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A Concise History of Science in India c8.s3: Āyurveda and Its Eight Classical Divisions: Other Medical Systems of Ancient India

A Concise History of Science in India c8.s3

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Āyurveda and Its Eight Classical Divisions: Other Medical Systems of Ancient India

The Eight Aṅgas of Āyurveda

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The term *aṣṭāṅga* (eight-limbed) used in the titles of Vāgbhaṭa’s works is actually a synonym of *Āyurveda* which, from ancient times, has been supposed to contain eight branches of medical knowledge. These branches are enumerated in the introductory passages of all important Āyurvedic works though most of them specialize in one or at most two branches and give only limited space to the rest. The lists given by Caraka, Suśruta and Vāgbhaṭa are identical though different in order.a Caraka uses the term *viṣagaravairodhikapraśamana* for antidotes and cures for poisons and venoms in place of *agada* (toxicology). The eight branches and the topics they include are enumerated below:
(i) *Kāyacikitsā* (therapeutics) dealing with the aetiology, diagnosis, prognosis, treatment and recommended diets in fevers, gastro-intestinal irritations, coughs, consumptive maladies, urinary complaints and other ailments, curable by the administration of drugs, externally or internally;
(ii) *Śalyatantra* (surgical knowledge) divided into two branches; the first deals with diagnosis, prognosis and treatment of conditions amenable to surgical methods, specifications and uses of different surgical instruments, methods of bleeding, cauterization by heat and alkali, use of leeches, and minor surgical implements in appropriate contexts; the second deals with surgical knowledge applied to gynaecology and obstetrics;
(iii) *Śālakyatantra* (treatment of diseases of the eyes, ears, nose, tongue, oral cavity and throat);
(iv) *Bhūtavidyā* (knowledge of mental diseases and diseases of supernatural origin) dealing with the true nature, symptoms and treatments of conditions like insanity, epilepsy, etc., in which people behave as if affected by demons;
(v) *Kaumārabhṛtya* (knowledge of infantile disorders, care of young children and treatment of diseases specific to children);
(vi) *Agadatantra* (toxicology) dealing with symptoms caused by accidental or intentional administration of mineral, vegetable and animal poisons, bites by venomous snakes and other poisonous creatures, their immediate antidotes and methods of treatment;
(vii) *Rasāyana* (knowledge of tonics and processes for arresting the process of physical and mental decay) dealing with potent drugs and prescriptions to combat ill health, natural decay and senility, their dosages and methods of administration; (viii) *Vājīkaraṇatantra* (knowledge of virilifics) dealing with lost or diminished virility, potency and procreative ability.

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a Keith (3), p. 510.

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b Subba Reddy, pp. 1–35.

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c Sen, Gananath (1), pp. 5 ff.; (2), pp. 32 ff.

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The Ātreya and Dhanvantari Systems

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The medical literature specializing in the therapeutic and surgical branches of medical knowledge has already been reviewed in the previous section. Most of the works mentioned there however claim to be a comprehensive treatise on *Āyurveda* (and hence on all its branches) and generally devote some passages or even sections to the other six branches.

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a *CS*, *Sū.*, 30; *SS*, *Sū.*, 1.

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Quite a number of treatises specializing in the other *aṅgas* were also in parallel existence with the works of the Ātreya and Dhanvantari schools. But the zeal displayed by later scholars for reproducing or editing the latter works seems to have been lacking for the other branches. Original works in the other *aṅgas* are generally met with only in the form of quotations in later works or in names only; commentaries and revised editions are conspicuous by their absence. Even the quotations that are found are few and far between. A study of the literature of *Āyurveda* in the post-Vedic period leaves a strong impression that the works of the Ātreya and Dhanvantari schools were always considered the elite among medical treatises while the others were considered second-class matter.

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The Śālakyatantra System

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A class of physicians known as *Śālākis* specialized in this branch of medicine, the chief treatise of which was *Videhatantra* supposed to be the work of King Janaka of Videha. This work is mentioned as important in the sections on *Śālakyatantra* found in the *Suśruta Saṃhitā*,a and has been extensively quoted by Ḍalhaṇācārya, Vijayarakṣita Śrīkaṇṭhadatta and others. Other works on this branch of medicine, quoted by the last three authors, are *Nimitantra* and *Sātyakitantra*. Caraka mentions the *Kāṅkayanatantra* and the *Śaunakatantra*. Ḍalhaṇa and Śrīkaṇṭha also mention other works in this branch, attributed to Gārgya, Gālavya, Karālabhaṭṭa, Kṛṣṇātreya, as also another work *Cakṣuṣyatantra* dealing with eye diseases alone. None of these works are available now but all must have been extant in Ḍalhaṇa's time (tenth-eleventh century). The sparse quotations available do not permit of a proper assessment of these works.

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Bhūtavidyā

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No special treatise on this subject has been quoted or even named in the surviving works. This branch of *Āyurveda* survives now only as chapters in the works of Caraka,b Suśrutac and Vāgbhaṭa.d The *Caraka Saṃhitā* treats all psychic maladies, including grave diseases of the nervous system, insanity and demoniac possessions, in a single chapter. The *Aṣṭāṅga* and *Suśruta Saṃhitā* consider demoniac possessions as separate from mental diseases. The *Agnipurāṇa* and the *Vāyupurāṇa* also deal with demoniac possessions and the remedial measures recommended for them. From the fact of Caraka's classification of demoniac possessions in the same chapter with mental disorders and Suśruta’s declaration that malignant spirits cause diseases but do not physically ‘possess’ human beings (*na te manuṣyaiḥ saha saṃviśanti*), it seems likely that in these times *bhūtavidyā* simply meant psychic disorders caused by unknown forces. The later treatises after Vāgbhaṭa ignore this branch of medicine altogether, possibly to avoid being branded with the stigma of superstition.

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a *SS. Sū.*, 24; *SS. Ci.*, 22.

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b *CS. Ci.*, 9.

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c *SS. Uttara*, 39-62.

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d *Aṣṭ. Hṛ Uttara*, 4 and 5.

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The Kaumārabhṛtya System

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The *Kāśyapa Saṃhitā*, as is to be expected, contains considerable information on infantile disorders and care of new-born babies and older children. The *Uttaratantra* of Nāgārjuna’s version of the *Suśruta Saṃhitā* devotes no less than 12 chapters to this branch of medicine. Invocation of divine blessings, chanting of holy words and propitiation of supernatural forces formed a major part of such treatment, along with treatment by therapeutic drugs. The chapters in the *Suśruta Saṃhitā* convey the clear impression that an extremely high value was put on the health, welfare and mental happiness of children at this time. This started even from the period of conception, and an equally high value was placed on the physical and psychological well-being of expectant mothers. Midwifery and gynaecological knowledge was not, however, included in the branch of *Kaumārabhṛtya*.

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The treatises known to have dealt specially with this subject were the *Jīvaka tantra* quoted in Cakradatta’s commentary *Bhānumatī* on the *Suśruta Saṃhitā*, *Pārvataka tantra*, *Vandhaka tantra* and *Hiraṇyākṣa tantra* (quoted by Śrīkaṇṭha Datta). These works survive only in names, except for occasional quotations.

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The Agadatantra System

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The *Caraka Saṃhitā* devotes only one chapter to this branch of medicine but the *Suśruta* has one of its six *sthānas*, e.g. *Kalpasthāna*, entirely on toxicology. Apart from symptoms, first-aid measures and long-term treatments, there is a very good classification of different poisons and on different methods by which unwary persons may be slowly or quickly poisoned. The detection of some inorganic poisons by flame tests is a remarkable feature. There is also an exhaustive classification and description of different types of poisonous snakes and the symptoms of their bites. Similar information (including a faithful account of the symptoms of hydrophobia) is found for poisonous insects, aquatic and amphibious creatures and land animals. In fact, the *Kalpasthāna* of the *Suśruta Saṃhitā* is a valuable treatise on toxicology by its own right.

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A treatise on toxicology, also named *Kāśyapa Saṃhitā*, written in Sanskrit but printed in local script, is found in South India. Some passages in this work are identical with certain quotations in the works of Ḍalhaṇa, Cakrapāṇi and Śrīkaṇṭha.a But the authenticity of the text cannot be verified. Śrīkaṇṭha also gives quotations from another work in this field, the *Avalamvayanasaṃhitā*, which must have survived up to the seventeenth century but is now untraceable. Another treatise on *agadatantra*, the *Sanaka Saṃhitā* (or *Śaunaka Saṃhitā*), survives in an Arabic translation discovered by Max Müller.b Ḍalhaṇa quotes from another treatise on this subject, apparently his own work, in his commentary on Nāgārjuna’s *Suśruta Saṃhitā*.

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In Cochin and Travancore, many other Sanskrit works on *agadatantra* are available in the local script. Their authenticity and antiquity have not been established beyond doubt.

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The Rasāyana System

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The conception of *rasāyana* (restorative treatment) is a notable feature of *Āyurveda*. With age there is a degeneration of bodily tissues, sensory perceptions, as also of physical and intellectual vigour. *Āyurveda* considers this process not only preventible but even reversible and does not consider senility an inseparable condition of old age. This branch of medicine employs some remarkable processes, as well as herbal, mineral and metallic substances as tonics. Here also most of the specialized works are unavailable, but a fair knowledge of the methods and drugs are obtained from the sections devoted to *rasāyana* in the works of Caraka, Suśruta and Vāgbhaṭa. Mercurial and other inorganic preparations of the *Rasacikitsā* school of medicine (*vide later*) found in Tantric works were also credited with similar rejuvenating powers.

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*Suśruta* extols the virtues of clean living, high thinking, proper physiological habits and regular exercise, regular use of milk, pure cold water, honey, clarified butter, various special diets including salt-free diets, preparations containing gold and minerals, and various prescriptions of recommended drugs for *rasāyana*.c The mythical *soma* plant (yet to be identified with any known plant), used with auxiliary tonics and a strict regimen of diet and conduct, is said to bring about complete rejuvenation in body and mind, ensuring a fresh lease of youth.d

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The lost texts on this subject include *Śodhanatantra* quoted in the *Cakrasaṃgraha* of Cakrapāṇidatta, the works attributed to Vyādi, Vasiṣṭha and Māṇḍavya (quoted in *Rasaratnākara* and *Rasaratnasamuccaya* and *Nāgārjunatantra*). The last-mentioned work is by one of the many medical scholars in successive ages with the title of ‘Nāgārjuna’.

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The Vājīkaraya System

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This branch of medicine is not dealt at any length in any of the medical works after *Caraka* and *Suśruta*, where they are found in fragmentary passages.a There is, however, unmistakable evidence of a considerable literature on this subject, current in the early Buddhist period. The famous *Kāmasūtra* of Vātsyāyana gives the names of three works on this branch of medical knowledge, including the *Kucumāra tantra*, which is said to be an exhaustive work, already ancient at the time (*c.* A.D. 300).

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a Sen, Gananatha (2), p. 43.

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b Rây (P. C.), p. lxv.

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c *SS. Ci.*, 27–29.

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d *SS. Ci.*, 29.

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The justification of including formulae of virilific tonics in a work of medicine is found in *Caraka*,b where it is stated that the final metabolic product of all nutritive food is the seminal fluid, and the loss of the latter is the most serious drain possible on the body's vitality, so that all sexual excesses lead to serious wasting diseases and even death unless counteracted by *rasāyana* remedies.

The Rasacikitsā School of Medicine

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Apart from the eight classical branches of *Āyurveda*, some other indigenous systems have survived as integral parts of the medical knowledge of ancient India. Some of the obscure pre-Aryan concepts and practices have been noted earlier. The quasi-religious system of *Rasacikitsā* has a reputation second only to *Āyurveda*. With a few exceptions this school employs only metals, alloys, metallic compounds and salts and also sulphur and its preparations in its *materia medica*. According to it, quicksilver is the foremost among all medicinal substances. This latter belief is found also in many Buddhist and Brāhmaṇic tantras, as a part of the Tantric faith.c The medical knowledge of India exported to Tibet, China, Indo-China and Ceylon contained much of this school of medicine mixed with classical *Āyurveda*.

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The early practitioners of this school were known as *Siddhas* who introduced many of the metallic preparations which were either unknown to, or not utilized in, classical Āyurvedic practice. The Tamil *Sittar* works on medicine, chemistry and allied subjects were possibly originated by the *Siddhas*. The first use of mercurial compounds in medicine is found in *Suśruta* (third-fourth century);d here the modern and surviving name of mercury, *pārada*, is used; the more ancient synonym, *sutāraḥ*, is found in the *Suśruta Saṃhita*,e but its omnipotence in all diseases and indeed in all phases of life was first propounded in Tantric texts written by the early *Siddhas*. The alchemical preparation of gold (which also was believed to be an embodiment of perfection and therefore a panacea for all ills) from mercury was another aim of this school and many supposed processes to this end are found. The classical work of Mādhavācārya (fourteenth century),f describing the sixteen schools of belief current in his time, gives a description of the *Raseśvaradarśana* (faith in divine mercury), in which the metal is believed to be the earthly embodiment of the omnipotent deity, Śiva, and as such to be worshipped. The use of mercurial preparations was also believed not only to give perfect health and cure of all diseases, but also prosperity, a perfect mind, bliss and eventual salvation.

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a *CS. Ci.*, 2; *SS. Ci.*, 26.

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b *CS. Ci.*, 2.

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c Ray (P. C.), p. xxxv.

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d *SS. Ci.*, 25. 20.

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e *SS. Ka.*, 2, 12.

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f *Sarvadarśanasaṃgraha*, pp. 137–44.

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The works of the Tantric period, devoted to the preparation of inorganic and metallic remedies, are among the most prolific and rewarding sources of the knowledge of Hindu chemistry. These works were, however, primarily concerned with rituals, alchemy and chemical processes. Their value as medical literature lies chiefly in their exposition of the medical philosophy of this school, their iatrochemical ideas and practices, and the inorganic remedies they contributed to medicine. The most important among them are: *Rasaratnākara* and *Ārogyamañjarī* of Siddha Nāgārjuna (seventh century), *Siddhayoga* of Vṛndakuṇḍa (seventh-eighth century), the *Cakrasaṃgraha* and the commentaries by Cakrapāṇidatta (eleventh century), *Rasahṛdaya* of Govinda Vāgbhaṭa (eleventh century), *Rasaratnākara* of Siddha Nityanātha, *Rasaratnasamuccaya* of Vāgbhaṭa (a namesake, living in the late twelfth century), *Rasārṇava* by Śambhu (twelfth century), *Rasendracintāmaṇi* by Rāmacandra (twelfth century) and *Rasendracūḍāmaṇi* by Somadeva (twelfth century). These works are available in most first-class collections of Āyurvedic literature in India and abroad. Many of them were edited and published during the last century, notably by the Āyurvedic Granthaśālā of Bombay.

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The *Rasacikitsā* school of medicine has been a rival of *Āyurveda* in popularity and prestige during many centuries in the past, specially in South India, the eastern provinces and Sind. It survives to the present day as a living system of medicine, but has largely discarded its deification of mercury and has absorbed many tenets of classical *Āyurveda*. The Kavirājas, that is medical practitioners who follow the Āyurvedic system of medicine in their treatment, possibly rely more on inorganic remedies than on the *materia medica* of classical *Āyurveda*. This preference can be explained by the greater facility in manipulation during compounding, greater portability and easier storage, easier preservation and less wastage, and simplicity of prescription and dosages of inorganic remedies.

The Nāḍīvijñāna System of Diagnosis

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The other quasi-Āyurvedic system of importance is termed *Nāḍīvijñāna* and, as the term implies, attaches great importance to the pulse felt at the wrists, a close study of which is supposed to give sufficient indications for the diagnosis of most diseases. The term *nāḍī* in *Āyurveda* means not only the arteries and veins but all major and minor tubes as well as nerves, etc., in the body; *nāḍī* does not mean the pulse in *Āyurveda*. Moreover, the very spirit of *Āyurveda* is opposed to the idea of putting complete reliance for diagnosis on the unaided touch perception of the physician. The earlier medical treatises recommended that while making a diagnosis all known factors should be taken into consideration and all the senses of the physician should be employed.a The main thesis of *Nāḍīvijñāna*, that diagnosis is possible and death predictable by feeling the pulse beats, implies that the condition of the heart indicates all diseased conditions, an idea open to doubt. On the other hand, it is quite possible that the acute perception of a highly trained person could discern the condition of the three *doṣas* (fundamental humours) in the body which, even according to *Āyurveda*, is the basic factor in the causation, prognosis and treatment of all diseases. Acute perception may also predict the failure of the heart and set a period to the termination of its functioning. The claim of ability to foretell death by *nāḍīvijñāna* need not be ruled out. It must also be pointed out that the school of *nāḍīvijñāna* does not forbid the consideration of other symptoms or the case history in arriving at a diagnosis; they are only considered much less important.

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A supposedly ancient treatise of this branch of medicine, *Nāḍīparīkṣā* by Rāvaṇa (a comprehensive treatise on this subject), and another work *Nāḍīvijñāna*, claiming to embody the teachings of Kaṇāda and Gautama on this science, give us an idea of this school of medicine. The styles of writing of both these works do not support any claim to antiquity and they may be comparatively recent works,b at least much more recent than the periods of the legendary demon-king Rāvaṇa of the *Rāmāyaṇa* (who is claimed to be the author of the first work) or even of the great philosophical teachings incorporated in the *Caraka Saṃhitā* and possibly the more ancient *Agniveśa Saṃhitā*. The classical compendiums of *Āyurveda* do not contain any clear reference to *nāḍīvijñāna*, and it is logical to suppose that this branch of medicine came into existence in much later times. The medical literature of the Tantras contains innumerable references to *nāḍī* but here the term has suffered a semantic change and generally meant nerves, which also were considered fundamental causative factors in diseases and bodily conditions.

The Yoga School

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The Yoga system of philosophy,c due to Patañjali (*c.* second century B.C.), with its mental and physical discipline by the eightfold path of *yama* (abstention), *niyama* (observance), *āsana* (physical postures involving muscular co-ordination), *prāṇāyāma* (regulation of breathing), *pratyāhāra* (voluntary control of the sense-perceptions), *dhyāna* (fixed attention), *dhāraṇā* (contemplation) and *samādhi* (ultimate and absolute mental concentration), is not only a philosophy but also a discipline of the body to make it function in a state of perfect health and flexibility. A branch of this discipline, known as *haṭhayoga*, is a refined form of physical culture involving the voluntary as well as involuntary muscles of the body and claims to cure many pathological conditions. This integrated system of mental concentration, breath control, sense-control and physical culture can also be called a medical system. *Āyurveda* has not borrowed from it but this system has always been held in high respect in India and has recently earned a spate of popularity in Western countries.

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a *CS. Vi.*, 4; *Ni.*, 1. 13; *SS. Sū.*, 10.

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b Sen, Gananatha (2), p. 69.

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c Das Gupta, II, pp. 273–463.

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