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A Concise History of Science in India c8.s8: The Āyurveda in the Middle Age (A.D. 1200–1800)

A Concise History of Science in India c8.s8

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English

Contents

The Āyurveda in the Middle Age (A.D. 1200–1800)

Static Period of Āyurveda

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The beginning of the thirteenth century A.D. is generally taken to mark the end of the ancient period of Indian culture, though a period of transition had begun many centuries previously. This date, A.D. 1200, is also significant in the history of Indian medical science, as it marked the end of an era of growth and standardization. At this period, the classical treatises of Caraka and Suśruta had already become hoary with age; it had been necessary to revise the archaic matter and restore parts which had been lost or misplaced. The later works of Vāgbhaṭa, Mādhava and Cakrapāṇi also held high places in professional esteem but, due to the highly conservative cultural traditions of India, the older classics had not been pushed aside in favour of the more concise and better written later treatises. Besides these, many other commentaries, specialized works on the eight branches of Āyurvedic knowledge, anthologies and lexicons held the field and served the needs of medical men throughout the political and cultural sphere of Indian influence. Apart from the emergence of some new remedies in the Tantric works and the *Rasacikitsā* school, nothing challenged the dominance of *Āyurveda*. Its prestige was not confined to India. Through missionaries, visiting scholars and emigrant doctors, and by the written word, it had penetrated to the far corners of the known world, from Mongolia in the north to Ceylon in the south, and from Eastern Mediterranean countries in the west to the Indies in the east. Adoption of Indian drugs, methods, and theories in these lands and the translation of Indian medical works in many languages testify to the fact that *Āyurveda* was one of the foremost medical systems prevalent in the world at that period.

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In A.D. 1200 then, *Āyurveda* had long reached its peak, but the intellectual energy and creative research which had contributed to its growth and vigour were definitely things of the past; so also were dispensaries, hospitals and medical services maintained at State expense by past Buddhist and Hindu monarchs. The new generations of medical students had to depend upon largely on their personal teachers for practical and theoretical training, augmented no doubt by the great treatises. The main prerequisite of sustained intellectual development—prestige and security of the intellectual and professional classes in a politically stable and progressive society—was gone; for India was constantly overrun by powerful foreign hordes. The martial classes not only ruled the land; they had replaced the intellectuals as the dominant class in the social hierarchy.

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It would be, however, an unjustified oversimplification to ascribe this static condition and the later stagnation and decay of *Āyurveda* solely to political reasons. The seeds of decay lay inherent in Indian thinking, religious beliefs and social system, and these profoundly affected the Indian sciences themselves; and medical science was no exception. The intellectual curiosity and passion for experimental research, which were associated with the Tantric and *Raseśvara* faiths, also petered out due to the same inherited factors.

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But, during the broad period of Indian history (A.D. 1200–1800), the residual impulse of the vigorous medical systems of the earlier ages produced an impressive array of valuable secondary works before reaching almost complete inertia. This inertia was helped by the adoption of *Unani* (originally Arabic) medicine as the system recognized by the ruling power along with a passive neglect of *Āyurveda*. This loss of prestige was followed, as we shall see, by a loss of popularity as well, during the last centuries of this period.

Āyurvedic Works in the Middle Age

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Many scholarly works on *Āyurveda* proper were written during these six centuries. One of the earliest was the *Saṃhitā* of *Śāriṅgadhara* (thirteenth century), which, for the first time in the history of Āyurvedic works, includes opium in the *materia medica*, possibly following Chinese or Arabic practice; mercurial and other metallic compounds are also freely used in the text. A voluminous and possibly later treatise is by Vaṅgasena, with the title *Cikitsāsaṃgraha*. This work, which is not to be confused with an earlier work of the same name by Cakrapāṇidatta, has always been known as *Vaṅgasena*, possibly to avoid this confusion. It has been a popular handbook in Bengal for many centuries and is available in all respectable collections. The author claims in a concluding colophon that his work is a redaction of an earlier *saṃhitā* by the sage Agastya of South India fame and the legendary originator of the Sittar school of pseudo medicine. But, though it contains many prescriptions from this school, its language and presentation prove its later date of composition.a The *Yogaratnākara*, another comprehensive and monumental treatise on *Āyurveda* by an unknown author, has been popular in South India for many centuries; its chemical methods for preparing drugs are extremely valuable. Possibly the most renowned work during this period is that of Bhāvamiśra (fifteenth-sixteenth century). This work, *Bhāvaprakāśa*, contains an exhaustive list of diseases and their symptoms and a complete list of drugs current in his time. This encyclopaedia includes the aetiology and treatment of syphilis, a disease introduced into India by Portuguese seamen in the fifteenth century. Its list of drugs includes many that were not previously included in Indian medicinal usage, including metallic preparations and imported drugs.

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a Sen, Gananath (2), p. 59.

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Another class of medical works, which had existed from earlier times but which became increasingly important as handbooks in medical practice during this period, were the *nighaṇṭus* (ready guides or lexicons), which contained long or short monographs on different medicinal substances and terms. The works of this period were by Madanapāla, Narahari, Bhīmapāla and Rājavallabha, which supplemented or supplanted earlier works by Dhanvantari, Halāyudha, Viśvadeva, Amara, Śeṣarāja, Soḍhala, Mādhava and Cakrapāṇidatta. None of these works claim any originality in matter or presentation of theoretical knowledge. Among specialized treatises of this period may be named *Arkaprakāśa* by Rāvaṇa, of unknown age (possibly of a date not later than the twelfth century as indicated by the style of writing), dealing with aqueous and tinctorial extracts; *Cikitsākalikā* by Triṣaṭa (fourteenth century), a manual on diagnosis; *Cintāmaṇi* by Ballabhendra (fifteenth-sixteenth century), another comprehensive work on aetiology and diagnosis of diseases and clinical examination of the bodily eliminations; *Vaidyāmṛta* by Moreśvara (early sixteenth century), dealing with treatment of diseases only; and *Vaidya-Jīvana* by Lolimbarāja (seventeenth century), dealing with the clinical and therapeutical aspects of marital relations. Most of the works mentioned above are available only in manuscript form. An assessment of these works has been given by Gananath Sen (2) and Keith (3).

Works on Rasacikitsā and Iatrochemistry

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The works of the *Rasacikitsā* school of this period compare favourably, in material and presentation, with earlier works of this branch of medical and chemical knowledge. *Rasaratnākara*, the monumental work by Siddha Nityanātha in five volumes, was the earliest work of this period, though it might have been composed in the last years of the ancient period. It is a compendium of medical knowledge pertaining to this non-Āyurvedic school and deals with non-mercurial metallic compounds, mercurial preparations, therapeutic actions and rejuvenating effects of such preparations and the religious faith of the *Rasacikitsā* school. *Rasasāra* and *Rasahṛdayatantra*, two important works on alchemy and mercurial preparations, are widely believed to have been written by Govinda Bhāgavata Padācārya, the preceptor of Śaṅkarācārya (ninth century), but they are very possibly the works of another later Govinda Bhāgavata (*c.* thirteenth century) of Gujarat. The *Rasendrasārasaṃgraha* by Gopālakṛṣṇa (fourteenth century) has been a favourite book for inorganic remedies in North India and Eastern India for many centuries. The *Dhāturatnamālā* by Devadatta (fourteenth century)—a complete manuscript is available in the Palace Library, Bikaneer—describes the winning of metals from native ores and their conversion into oxides, carbonates and salts by oxidative methods and action of mineral acids. *Rasāvatāra*, a voluminous treatise by an unknown author of unknown date, and *Pārada Saṃhitā* by Niranjan Prasad Gupta (eighteenth century or earlier) are informative treatises on the mercurial faith, mercurial remedies and the Rasa school of medicine.

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During the latter part of the period under review, a combination of adverse political, social and economic factors gradually undermined the reputation and usefulness of Sanskrit-based learning, and the old cultural achievements fell into disrepute. Physicians, who also had to be erudite scholars in many branches of philosophy and sciences as required by classical *Āyurveda*, seldom found satisfactory successors, for the new generations were gradually losing their mastery over the archaic phraseology of the Ayurvedic texts; apart from a working knowledge of diagnosis and drugs suitable for treatment, many of them did not have any acquaintance with the concepts and theories which formed the basis of *Āyurveda*. Replacement of existing texts by new copies which had to be laboriously done by hand had long ceased to be an economic proposition, no new works were being written and the old copies were getting scarce due to natural decay in a damp and humid climate. The very basis, on which knowledge could be standardized and passed on, was tottering. There were also no hospitals, no medical colleges, no forums of discussions and, needless to say, no research in *Āyurveda*. The noble profession gradually passed from erudite scientists into the hands of semi-ignorant people with only hearsay knowledge or knowledge gathered from an imperfect comprehension of incomplete and incorrect texts. The members of families of long lines of Āyurvedic practitioners, often foremost in education and aptitude in their society due to centuries of family tradition in a scientific profession, quickly found other and more lucrative professions. Not knowing Sanskrit they considered the manuscripts of their forefathers as useless lumber.

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The long and rigorous training in theory, medicine and surgery, compulsory in classical times,a gave place to a few years of apprenticeship as compounder-*cum*-assistant. The new entrants to the professions were very little interested except in methods of easy cure and were psychologically inclined to follow the path of least resistance. Actual dissections on cadavers, so necessary for surgical and anatomical knowledge,b had been discontinued for many centuries due to changed ideas of caste purity, and surgery was avoided or relegated to barbers when absolutely unavoidable. Obstetric practice was shunned by the male physicians due to changed ideas of social intercourse and was relegated to untrained and illiterate midwives with horribly insanitary and often highly harmful methods. The teachings of the classical works regarding detailed examination of bodily eliminations and applications of douches, enemas, etc., were conveniently forgotten; for social and caste considerations, as well as prudery, dictated against such methods. The painstaking methods of diagnosis found in *Āyurveda* were replaced by diagnosis on the basis of case history and feeling the patient’s pulse; the equally painstaking methods of treatment often became limited to oral medication. In the latter sphere, the metallic preparations alone were reliable, as the original pharmacognosy of plant drugs had long been forgotten and rubbish offered by traders was often passed on as genuine; for genuine prescriptions were costly to collect, prepare and store. When results were disappointing, the science had to take the blame and people turned more and more to the newly imported Western science of medicine in hope of cure.

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a *CS. Vi.*, **8** and **9**; *SS. Sū.*, **2** and **4**.

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b *SS. Sū.*, **9**.

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That *Āyurveda* did not completely die out in these circumstances is a great tribute to its intrinsic merit and vitality.

Present Condition of Āyurveda

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In spite of its glorious career both in India and outside for more than two millenniums, *Āyurveda* has fallen on evil days and evil tongues. This is, of course, mainly due to the greater importance attached to the allopathic treatment introduced in this country during the British rule in the second quarter of the nineteenth century. The people of India hailed the new system as more scientific than *Āyurveda*, as there has been no development in the latter for wellnigh thousand years, and it has failed to take advantage of the modern scientific inventions and appliances. As a consequence of this, *Āyurveda* did not enjoy the patronage of the government. While medical colleges and hospitals were established all over India during the British rule, there were no such government institutions for the Āyurvedic system until recently, though a few have been established entirely through private efforts. An attempt to place the education and practice of the *Āyurveda* as well as the *Siddha* and *Unani* systems in a proper footing was made by the Madras Government through the establishment in 1924–25 of the Government School of Indian Medicine. Shortly afterwards similar efforts were made by Bihar, the United Provinces, the Punjab, Bombay and other provincial governments. The situation has not improved very much even after the achievement of independence in 1947.

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But though the Āyurvedic system has languished, it is still a living force. A large majority of Indians, specially the rural and poorer people in urban areas, take Āyurvedic medicines. It is also a happy fact that a galaxy of brilliant Vaids and Kavirājas (practitioners in *Āyurveda*), whose name and fame spread all over India, has revived the importance and popularity of the Āyurvedic system. Thus, in spite of the apathy of the government and a section of the people, *Āyurveda* has held its ground all over India, thanks to the private patronage and financial help from Indian States.

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Reference may be made to a few private Āyurvedic institutions referred to above. Gurukul Āyurveda University, Kangri, is the most famous and there are Āyurvedic colleges and *ṭols* where the pure Āyurvedic system is taught in the old orthodox style. But a new turn was given to the system of instruction towards the end of the nineteenth century by the efforts of a number of allopathic doctors who were also trained in Āyurvedic system and actually practised it. As a result, Aṣṭāṅga Āyurveda College with hospitals was established by Kaviraj Jaminibhusan Ray with a handsome donation and gift of land. Thereafter, the Viśvanātha Āyurveda Mahāvidyālaya, Vaidya Śāstra Pīṭha and Mahārāj Kāśimbazar Govinda Sundarī Āyurvedic College were established respectively by M. M. Kaviraj Gananath Sen, Kaviraj Syamadas Vacaspati and Kaviraj Ram Candra Mullick. It was thought fit and proper to follow a mixed syllabus, both in theory and practice, giving rise to what is known as the integrated system. It has produced a class of practitioners who use both Āyurvedic and allopathic medicines. In this way the influence of allopathy has entered into the precincts of *Āyurveda* all over the country.

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Opinions differ as to the propriety and usefulness of the integrated system. It is held by some that the products of this system acquire no deep knowledge of *Āyurveda*, i.e. treatment and preparation of medicine, and, what is worse, use allopathic medicines under the disguise of *Āyurveda* without mastering the rudiments of allopathy. The mischief, they hold, is mainly due to the fact that those who administer the Medical Department, including the integrated system, are all allopathic doctors without any knowledge of *Āyurveda*.

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On the other hand, it is argued by others that in the present scientific age, State recognition should not be extended to a system of medical treatment which does not take cognizance of the modern developments in our knowledge of anatomy, chemistry, biochemistry, physiology and other allied sciences, or of such ‘precision’ methods for probing the human malady as are offered by thermometer, stethescope, X-ray, microscope, test of blood, stool and urine, etc. The absence of surgery is also a great drawback in Āyurvedic treatment.

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It is an intriguing problem of which no easy or immediate solution seems to be at hand. Nevertheless, the fact remains that Āyurvedic system is still a living one and is likely to retain its popularity among the masses and even a section of the educated classes, save for such diseases as malaria, typhoid, kala-azar, smallpox, cholera, plague, etc., for which successful specific remedies have been discovered in modern days. It is but fit and proper, therefore, that the State should take adequate steps to ensure a good training in the purely Āyurvedic system for those who seek it. The government should provide adequate resources for the improvement of teaching on purely Āyurvedic syllabus, make proper arrangements for preparation of all sorts of Āyurvedic medicines and experiment in Āyurvedic laboratories under eminent Āyurvedic physicians, and provide for proper training in all the departments of *Āyurveda* for students having proficiency in Sanskrit, by sanctioning proper emoluments and salary for the staff, etc. Perhaps the problem of an integrated medical system, referred to above, would be easier to solve if highly efficient Āyurvedic colleges grow side by side with the existing medical colleges.

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