The Classical Doctrine of Indian Medicine: Its Origins and its Greek Parallels c4: Preface for the English Version

The Classical Doctrine of Indian Medicine: Its Origins and its Greek Parallels c4

Language: English

Preface for the English Version

c4.1

THE WORK ON HIPPOCRATIC MEDICINE which continues actively and has, during the last few years, helped produce the thesis of Mr. Bourgey at Paris and Mr. R. Joly at Liege is chiefly interesting for the history of the scientific spirit of the Antiquity and for ancient Greek Philology. On its side, the history of the Ayurveda reaches into the same Antiquity but concerns something always modern. The Ayurvedic medicine is still alive. Some attack it as the anachronic survival of a once glorious past but unworthy of being ranked with new scientific achievements. Others defend it with a conviction and ingeniousness which do harm to its cause. In fact, some support the view that it is fully worthy of figuring in the front rank of modern medicines and even that it is the only one worthy of the front rank. In their view it already contains all the useful discoveries of not only the present-day medicine but also of medicine in future. It is the complete science, revealed once for all for the good of the feeble humanity and does not require any research and trials of present-day science. All that the latter discovers with a great deal of effort, had not only been foreshadowed but had been written down in its books. It is because we cannot understand them properly and cannot understand their formulae because of the condensed expression of the truth, that we always look for the detailed solutions of physiological and therapeutic problems which had been, in general, fully solved by Ayurveda.

c4.2

Moved by this spirit, a number of the partisans of Ayurveda have written about the identification of modern concepts with those of Ayurveda. This is how it is desired to recognise in certain organic elements mentioned by the Ayurvedic texts, the elements defined by present-day physiology and geological Chemistry. For instance, as the action of *prāṇa* is invoked by Ayurveda for explaining the physiological movements of the organs, and as modern Nerurology talks about nervous influx, some have claimed that *prāṇa* is that nervous influx and that modern Nerurology has merely rediscovered what Ayurveda had already taught. This is how, once again, a substance like ojas, which plays an important rôle in the organism, according to the Physiology of Ayurveda, has been identified with albumin, because albumin appears as playing a rôle of fundamental importance in the same organism. Numerous other identifications in detail or identifications of theories explaining the same phenomena proposed on both sides by the Ayurvedic authors and modern medical men have, once again, been recently put forward. But it should be evident to everybody that the majority of these identifications cannot be defended because the elements mistakenly held to be the same, as they serve to explain the same functions, are altogether differently defined on the two sides. It is certainly much more important to note that the Ayurvedic authors have recognised numerous problems posed by life and by the inter-play of pathological functions or by their alterations and that they have sought to solve them by means of rational explanations, on the basis of data obtained from observations available to them, as can always be done by the Physiologists, Biologists and the Pathologists with the help of data gathered by them. But it is absolutely unwarranted to claim that the explanations thus offered are equivalent and that the more ancient ones had already the value of the latter ones; indeed they have an absolute and definitive value. Now in the European science of the Middle Ages the maintenance of any liquid in a tube, first filled and then turned upside down on a vat containing the same liquid, had been sought to be explained by means of the property of nature having horror of the vacuum. Later on Physics, having discovered atmospheric pressure, has explained the same phenomenon because of the atmospheric pressure. But no one has, however, come to the conclusion that mediaeval science had already known the atmospheric pressure and had named it, "horror of the vaccum".

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The same should have been the case with regard to Ayurvedic explanations. It gives evidence of a rational scientific spirit, rarely seen in other civilisations of the world. But these explanations have for their basis a knowledge, as yet rudimentary and incomplete in so far as the real conditions of the production of these phenomena were concerned; they cannot, therefore, prevail against those which today rest on much more detailed information and which will not be valid before those of the future, the latter being based on much more complete knowledge. Making claims to the contrary is not only to naively mix up concepts and theories which, though applicable to the same phenomena, have altogether different bases, but is also to give to the detractors of Ayurveda a chance of denigrating its partisans as making unjustifiable claims for the same. One should not plead a good cause with bad arguments.

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In the history of universal scientific development, Ayurveda has an eminent place, which should be conceded to the same and we will refer to it a little later, but its theories of yesterday do not supercede those of today. It retains its importance for other reasons.

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From another side, the extremely widespread persistence of the usage of Ayurvedic remedies and treatments does not, by itself, prove their value. It is known that in the absence of a sufficient number of practitioners of modern medicine, a large number of Indian people have no other choice save that of having recourse to Ayurvedic medicine, the only one available in a large number of localities. Often when modern medicine is represented by perfectly qualified practitioners, it remains inaccessible because of the high cost of its therapeutics or because of the complexity of the installations required by the same.

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Even when inferior in efficacy, Ayurvedic medicine will be able to maintain itself, regardless of the fact that it is traditional, because it is at the same time cheap. This is an important practical problem, regarding whose solution opinion is divided.

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Certain persons think that it is useful, even necessary, while waiting for a more complete propagation of modern universal medicine, which India, besides, possesses and to whose progress its research-workers are contributing and which alone should be spread all over and installed over its entire territory. While waiting for this propagation and only for this propagation, Ayurvedic medicine must be encouraged. But in that case it must be correctly practised by the Ayurvedic practitioners, with verified competence, instead of being, sometimes, practised at the hands of healers who use it ill and render it inefficacious or dangerous.

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But this presupposes that its value be well-established and that a distinction be clearly made between those cases where it can be usefully applied and those which can be treated only by modern methods. In other words it will be necessary that its competence be proved and defined. It will also be necessary that its teaching-programmes be properly established.

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In the absence of decisive research concerning the value and the scope of its methods, others think that its teaching should not be encouraged and must not be officially sanctioned by means of diplomas. In their view, official sanction would perpetuate worn-out methods and this would lead to delay in the complete medical equipment of the country and the replacement of Ayurvedic medicine by inferior techniques.

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The former retort that as it is impossible to carry out this replacement in a very short time, no matter how desirable, there is a danger in abandoning it to private initiative, generous but sometimes ignorant or imprudent. For example, mercurial medicines, used by the practitioners of the rasāyana-tradition, are toxic. Administered by a prudent practitioner, closely in touch with indications and dosages, they can be salutary. Otherwise, as is unfortunately proved by experience, they can give rise to grave nephritis or can be immediately fatal. As a precautionary measure their use can be prohibited, but they will still be sometimes used either surreptitiously or in ignorance of their real nature and the danger will not be entirely removed. Even medicines, made from non-toxic plants or from plants which are only a little toxic, can be harmful when not administered in proper measure. The most harmless can also, unduly prescribed, make one lose precious time which could, otherwise, have been utilised for efficacious treatment, which a more competent doctor, even Ayurvedic, could have begun. In brief, as Ayurvedic medicine exists without being immediately replaced, it should be better practised and not at random.

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During these arguments from both the sides, at least the difficulty of the problem comes to the surface. It is a social problem because the existence of Ayurvedic medicine, being actually practised in Indian society, is a fact, the health and life of a part of this society depend on it and on the manner in which it is practised. Now this problem can only be resolved by a clear determination of what is Ayurvedic medicine and what it can become.

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Under these conditions, it appears that, first of all, it must be deeply studied. The interest in its study is, therefore, not simply retrospective, as if it were a mere historical fact without any importance for the present, like the medicine of Greek or Egyptian or Mesopotamian antiquity. It is also, and above all, practical as it has a social presence, which cannot be overlooked.

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In the present work, written in France and outside the domain of practical Ayurvedic medicine, we have only tried to examine its doctrinal bases, examine the nature and foundations of its theories. They have appeared to us to be highly respectable because of the spirit of rational comprehension of vital and pathological phenomena they reveal. Upto now, after studying the ancient medical systems, we have found proofs of an original rational effort only among the Greeks and the Chinese (not counting the medical systems which are only derived from those of Greece and China)—an effort analogous to that of India, which is shown in the Ayurveda.

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Thus we observe that Ayurveda is definitely in the front rank of the scientific realisations of ancient time, when its doctrines were constituted. But it is for the Indian practitioners of today, for Biologists, for Pharmocologists, for Dieteticians, to find out the practical results which can be obtained from the practice of Ayurveda, whose theories and accumulated treasure of observations are remarkable but whose power of investigation has been by-passed by present-day research, always going ahead.

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It is an immense and difficult but necessary task. It will have been necessary even if there were no need of justifying or condemning the methods which are, rightly or wrongly, applied at present. In fact, the data of the Ayurvedic texts refer to real diseases, to dietetic measures effectively applied, to largely applied remedies. It constitutes a considerable mass of information relating to Pathology, to nutrition and to the effect of drugs and all this information should be gathered and verified by modern research.

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Already numerous Ayurvedic drugs have been examined from the point of view of their pharmocological properties. The cases of their application are not equally well-known, because of the difficulties often present in the identification of diseases, enumerated by modern nosology, in the descriptions furnished by Ayurvedic texts. These texts have, in fact, classified a large number of diseases in a different manner, according to the analogy of the symptoms, confusing, for example, under the nomenclature of *jvara*, “fever”, different diseases, in which fever is only a secondary manifestation. On other occasions, and quite frequently, these texts distinguish several varieties in a single disease, according to whether certain symptoms are attributed to the predominance of one of the three morbid elements (*tridoṣa*), theoretically and hypothetically distinguished by them but whose real presence cannot be found by modern medicine.

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Besides, the extremely rich dietetic indications of Ayurveda, necessarily based on observations over long periods, cannot but have interest for us, both from the practical view-point and for the study of the problems of nutrition. Systems of ancient medicine always attached a great deal of importance to regimen and to behaviour whether for the preservation of health or for the treatment of diseases. They often explained diseases as being due to a departure from regimen or to inadequate hygiene. In this regard their prescriptions were extremely thorough. The medicine of the nineteenth century, following its great discoveries and notably after the work of Pasteur concerning the pathogenic role of bacteria, has undermined many of their hypotheses. This has tended to relegate to the second rank the preoccupation concerning the regimen of diseases, exception however being made in the case of diseases of nutrition, as Diabetes. Alimentation and behaviour, being no longer considered as the essential causes of diseases, have lost a great deal of their importance in the eyes of doctors and are now considered among the favourable circumstances or among the accessory means of therapeutics. At present, however, a deeper study of the biological conditions, particularly the biochemical conditions of normal equilibria and of minor pathological perturbations is once again drawing attention to the effects of alimentation and to the mode of life, to the influence of climates, of seasons and to environmental conditions. For example, in regard to alimentation, observations have been made and experimental verifications are being made *in vitro*, concerning the influence of rice on the development and activity of pathogenic amoeba, which lose this activity when the proportion of rice in the contents of the digestive tube becomes too high. Therefore, in this respect the data of the Ayurveda deserve examination and verification. They can help many lines of research.

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A number of Indian doctors, in the know of both modern medicine and Ayurveda, have understood this point. Some editions of ancient texts accompanied by interpretations made in the double light of tradition and of present-day clinical conditions have been published. Among them we may mention the edition of *Caraka-samhitā*, published by the Gulabkunwarba Ayurvedic Society, under the direction of Dr. Mehta.

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Ayurveda need neither be exalted beyond measure nor condemned either for its antiquity or for the failure of those who practise it without prudence. It should be studied as an original system of science and as an exceptional source of medical experience.

c4.20

College de France, Paris.

Linked texts (1)

Carakasaṃhitā — Agniveśa (Āyurveda) & Caraka, Sanskrit