Pramāṇa · Search · About · API

The Classical Doctrine of Indian Medicine: Its Origins and its Greek Parallels c11: Chapter VI: Veda and Āyurveda

The Classical Doctrine of Indian Medicine: Its Origins and its Greek Parallels c11

Language
English

Chapter VI: Veda and Āyurveda

c11.2

We have, at first, summarised the data of classical Āyurveda as it is found in the form of already constituted classical doctrines in the schools of Caraka and Suśruta. We have thereafter analysed the medical notions found in the Vedic saṃhitās. We should now try to have a short estimate of these Vedic notions. We can, at the same time, seek to determine the exact position of the Āyurveda in relation to the Veda.

c11.3

The comparison of the data of ancient Iran with that of the Veda has enabled us to recognise the antiquity of the speculations which were prevalent on both the sides and which were, later, to find a place at the base of the theories of classical Indian physiology. In fact cosmological speculations go back to the period of Indo-Iranian pre-history as they are found in the ancient texts of both India and Iran. They relate to the rôle of elements such as fire and water and to that of wind considered as one of the chief forces of nature. But the details of medical knowledge had, still, not been fixed in this period. The nosological nomenclatures of the Veda and of the Avesta are independent and do not share a common heritage.

c11.4

During the period of the most ancient Vedic texts, between 1500 and 1000 B.C., appear numerous allusions to diseases, to remedies and to limbs of the body or to its constitutive elements. There is already a number of terms which will be found later in the medical texts, and the sense they have therein most of the time helps us to understand the ancient passages where they occur. But the names of explicable diseases refer to affections with evident manifestations and not to doctrinally individualised syndromes. This shows that during the Vedic period pathology, although possessing a rich nomenclature, was not yet scientifically developed. The therapeutics is magical or rudimentary and does not yet prescribe treatments conceived and applied following scientific theories, as will be the case with classical medical texts. These later texts have preserved, only in an extremely reduced measure, the heritage of this Vedic therapeutics.

c11.5

Anatomy possesses an extremely ample vocabulary in the Veda, but quite a large number of terms in use are only metaphorical designations and all of them have not survived. Many of the internal organs are named, notably in the texts referring to the sacrifice of the horse. But the principal lists of anatomy are found in the hymns which establish similarities between the human or the animal body and the various parts of the universe, considered as the immense body of man or animal. A certain number of notions concerning the constitutive elements of the organism, which have been preserved in classical medicine, come from the Vedic tradition: that of organic sap, the *rasa*; that of the vital sap, seat of vigour, the *ojas*; that of bile conceived as liquid fire.

c11.6

Vedic physiology is essentially based on the belief that multiple breaths circulate inside the organism. The concept of this circulation is associated with the existence of a system of internal canals. Both this concept and this notion will become fundamental in classical medicine. Already in the Veda the breaths have names which they will constantly have later on. When only two of them are named, they correspond either to inspiration and expiration or to the breath of the antiro-superior part of the body and to that of the postero-inferior part. When three, four or five breaths and sometimes more are named, they correspond to specialised diverse animal spirits whose functions have been specified by classical medicine.

c11.7

Therefore Āyurveda has chiefly inherited from the physiological speculations and from the anatomical notions of the Veda. It has preserved a part of the nosological nomenclature but has almost entirely abandoned ancient therapeutics. It has thus drawn chiefly for doctrinal elements on Vedic speculations to establish its physiological theories, the one concerning the primordial rôle in the body of the wind of nature, and also the one concerning the rôle of water and fire, the latter being represented by bile. But the theory of three active elements of the organism which, on their equilibrium being disturbed or because of functional anomalies, become its three elements of trouble (*tridoṣa*), the wind, the phlegm and the bile, had not been constituted at the times of the Vedas themselves. In fact the notion of phlegm hardly prefigures in the *Atharvaveda* which limits itself to mentioning an oedomatous affection whose name will be, later on, used to designate occasionally the phlegm itself. It is only in a Brahmanic text, really ancient and going as far back as the first centuries after 1000 B.C., the *Śatapatha-Brāhmaṇa*, that the phlegm is named under one of its principal names, the *śleṣman*. But even here phlegm is not presented as an essential element of the organism.

c11.8

Indian medicine has, therefore, drawn on the Veda even for the principal elements of its general doctrines. Thereby Āyurveda is the legitimate heir to the Veda, but it has developed to a large extent the patrimony thus received. It has coordinated and systematised ancient ideas and it has constituted an immense treasure of observations and experience, both concerning the diseases and the means of curing them. When we come across it for the first time in classical texts, it seems to us as if there is a chasm between the knowledge accumulated by it and the scanty medical notions which can be found in the ancient Vedic texts. The intermediary works, those where we could have seen the gradual constitution of the vast edifice which, all of a sudden, appears before us in an already achieved form, have not reached us. It is, therefore, all the more precious to measure the considerable depth of the Vedic soil to which go the basic roots of Āyurveda. It is also because of the necessity of a continuity between Vedic speculations and the classical doctrines of Āyurveda that we can affirm with certainty the existence of an intermediary tradition.

c11.9

The legends of the origins of Āyurveda could not have, in this respect, fixed our judgement. They may take back its origins to the farthest antiquity and attribute the transmission of its teaching to Vedic personalities with known names, but we cannot follow them therein. They do not, as we have seen, inspire confidence. They cannot be taken to be based on authentic facts. Above all, they invoke arbitrary and tendentious geneologies whereby obscure families claim descent from illustrious stocks. They form a part of a system of similar legends concerning the origin of other sciences; therein they resemble more the products of a competition in a sort of nobiliary pride than the souvenirs of schools concerning their real history. At present we see, however, that these legends have not deceived us, at least concerning the essential fact emerging therefrom, namely, the existence of a continuous intermediary tradition between the speculations of Vedic times and the teachings of medicine in the specialised manuals.

c11.10

It is true that one may ask oneself, whether their data, artificially combined, do not prove that a solution of continuity has been produced in this tradition. In fact, one may suppose that if medical ideas had been regularly transmitted since the Veda, the memory of the actual transmission could have been as well preserved as that of the teachings and could not have been replaced by legends. One may put forward the hypothesis that at first the medical ideas of Veda got fixed without giving rise to evolutionary developments and that the authors of medical systems that arose later, for example, under the Greek medicine, desiring to refer their new science to its antique traditions, have covered this science with Vedic reminiscences and have cooked up the history of a tradition fictive in reality. But such an hypothesis cannot be maintained and we will see that it is essential to look for other explanations because legends have replaced the real history of tradition.

c11.11

It should be observed first of all that it is not only in the domain of medicine and of other sciences that India has legends in place of history. The desire for perpetuating lists of masters and disciples is attested frequently and in quite ancient times in Indian literatures. Sometimes even the circumstances of the transmission are indicated with a wealth of detail but not in a systematic manner. Evidently more constant attention has been paid to basic things than to the manner in which the ancestors had learnt them and every time it has been desired to establish the continuity of tradition it has been found necessary to reconstitute, with the aid of probability, the chain, all of whose links had not been preserved. This can be undoubtedly explained by the facts that the notions concerning the instruction received, being considered as accessory, were not put to heart with as much of care as the tenor of this instruction. Orally transmitted without the rigour observed in the study of fundamental texts which were, however, exactly learnt by rote, the traditions concerning instruction have got altered and sometimes got lost so as to be later restored by conjectures or by imitation of the parallel traditions claimed by other schools.

c11.12

In any case, it is impossible that the legendary character of the teaching concerning the origins and the transmissions of instruction implies the non-existence of real transmissions or of long breaks in the traditions, because we see everywhere a legendary character and we cannot suppose everywhere the irreality of or the break in traditions; that means supposing a chasm between the entire culture of ancient India and the entire one of classical India.

c11.13

In fact, whether we study the Brahmanic, Buddhist or Jaina texts or the scientific treatises, the *Dharmaśāstras* or the technical manuals, we always find legends replacing history we have been looking for. In the most favourable cases the legends are at least mixed with historical data. One should also note that it is in Brahminism, where the continuity of tradition is most certain, that the obscurity regarding the transmission of teachings is at its worst, whether because of the absence of information or because of the effect of legends. However, the old texts are available to us in their authentic form and in their archaic language. They could not have come to us without a continuous and uninterrupted tradition although this itself may have been forgotten. In the presence of this important fact, we must recognise that the legendary character of the data concerning the origins and the transmission of medicine is in conformity with Indian practice and in no way implies that the antiquity claimed for the origins is false and that the existence of a continuous transmission of teaching since antiquity is fictitious.

c11.14

We have, besides, positive indices concerning the real existence of this continuous transmission and the progressive development of doctrines. A number of allusions and important pieces of evidence, in fact, cover the considerable space of time which separates the Vedic *saṃhitās* from the manuals of classical medicine.

c11.15

First of all, there is at least one theory whose permanence can be observed by us and it is an essential theory, namely that of breaths. It appears constantly across the entire literature of Upaniṣads which goes in its origins to the Brāhmaṇas and comes right into the classical period. We have already seen references to breaths in the principal and the oldest Upaniṣads.

c11.16

notably in the *Bṛhadāraṇyaka* which forms a part of the *Śatapathabrāhmaṇa*. In the more recent upaniṣads these references become more and more clear, and come nearer the final data of classical medicine.

c11.17

In the *Bṛhadāraṇyaka*-and in the *Chāndogya*-the distinction of five breaths is clear (*Bṛh.*, III, 9, 26; *Chānd.*, III, 13, 1-5; V, 19-23) but it is not found alone, chiefly in the *Bṛhadāraṇyaka*. Sometimes three breaths are considered (*Bṛh.*, III, 1, 10; V, 14, 3; *Chānd.*, I, 3, 3), or four (*Bṛh.*, IV, 4, 1), or six (*Bṛh.*, I, 5, 4) or seven (*Bṛh.*, II, 2, 3); indeed ten (*Bṛh.*, III, 9, 4). Moreover, the precise doctrine of the localisation of five breaths is not formally enunciated therein. Several passages can be understood better on admitting that these localisations were already conceived as indicated in the classical doctrine but they are not described. On the contrary, later Upaniṣads clearly formulate the theory of five essential breaths with indications of their physiological rôle.

c11.18

The *Maitrī*-, (II, 6) defines *prāṇa* as the breath which goes up (*ya ūrdhvam utkrāmati*), *apāna* as the one which goes down (*yo’yam avāṅ saṃkrāmati*), *vyāna* as the one which favours other breaths (*yena vā etā anugṛhītā*), *samāna* as the one which sends the thickest element of nourishment into the *apāna*¹ and brings the minutest in each member (*yo’yam sthaviṣṭho dhātur annasyāpāne prāpayati aniṣṭho vāṅge’ṅge samānayati*) and *udāna* as the one which disgorges and swallows the drunk and the eaten (*yo’yam pītāśitam udgirati nigarati*). These definitions denote a theory which differs in certain details from the classical theory, *vyāna* being simply given as the adjutant of the totality of other breaths and not as a principle of the movement of the body and the function of swallowing being attributed to *udāna*, whereas in the classical doctrine it has become *prāṇa*. This last difference, moreover, does not in the least indicate that classical theory had not been conceived at the time of the *Maitrī* because the *Chāndogya*, (I, 2, 9) had already taught that one ate and drank thanks to the *prāṇa* of the mouth (*mukhya*). Therefore, it shows simply the existence of a view different from one that has become classical.

c11.19

¹ *Apāna*, therefore, is not, in this text, the inhaled breath but the internal wind of the body, that of the excretion of the refuse of digestion, digestion rendered effective by *samāna*.

c11.20

The *Praśna* (III, 5 ff) situates *apāna* in the anus and in the organs of generation, *prāṇa* in the eyes, ears, mouth and the nostrils, *samāna* having a digestive function, in the centre (of the body), *vyāna* in the canals and in one of them, *udāna* which loses here its physiological rôle to assume that of conducting the Self of man to its destinies after death.

c11.21

In later Upaniṣads, particularly in those of the Yoga, references to the doctrine of five breaths are very frequent but are often later than in the texts of classical medicine; they do not have, therefore, as opposed to the earlier ones, much of interest to show this doctrine in an already constituted form between the period of the Veda and that of Āyurveda.

c11.22

A chance reference in a grammatical text, which was pointed out to me by my *guru*, Jules Bloch, gives us another decisive proof for the history of the Ayurvedic doctrines in this very period. A *vārttika* of Kātyāyana on Pāṇini (V, 1, 38) mentions, in fact, in a number of examples concerning suffixes indicative of cause, the appeasement (*śamana*) and the excitement (*kopana*) of wind, bile, and phlegm (*vāta-pitta-śleṣman*) and their morbific coming together.¹

c11.23

¹ Thus vātika designates that which appeases or excites the wind, vāta; sannipātika that which is caused by the reunion of the wind, bile and phlegm.

c11.24

This simple reference fully assures us that the pathological doctrine of the *tridoṣa*, whose elements, as we have seen, had not been gathered together in the period of the Vedic *saṃhitās*, as the mention of the phlegm does not appear before the *Śatapatha-brāhmaṇa*, had been fully constituted in Kātyāyana’s time. Kātyāyana is traditionally said to have lived under the Nandas, overthrown in 313 B.C. by Candragupta, and was therefore an author of the time of Alexander; this is in accord with the chronologies of other well-known grammarians, his predecessor, Pāṇini and his successor, Patañjali², although somewhat lower dates could also have been proposed.³

c11.25

² cf., Max Müller, *A History of Ancient Literature*, repub. Allahabad, 1962, pp. 126-27.

c11.26

³ cf., L. Renou, *La Durghaṭavṛtti*, Vol. I, pt. 1, Paris, 1940, p. 23.

c11.27

Under these conditions and although we do not possess the real medical texts of the period which elapsed between the *Śatapatha-brāhmaṇa* and Kātyāyana, we have to place in this period the definitive formation of the general doctrine of the pathology of Āyurveda which we have later found to be common to all the great manuals of classical period.

c11.28

A detailed study of the later Upaniṣads and the Vedic Sūtras will yield still more indirect proofs of the existence of great activity in the field of physiological speculations anterior to these great manuals and on which they have clearly drawn. We have, already, had the occasion to show elsewhere as to how the theories of Suśruta and Caraka on sleep and dreams and on the relation of the spirit with the heart could be related in part to concepts taught in this respect by older Upaniṣads like the Bṛhadāraṇyaka and comparable for most of the time to those of the Greeks.¹

c11.29

¹ Le sommeil et les rêves selon les médicins indiens et les physiologues grecs in Journ. de psychologie, July-Sept. 1947, pp. 326 ff., specially pp. 329, 332, 337 and 342.

c11.30

Lastly, another type of evidence comes from without to assure us the continuity and the activity of the Indian medical researches before their literary blossoming. The Greeks who were the contemporaries of Alexander have left this evidence for us.

c11.31

It is true that their opinions are divided. Nearchos says that medicine has very little use in India, except against snake-bites, the sobriety of the inhabitants ensuring them freedom from disease and that the Sophists cure the diseases that are eventually caused by some divine help (Nearchos in Strabo, XV, 1, 45; Arrian, Ind., XV, 12). Others say that the Śramaṇas call themselves doctors but are only magicians (Strabo, XV, 1, 70, where the Śramaṇas are ‘Pramnai’). On the other hand Megasthenes talking of these very Śramaṇas indicates that the second rung in esteem after that of the ascetics who have retired to the forest is given to doctors by the population. Of these doctors he says that they make use more of diet-control than of medicines and that among the latter liniments and cataplasms are made use of more often; the rest appears to them to be more or less suspect of bad effects (Strabo, XV, 1, 60, where they are called ‘Garmanes’). The same Megasthenes also talks in the same passage of the existence of the speculations on man and elsewhere of the existence of ideas analogous to those of Greeks relating to cosmology, to elements and attenuates the reproach made of Indians, of mixing too much of fiction with philosophy, by saying that Plato had done the same thing. On his side Onesicritos says that the Gymnosophists undertake much research concerning natural phenomena, the presages, the diseases (Strabo, XV, I, 65) and among the Musicanos, where he observes that the sciences are not cultivated, he notes that in this respect medicine is an exception.

c11.32

We have certainly to reject opinions similar to those of Nearchos, the belief in the perpetual health of Indians being a proof of the insufficiency of information. The evidence of Megasthenes who had lived for a long time in India as ambassador and not for a short period as a conqueror is necessarily more competent and is to be accepted as it is in full accord with all the Indian data.

c11.33

In other points of information furnished by Megasthenes we have got an indirect proof of the activity of medical research in India from the end of the 4th century B.C., because Megasthenes tells us how the diseases of elephants were treated. and we see thereby that a secondary branch of medicine, that of the veterinary art of elephants had already assumed a physiognomy which we find it to possess in later texts of elephantology, particularly in the Āyurveda of Elephants, the Hastyāyurveda attributed to Muni Pālakāpya. In fact we have already had an occasion to show that the prescriptions indicated by Megasthenes were in conformity with those of this Āyurveda.¹

c11.34

¹ Les gajāsāstra et les auteurs grecs, JA, 1933, pp. 163 ff.

c11.35

We are, therefore, very well assured by the data of the Indian texts corroborated by foreign sources, that Indian medicine, during the seven or eight centuries preceding the Christian era, had never ceased to be actively cultivated and directed towards the definitive constitution of its doctrines; this is when the great classical texts have appeared. The loss of earlier works should be attributed to the exclusive authority acquired by these latter and possibly as we have seen, due to the contempt felt by certain Vedic circles concerning the doctors, in spite of the general opinion which had been favourable to them.

c11.36

We thus reach the conclusion that classical Indian medicine which is found in a fully constituted form in the didactic manuals belonging to the environs of the Christian era, has its essential bases (doctrines of wind and of the breaths, of the fiery nature of bile, etc.) in the ancient Vedic texts, anterior to the formation of the Greek science, but that it has been elaborated and constituted as a system during the period of the efflorescence of Greek science and parallel to it. We have now to examine the analogies and the eventual relationship the two could have had.

Linked texts (12)