indian medical science is obtained from these two standard works.

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By their own testimonies, the extant texts of the two great *saṃhitās* are revisions of the original with additions and alterations. There is evidence of many medical treatises which were composed before these two but are now quite untraceable, and each of these two names a particular earlier treatise on which it is based. Caraka's original was the *saṁhitā* of Agniveśa,a a disciple of the medical sage Ātreya. Long passages in the *Caraka Saṁhitā* are in the form of questions and answers between Ātreya and Agniveśa. This original *Agniveśa Saṁhitā* was referred to even so late as the eleventh century A.D. by Cakrapāṇi Datta in his *Āyurvedadīpikā*. In a similar way the *Suśruta Saṁhitā* contains a series of discourses between the holy sage Dhanvantari and his disciple Suśruta,b but much of the original material seems to have been revised by the redactor, Nāgārjuna, who has also made considerable additions to the text, according to the commentator Ḍalhaṇācārya.

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a Sharma, (S. V.), pp. 228–30; *see Journal of Dept. of Letters*, Calcutta, 6, p. 30.

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Chronology of the Saṃhitās

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There is no reason why the given sequences of authorship and editorships should not be accepted as correct, but acute difficulty is encountered in providing the above-named persons with actual historical dates. There is a sage Ātreya in the *Ṛgveda*; another one of the same name was a famous medical teacher at Taxila at the time of Gautama Buddha; and two more are found in the *Caraka Saṁhitā*c itself; an Agniveśa is found in the *Mahābhārata* who is unlikely to be the disciple of Ātreya. Caraka is a class title of a school of physicians, existing from Vedic times,d and also the personal title of a physician in the court of King Kaniṣka,e and very possibly the title of many other physicians belonging to the same school of medicine. According to many commentaries by reputed Indian authors of the first millennium A.D. and later, Patañjali, the great philosopher and alchemist of early Buddhist times, was identical with Caraka of the *Saṁhitā*.f Again Dhanvantari is a legendary, divine personage in many Vedic texts of widely different ages; Suśruta is said to be the son of the Vedic sage, Viśvāmitra, but another Suśruta is referred to by Kātyāyana (a contemporary of Candragupta Maurya), the author of a *vārtika* to Pāṇini's *Vyākaraṇa*; Nāgārjuna is the name or title of at least two, possibly three, philosophers, alchemists and scholars between the third century B.C. and al-Bīrūnī's time, tenth century A.D. The difficult task of identifying the medical authors has to be undertaken only on the basis of available evidence and chance references in other sources of established chronology. The most commonly accepted dates for the composition of the *Caraka Saṁhitā* (which formed the basis of Dṛḍhabala's version) and Nāgārjuna's redaction of the older *Suśruta Saṁhitā* are A.D. 100, and third to fourth century A.D. respectively. These conclusions were arrived at by the Chronology Committee of the National Institute of Sciences of India after considering the entire available data on the subject. The original *Agniveśa* and *Suśruta Saṃhitās* must have preceded these works by many centuries, as they had to be extensively revised and restored.

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a *CS. Sū.*, 2.

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b *SS. Sū.*, 1. 1.

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c *CS. Sū.*, 1. 9.

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d *Taitt. S.*, vi. 4. 9.

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e Levi, pp. 444–84.

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f Sen, Gananath (1), p. 11.

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The Contents of the Āyurvedic Saṃhitās

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The *Caraka* and *Suśruta Saṃhitās* mention the eight different branches of medical knowledge,a but the treatises are not written accordingly. The former is an exhaustive work on the first branch (therapeutic medicine) only, though it contains many sections dealing with surgery and the other six branches. It deals mainly with anatomy, physiology, aetiology and prognosis, pathology, treatment, objectives, influence of environmental factors, medicines and appliances, and procedure and sequence of medication. For discussion of these topics the work is divided into eight *sthānas* (sections) containing 150 chapters in all. The *Suśruta Saṃhitā* follows more or less the same pattern, but it gives surgery the place of honour. In fact, the Dhanvantari school of medicine, to which it belongs, believes surgery to be the most ancient and most efficacious of the eight branches of medical knowledge.b The *Suśruta Saṃhitā* contains six *sthānas* dealing with fundamental postulates, pathology, embryology and anatomy, therapeutic and surgical treatment, toxicology, and a final section on subsequently gained and specialized knowledge of topics dealt with in earlier sections, and contains a total of 184 chapters. In both the works the topics are not distributed in the text in the way that would appear logical to modern minds, and often the same topic recurs in different isolated chapters. Still, the over-all picture is of codified, scientific treatises, the *Suśruta* being more concise in language and a repository of more factual information; it describes the necessity and *modus operandi* of dissections on human cadavers for gaining accurate anatomical knowledge.

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The special physiological and pathological ideas of *Āyurveda* as also its special methods of a diagnosis and treatment will be discussed later. Some of its achievements merit special mention. The *materia medica* is extensive and represents a full utilization of environmental resources. More than 600 drugs of animal, plant and mineral origin are used in the *Caraka* and about 650 in the *Suśruta Saṃhitā*. The large variety of medicinal prescriptions, methods of compounding, therapeutic methods including psychiatric processes and surgical processes employing specific instruments for each type of operation are scientific, sound and exhaustive. Suśruta describes more than 300 different operations employing 42 different surgical processes and 121 different types of instruments. Some irrational methods are, however, prescribed for some mental aberrations and diseases of new-born infants.

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Symptoms are described for a large number of pathological conditions and diseases, including *diabetes mellitus*, pulmonary tuberculosis, malignant growths, leprosy, gangrene, erysipelas, jaundice, diphtheria, tetanus, calculi, general paralysis, insanity, epilepsy, epidemic diseases, bites of poisonous snakes and animals, and hydrophobia. Rational and apparently efficacious surgery is described for many conditions including complicated fractures and dislocations, piles, fistulas and sinuses,a tumours, carbuncles and malignant growths, cataracts and complicated opthalmic operations,b strangulated hernia,c urinary stones causing uraemia, impacted gall-stone, intestinal perforations and protrusions of the viscera due to accidental injuries,d amputation of major limbs, tonsilitis, bone abscesses and abscesses of internal organs, serious head injuries with exudation of brain matter, major obstetric operations including removal of the foetus by craniotomic and other methods,e and congenital malformations of the nose, ears or lips.f The last-named operation required plastic surgery involving grafting of skin and muscular tissues from surrounding areas and other parts of the body and was also used to help people whose noses or ears had been removed for penal reasons, apparently a common practice of the period.

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a *CS. Sū.*, 30, 28.

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b *SS, Sū.*, 1.

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Apart from the above achievements, *Āyurveda* is remarkable for its special conceptions and theories. It must be emphasized that the curing of diseased conditions and the maintenance of health are not the only aims of *Āyurveda*. It is also concerned with harmonizing secular conduct and spiritual pursuit through a realization of the true relationship between the complex of body, mind and soul and the eternal universe. As such, it is more a comprehensive philosophy of life, with salvation as its goal, than a science in the modern sense of the term. Theories of creation of life, of biological processes, of sensory and intellectual perceptions,g genetic and eugenic rules, and the physiological and pathological effects of heredity and gestation,h theories of digestion, metabolism, circulation of body fluids and functions of bodily eliminationsi and the all-embracing theory of the three omnipresent humours responsible for the origin and prognosis of all pathological conditions and forming the very basis of Āyurvedic treatment—all are found in the medical *saṃhitās*. There is a rigorous standard for the training of physicians, and a meticulous code of personal ethics and social conduct for the medical profession.j In insight, farsightedness and depth, the Āyurvedic medical code stands a favourable comparison with the Hippocratic code. The entire texts of the *saṃhitās* are also distinguished by careful and penetrating observations, exhaustive and classified information, and an able presentation of the available knowledge in medicine and allied subjects like chemistry, botany, etc., contributing to medicine.

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a *SS. Ci.*, 3, 7, 8.

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b *SS. Ci.*, 3, 8, 17. 12; *Uttara*, 3, 7, 8.

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c *SS. Ci.*, 19. 9–12.

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d *SS. Ci.*, 2.

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e *SS. Ci.*, 15.

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f *SS. Sū.*, 16.

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g *CS. Śā.*, 5.

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h *CS. Śā.*, 3; *SS. Śā.*, 1–3.

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i *CS. Ci.*, 15; *CS. Vi.* 6; *CS. Sū.*, 28; *SS. Sū.*, 14, 35.

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j *CS. Vi.*, 8; *CS. Sū.*, 9, 10, 29, 30; *SS. Sū.*, 2, 5, 7, 10, 25, 34.

Lost Treatises of Āyurveda

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Apart from the two great *saṃhitās*, there were many other treatises on the therapeutic branch of medicine, termed the Ātreya school of medicine. Some of them are lost beyond all possible hope of recovery, but their names and subjects are available from references in existing works. Such lost treatises include the *saṃhitās* credited to Agniveśa, Kṣarapāṇi, Jatukarṇa, Parāśara, Hārīta, Kṣaranāda, Viśvāmitra, Kapila and Gautama. Of the Dhanvantari school with its stress on surgery, the lost works are the *Vṛddha Suśruta* or *Sauśruta tantra*, the treatises credited to Aupadhenava, Aurabhra, Pauṣkalāvata, Gopurarakṣita, Vaitaraṇa and Bhoja. The *Bhoja-saṃhitā*, also known as *Vṛddhabhoja*, should not be confused with a lexicon compiled by Bhojarāja of a much later age.

Extant Classical Works on Āyurveda

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Among the major existing works of the Ātreya school (apart from the Caraka) are about 50 known commentaries and editions of the Agniveśa of *Caraka Saṃhitā*,a the notable works being those of Dṛḍhabala (ninth century), Cakrapāṇidatta (eleventh century) and Śivadāsa (eleventh century). Among a smaller number of editions and commentaries of *Suśruta Saṃhitā*, the most notable are those of Nāgārjuna (third to fourth century), Ḍalhanācārya (tenth-eleventh century) and Cakradatta (eleventh century).

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Next in importance as well as in age (with the possible exception of *Kāśyapa Saṃhitā*) come two works with somewhat similar names, the *Aṣṭāṅga Saṃgraha* also known as *Vṛddha Vāgbhaṭa* and the *Aṣṭāṅgahṛdaya*, known simply as *Vāgbhaṭa*. Both are comprehensive works on therapeutics and surgery, one in prose-*cum*-verse and the other in verse alone. From the distinctive name of the first work as the ‘ancient’ Vāgbhaṭa, some assumed differences in quality, and from the very fact of the existence of two different works, it has been supposed that there were two different authors of this name, one earlier and one later. The authors (or author) in both cases, however, claim the same parentage and profess the same school of Buddhist faith. It is known that Vāgbhaṭa was the son of Siṃhagupta, an inhabitant of Sind and a disciple of Avalokita, the Buddhist sage, but no separate particulars are available about the other author. The internal evidence also shows an identity of style, medical views and mode of presentation, and there is no real evidence to show that there was more than one author of this name.b

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The first mention of a medical book on *Aṣṭāṅga* is found in the memoirs of the Chinese traveller I’Tsing of the seventh century. The author of this book has been identified with the Buddhist Vāgbhaṭa who may, therefore, be placed in the seventh century A.D. or a little earlier.

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a Rây and Gupta, p. 1.

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b Sen, Gananath (2), p. 51.

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The *Aṣṭāṅgahṛdaya* is by far the most concise and scientific exposition of Āyurvedic knowledge, incorporating the teachings of the Ātreya, Dhanvantari and Rasāyanaa schools of medicine and distinguished by its knowledge of chemical reactions and laboratory processes. The work has been translated into many Indian and foreign languages, and enjoys a deserved reputation rivalling those of Caraka and Suśruta. The important commentaries on Vāgbhaṭa’s works are by Aruṇadatta (thirteenth century), Candrānanda, Hemādri and Indu.

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The *Kāśyapa Saṃhitā* is another ancient treatise dealing mainly with paediatrics. It is probably of an age not much later than that of the *Bhela Saṃhitā*, if we consider that it is admittedly an abridged edition or version of an earlier work, the *Vṛddha Kāśyapa*.b It is quoted in the Bower manuscript and contains many quotations, not found elsewhere, from the most ancient works of the Ātreya school including some missing treatises.

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A valuable work, specializing on the diagnostic aspect of medical knowledge, is due to Mādhavakara (eighth or ninth century) and is entitled *Rugviniścaya* or *Mādhava Nidāna*. It is a compilation from the earlier works of Agniveśa, Suśruta and Vāgbhaṭa, but its merit lies in its scientific selection of knowledge included, concise presentation, and as a valuable clinical guide. It is famous all over India as the best Āyurvedic work on diagnosis of diseases. Two commentaries on this work, *Madhukoṣa* by Vijayarakṣita and *Ātaṅkadarpaṇa* by Vācaspati, are also valuable aids to diagnosis. The *Gadanigraha*, a medical treatise by Ṣoḍhala (seventh century), *Ṣoḍhalanighaṇṭu*, a medical lexicon by the same author, *Siddhayoga* by Vṛndakuṇḍa (ninth century), and *Cakrasaṃgraha*, a valuable treatise containing quotations from earlier works by Cakrapāṇidatta (about A.D. 1050), are other important works on the Ātreya and Dhanvantari schools, containing also some information on inorganic medicines, written before A.D. 1200. Only a few of the Āyurvedic works listed above are available in printed editions, others being in the form of written manuscripts preserved in various collections in India and abroad. The descriptions and locations are to be found in Aufrecht’s Catalogue. Kavirāj Gananath Sen has made an assessment of the comparative merits of these different works.c

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