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The Classical Doctrine of Indian Medicine: Its Origins and its Greek Parallels c13: Chapter Eight: The Timaeus of Plato and Indian Medicine

The Classical Doctrine of Indian Medicine: Its Origins and its Greek Parallels c13

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Chapter Eight: The Timaeus of Plato and Indian Medicine

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ANALOGIES of the same type as those that have been noted between Indian medical texts and the Hippocratic manual *On Breaths*, being expressions of ancient Greek pneumatic conceptions, have already been pointed out between a theory taught in the *Timaeus* and the Indian doctrine of pathology. Armand Delpeuch¹ has been struck on finding in the *Timaeus* in the form of explanation, quite aberrent in comparison with Hippocratic medicine, the classical teaching of Ayurveda, whereby diseases are provoked by the wind, bile and phlegm. But he believed that he could refer this teaching back to the Veda and thought that Plato had received it from the Pythagorean tradition, Pythagoras being reported to have searched for a medical philosophy in India.

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¹ A. Delpeuch, *La goutte et le rhumatisme*, Paris, 1900, pp. 26 ff. ² The quotations which follow are borrowed from the translation of M.A. Rivaud, Coll. Guillaume Budé, *Platon*, Vol. X, Paris, 1925, pp. 217-219, with very minor changes.

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It is impossible to accept the idea that the doctrine in question goes back, in its complete form, up to the Veda, but it is certain that its analogy with the thesis of the *Timaeus* is remarkable.

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Plato recognises three classes of diseases. The first are due to the alterations of the four constitutive elements of the body similar to that of the universe—earth, fire, water and air (82 a-83 e). Others are related to humours produced by the elements and are susceptible to corruption (83 e-84 c). The third class (84 d) comprises diseases due to pneuma, to phlegm (*phlegma*) and bile (*khole*). This is the thesis which is in accord with the classical Indian doctrine. The exposition of Plato is, unfortunately, extremely rudimentary and very confused.²

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*Summary and Extracts* (84 d-86 a): “When the lung, distributor of air in the body, is obstructed by discharges of (*reūma*), the circulation of air in the body is troubled, on the one hand the parts that do not receive their freshening (supplies) get corrupted and, on the other, air does violence to certain vessels (*phleps*), causes them to be distended, twisted and dislocates them. And it shuts itself in that part of the body where the diaphragm is found.¹ Thus are born frequently a number of painful diseases accompanied by abundant perspiration. Often in this way, the flesh gets disjoined inside the body, air gets therein, unable to get out therefrom and (becomes) the cause of suffering identical to that provoked by air come from without.² Such suffering is, above all, very great when the air applies itself to the tendons (*neuron*)³ and to the vessels which are there and causes them to swell. Then it causes the extensor muscles to distend as also the muscles adhering thereto and causes them to contract in the contrary direction. The diseases resulting from this tension have, for this reason, received the name of tetanus and episthosnos. It is difficult to bring any remedy to them and, most often, it is the fevers which, coming in then, resolve them.⁴

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¹ Rivaud thinks that it refers here to the pathogeny of pulmonary congestions and to bronchitis, but the air which shuts itself in the diaphragmatic region could not determine similar affections. It refers to the air retained in the centre of the body and which provokes the diseases that follow, the latter not being of the respiratory type.

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² cf., *On Breaths*, 11; Suśr., 20, 26, 27.

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³ The nerves and the tendons, all the 'cords' are confused in Greek anatomy, the same being the case in Indian anatomy, the 'nerves' in the modern sense of the word are confused with the *snāyus* or tendons.

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⁴ The Hippocratic manual *On Diseases*, III, 14 and 15, describes the tetanus quite well and also admits its curability in certain cases. It omits among the symptoms fever, which is, nevertheless, extreme and which is noted by Plato, who, in accord with other Hippocratic manuals (*Aphor.*, IV, 57; *Coan Prognoses*, 348; *On Diseases*, 1, 7; *On Crises*, 61) makes of it a favourable symptom. On tetanus and on opisthotonus; Suśr., 51-57, who relates them similarly to the wind, but in association with the phlegm.

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The white phlegm (defined in 83 d as mixed with bubbles of air) is dangerous if the air of the bubbles contained by it is retained in the body; it is less dangerous, if the air goes out, but then the skin gets spots of white (85 a). If the phlegm gets mixed up with black bile and troubles the "extremely divine revolutions" which occur in the head, there can be produced the disease called the sacred one because it appertains to the sacred substance in us.¹ The sour and salty phlegm produces extremely diverse catarrhal diseases.

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¹ This explanation of the name is not, as is known, in accord with the Hippocratic manual *On the Sacred Disease* which says that it should be so called as it is considered to be coming from the gods, but who contests the opinion that it can be provoked by divinity.

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“For the ailments called phlegmonous, because they provoke burning and swelling, they are, all of them, caused by bile” (85 b). When the bile goes out, it provokes tumours; retained, it provokes inflammatory diseases, mostly when it gets mixed with the blood. The blood contains fibres which prevent it from being too liquid (it is the observation of the coagulum separating itself from the serum which, apparently, has given rise to this theory of fibres). The bile which belongs to the blood become old, which is “hot and liquid”, causes by its heat, if it flows in the blood in abundance, disorder in the fibres. It can penetrate up to the marrow and burn it, provoking death. But if it is in small quantities it can be pushed back by the vessels in the thorax or in the abdomen and from there can be evacuated (85 e).

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The passage terminates with an enumeration of fevers. The continuous ones are due to fire; the daily ones are due to air; those occurring every third day to water, slower than fire and air; those occurring every fourth day are due to earth, which is slower still. The sources of this pathology have not been fully elucidated.² Mr. Rivaud asks himself if Plato had not accepted from all sides different hypotheses which he had not sought to reconcile. It is certain that one could find, scattered in various texts, the elements of the doctrine of the *Timaeus* and that uptil now no Greek medical text, grouping these elements in the manner in which he has grouped them, has been pointed out. The Hippocratic manuals present different pathological theories but they recognise most often the action of the four elements (which is also done by Plato in his description of the first class of the diseases), or of four properties, the cold and the hot, the dry and the humid (cf., *On Ancient Medicine*, 1, which combats this theory); or of four humours, blood, phlegm, yellow bile and black bile (*On the Nature of Man*, 4) or blood, bile, water and phlegm (*On Generation*, 3 and *On Diseases*, IV, 32); or of bile and of phlegm (*On Diseases*, II, 2), etc. Only in Indian medicine is found in the form of a received doctrine a pathogeny similar to that of Plato, some details being in concordance on the two sides, some being different.

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² cf., A. Rivaud, *loc., cit.*, pp. 114-5. A.E. Taylor, *A Commentary on Plato’s Timaeus*, Oxford, 1928, p. 599, is embarrassed; he believes that Plato must have made use of a source which he does not find in what is known of the Greek medical tradition.

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The pathogeny of troubles due to the wind differs in the Sanskrit texts and in the *Timaeus*, because of the fact that, in the latter, Plato brings in the lung as the distributor of the air in the body whereas the Sanskrit texts do not even mention it on that occasion. Plato has also a theory of breathing which says that something like a trap of fire and of air was introduced by God in the body, where it would go out alternatively.¹ This theory does not appear to be found in India. But the idea that the wind retained in the body provokes therein pains and convulsions, is a part of classical Indian teaching. The text of Suśruta, studied above, links specially tetanus to the wind under its various forms, stressing the predominance of contractions on such and such a group of muscles, extensor or flexor. The concordance with the *Timaeus* in this respect is complete.

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¹ 78. Galen had rightly judged this concept to be difficult to follow. He has, nevertheless, explained it in detail, cf., Ch. Daremberg, *Fragments du commentaire du Galien sur le Timeé de Platon*, Paris-Leipzig, 1848, pp. 18 ff.

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The theory of phlegm in Plato is quite similar to that of the *śleṣman* of Indian doctors. Plato has described the phlegm before indicating its rôle in diseases. "Serosity (*ikhor*) when it comes from the blood is sweet, the one that comes from black and acid bile is malignant, above all, when because of the action of heat, it gets mixed with the salted quality. Another type of serosity is formed from new and tender flesh, dissolved in the air . . . we call it white phlegm (*leukhon*)" (83c-d). Suśruta, on his side, teaches: "The phlegm is white, heavy, unctuous, viscous and cold. But, sweet when it is not burnt; when burnt, it can be salty".² Although the formation of the phlegm is taught differently in the Greek and Indian texts, and although only the Greek text brings in the black bile, both agree on a theory which is quite strange and to which the observation of real facts does not naturally lead, namely the passage of the phlegm from sweet to salt under the action of heat.¹

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² Suśr., *Sūtr.*, XXI, 12: *śleṣmā śveto guruḥ snigdhaḥ picchilaḥ śīta eva ca, madhuras tv avidagdhaḥ syād vidagdho lavaṇaḥ smṛtaḥ*.

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¹ The experience of heating the phlegm and of subsequently testing it after having tasted it before could have been carried out. The manual *On Flesh*, 4, prescribes to cook the tissues to appraise the properties. But the phlegmatic secretions (mucosity for example) are salty before being cooked. It should, therefore, be a theoretical opinion and not an experimental statement.

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Concerning the ‘hot and liquid’ nature of the bile, Plato agrees fully with the old Vedic idea of the igneous nature of bile, an idea inherited by Ayurvedic medicine. He brings in the bile from a liquefaction of extremely old fleshes, getting black under the action of prolonged heating and becoming bitter or acid. The bitter parts plunge themselves in the blood and this results in a green tint. Finally the younger parts of the flesh give the yellow colour along with bitterness (83 a-b). Suśruta cites a verse summarising the Indian ideas concerning the bile: “The bile is bitter, liquid, fetid, black and also yellow, hot and of acrid taste, and when it is burnt, it is acid.”² Some of the notions which agree on both sides, are of little significance. The amertume of the bile is a commonplace and universal fact but the same is not true of the theory saying that the bile, under the influence of heat, becomes acid.

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² *pittam tīkṣṇam dravam pūti nīlam pītam tathaiva ca, uṣṇam kaṭurasañ caiva vidaghan cāmlameva ca.*—Suśr., *Sūtr.*, XXI, 8.

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The explanation of certain diseases by the irruption of bile in blood is common to Plato and to Indian doctors who call this accident *rakta-pitta*, “blood-bile” (Suśruta, *Uttaratantra*, XIV) and attribute to it the origin of the spontaneous haemorrhages which occur principally in the course of acute diseases. It is probably because the idea has been conceived in the presence of the forms of grave icterus, relatively frequent in a tropical country and characterised both by jaundice and multiple haemorrhages. But the Platonic theory of the fibres of the blood does not appear to be found in Indian medicine.

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The fevers enumerated by Plato, while finishing his exposition concerning the diseases of the body, are well known in India, not only to doctors, but even to the authors of the magical conjurations of the *Atharvaveda*.³ In any case their knowledge is necessary in all those countries where they occur within the eastern basin of the Mediterranean as also in India.

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³ cf., *supra*, pp. 115-116.

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The explanation of their varieties, given by Plato, according to the elements in question, does not agree with the usual pathogenic theories of Indians.

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Leaving aside the passages dealing with the pathogeny by air, with phlegm and with bile, and those that concern the very nature of phlegm and bile, other concordances with Indian ideas are also found in the *Timaeus*.

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One and the same comparison is proposed in the *Timaeus* and in Suśruta. Plato says that the gods have “dug canals in our body, similar to those established in the gardens, so that it may be watered, as by the course of a stream” (77c-d). Suśruta does not bring in the demiurge but says that by the presence of vessels “the body is like a garden or like a field with water-drains”.¹ But it is evident that such a comparison is so natural that it could have come to the minds of both Plato and Suśruta quite independently.

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¹ Suśr., *Śār.*, VII, 1, cf. *Supra*., p. 163. This comparison is also found in Aristotle (*De part. anim*, 668 a, 10) as has been pointed out by Rivaud, *Timaeus*, p. 207, note.

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Among the vessels Plato distinguishes two conduits placed on both sides of the vertebral column, and of the generating Medulla and which, near the head, branch out in interconnected form (77d-e). Mr. Rivaud rightly hesitates regarding their identification², but it seems to refer in Plato to a theoretical concept, based merely on a vague knowledge of the existence of thick vessels near the vertebral column, because he says: They (the gods) dug two dorsal vessels, as the body was in double, having a right and a left” (77 d). These vessels do not really correspond to any anatomic reality but are, on the other hand, a datum of theoretical anatomy of India which is, this time, not furnished by the Sanskrit medical texts themselves but by the mystical literature o f the *Tantras*. In fact it is a thesis current in this literature as also in the later Upaniṣads which refer to the same ideas. It amounts to saying that two canals called *iḍā* and *piṅgalā* are found on the two sides of the vertebral column and of a central canal called the *suṣumnā*³, the three cross one another in the body. Moreover, the tantric texts vary as regards the question of their crossing one another.¹

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² Page 207, note, he identifies them with the Aorta and the veins of the superior and the inferior cave, but, at p. 98, he shows the difficulties in this identification.

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³ cf., *Ahirbudhnya-saṃhitā*, XXXII, 27 and 29; *Kṣurikopaniṣad*, 16. Numerous references are to be found in the index of Mahadeva Sastri, *The Yoga Upanishads*, Adyar, 1920.

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¹ The idea of a similar crossing of thick vessels in the body is found in the Hippocratic collection (*On the Nature of Man*, 11, where several "veins" forming the third pair of the system described, go from the temples to the lungs, the one from the right side coming to the left side and vice versa).

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In *Timaeus* is to be found yet another concordance with the doctrines of Tantric mysticism. Plato, while establishing a relationship between the elements of nature and geometrical forms (55e-56b), gives the figure of the cube to earth, that of the triangular pyramid to fire, that of the octahedral to air and that of the icosahedral to water. Now the *tantras* also represent the elements symbolically in various diagrams (*maṇḍalas*) by means of analogous geometrical figures, although plane ones; earth by the square, fire by the triangle, air by a figure of six points (two equilateral triangles superposed one on the other), water by a figure resembling the crescent Moon and ether by the circle.² This is a case of the encounters of symbolism whose history is quite complex; because in Egypt on the Zodiac of Denderah, a monument later than Plato (of the epoch of Ptolemy) is found a representation of the solar light by several chains of triangles.³ The Tantric texts containing these several points of agreement with the ideas of *Timaeus* are also much later than this last work.

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² cf., Avalon, *Tantric Texts*, Vol. III, Calcutta, London, 1944, p.7 (Introduction to the edition of the *Prapañca-sāra-tantra* by Tārānātha Vidyāratna).

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³ cf., Antoniadi, *L'astronomie égyptienne*, Paris, 1934, fig. 25 and p. 88.

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One should also count the belief of Plato in metempsychosis and his theory of the vision among the concordances of his ideas with that of India. This is not the place to examine the former but the latter conforms to the medical concepts of India in so far as Plato admits the existence of a fire inside the eye, the fire which, on meeting the external light, links up, by the union of the similar with the similar, the object with the perceiving soul (45 b-d). Similarly Suśruta describes a fire which is a form of bile called *ālocaka* and which, localised in the eye, is the agent of vision.⁴ The Platonic theory of the visual fire is, moreover, far from being isolated in the Hellenic world¹ and Bühler had, long ago, drawn the attention of Th. Gomperz on the analogy presented by the theory of the vision of Alcmaeon of Croton (VIth century B.C.) and that of the *Nyāya-Vaiśeṣika* philosophy of India.² In Alcmaeon the theory seems to be different from that of Plato but the existence of an intra-ocular fire is put forward in principle.³ On this point the accord is complete between India on the one hand and Alcmaeon and Plato on the other.

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⁴ Suśr., *Sūtr.*, XXI, 7.

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¹ cf., Rivaud, *Timaeus*, p. 105.

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² cf., Th. Gomperz, *Les penseurs de la Grece*, French trans., p. 185, f.n. 1.

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³ cf., Theophrastes, *Des Sensations*, 27.

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The interpretation of all these concordances between the doctrines of *Timaeus* and those of the physiologists, indeed the mystics, of India is delicate. It seems difficult to relate all of them, at the same time, to the coincidences of hazard. The similarity of subjects studied and the rudimentary means then available, both in India as in Greece, to the human mind for solving the problems of Physiology and of Pathology can explain all of them only with difficulty. Noted at a time when it was readily believed that Plato had reproduced the ideas of the so-called Pythagorean *Timaeus* and that Pythagoras had known the ideas of India, these concordances could have been easily considered as the witnesses of the dependence of Pythagorism and Plato on India. But today, and although the question of the eventual relationship of Pythagoras with India has never been seriously settled, this question cannot be settled with equal ease. The romance of the Pythagorean *Timaeus* is considered as based, for a large part, on the dialogue of Plato⁴ himself and the value of the ancient tradition which says that Plato had probably borrowed the clearer part of his Physics and Biology from the Pythagoreans, is contested.⁵ From another side, the possible influence of the Orient on Plato has been postulated by several authors⁶, without anybody having been able to point out any precise data as our sources of information, concerning the Iranian or ‘Chaldean’ doctrines, which have been almost exclusively considered, are quite precarious. All that we can say today is this: that the concordances of *Timaeus* with Indian doctrines appear to us to be more striking because these Indian doctrines are much more accessible to us.

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⁴ Rivaud, *Timaeus*, p. 18.

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⁵ ibid., p. 24.

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⁶ cf., W. Jaeger, *Aristoteles*, Berlin, 1923, pp. 123 ff; H.S. Nyberg, *Questions de Cosmogonie et de cosmologie mazdéennes* in *JA*, July-Sept, 1931, pp. 104 ff. Last of all J. Bidez, *Eos ou Platon et l'Orient*, Brussels, 1945, and A.J. Festugiere, "Platon et l'Orient." in *Revue de Philologie*, XXI, fasc. 1, pp. 5 ff. (the latter is more reserved).

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We have briefly pointed out the resemblances between the *Timaeus* and the Indian ideas found at quite a late date. We have chiefly stopped to look at patent similarities between the medical doctrine of the *Timaeus* and the Ayurvedic pathology whose essential elements, as we know, date from the Vedic epoch and which became a system between the epoch of the *Śatapatha-brāhmaṇa* and that of the grammarian Kātyāyana, i.e., approximately between the VIIth century and the end of the IVth century B.C. Plato lived from 428 or 417 to 347 B.C. and the *Timaeus* belongs to the end of the life of Plato, to the second quarter of the IVth century. On his side, the Hippocratic manual *On Breaths*, whose pneumatism has been found by us to be comparable to that of India, although not dated, belongs to a period quite near that of Plato and, in any case, to a period before that of Aristotle and of Alexander.

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Thus the two groups of precise concordances noted by us between Greek and Indian medicine refer to the same period, anterior to the expedition of Alexander in India, an expedition about which it is generally said that it marked the first contact between India and Greece. In order to interpret correctly the concordances noted above, we will, therefore, have to see if the two worlds presenting them were, at that time, in reality, totally strangers to each other.

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