Hindu Medicine c5.s3: III

Hindu Medicine c5.s3

Language: English

III

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Zimmer’s research in Hindu medicine extended over many years. According to his autobiography, he first turned to this subject in 1925, immediately after he had finished his book on *Kunstform und Yoga*. At that time, he saw in Paris a “charming minor hunting relief. It showed huntsmen on an elephant, the animal handing them with its trunk the deer they had killed. It gave me a pang; I felt a criticism and remorse for having dealt so exclusively with Hindu and Buddhist devotional yoga and esoteric doctrines. Here I was confronted with a scene of everyday life. I felt the necessity of

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balancing my interest in transcendental Hindu wisdom by knowledge of the realistic approach to life's experiences in the Indian tradition. Thus I delved into medicine, the best representative of Hindu earthly life and wisdom.”¹

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¹ *Two Papers*, pp. 16 f.

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The first fruit of these studies was a book on animal medicine, more specifically, on the treatment of elephants: a translation of the Mātaṅgalilā of Nīlakaṇṭha and of excerpts from the Hastyāyurveda; an introduction and commentary were added.² This is not the place to review in detail the results of Zimmer’s interpretation. But it is of interest to note certain parallels between Hindu animal medicine and human medicine, and to emphasize some of the findings concerning medicine in general which Zimmer formulated here, yet failed to integrate into the Noguchi lectures.

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² *Spiel um den Elefanten* (see above, p. xxxv, n. 18), pp. 91 ff.; 136 ff.

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The animal doctor—who is a specialist and not allowed to treat human beings, just as the human doctor may not treat animals (p. 148)—is chosen on the basis of the same qualifications and initiated into his art in the same way as the healer of

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human diseases (pp. 85 f.). In animal medicine, too, the pre-Aryan knowledge which became part of the priestly medicine of the Vedas (pp. 57 f.) is believed to be an insight derived immediately from the gods (p. 81); the physician to a certain extent remains a sorcerer (pp. 139; 142). Again, the self-reliant optimism of science is entirely absent (pp. 141 f.). Experience and tradition (pp. 138; 167 f.), observation and speculative theory (pp. 148; 138) go hand in hand. No attempt is made to establish a system consistent in itself (pp. 139; 141 f.; 172; 179).³

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³ Note also the references to the macro-microcosm relationship (p. 147), to diseases in men and animals (p. 164), to places suitable for incision (p. 166).

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A unique feature of the analysis of animal medicine is the discussion of physiognomy (pp. 54 ff.). Such a science is first of all developed for the sake of practical knowledge; it teaches what to expect from those with whom one comes in contact. In animal and human medicine alike, types are established which conform to the "essence" as expressed in each specific incarnation. They are constituted by what might be called a metaphysical theory of inheritance (p. 60), and they are the

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same in animals and men; for men and animals can be compared, while plants and human beings show no affinity (p. 62). As for the principles of classification, some of them are taken from the political order, since for the Hindu the castes echo natural distinctions of qualities (pp. 63 ff.). Others are derived from physiology. Phlegm, gall, wind, but not blood, are considered to be the constituents; the mixed or balanced type is the highest (pp. 66 ff.).⁴ Yet, many systems know only of three species (p. 70), and the phlegmatic type, at any rate, is nearest to the ideal combination of the humors, often it represents the supreme value. That this is so is in agreement with the climate of India and the temperament which derives from it. The same feeling, so utterly at variance with that of the Western world, is expressed in the Hindu ideal of contemplation, of inactivity, as the highest form of life, celebrated in Hindu philosophy and art (pp. 74 ff.).

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⁴ Colors too play a rôle (p. 72). The elephant’s place of origin is important (p. 76). The variations in behavior must be considered (p. 78).

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In those books that followed Zimmer’s study of elephant medicine and were dedicated to an ana-

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lysis of Hindu thought and culture in general, medicine is at least occasionally referred to, and some of its major aspects are emphasized. Thus, the origin of medical knowledge is characterized: “The sages, the wise men, who achieved knowledge comparable to that of our experimental science, in India were called *Kavi*, prophet-poets. It is on their immediate observation of the body, for instance, and of the powers which preserve and heal it, that all mediate and communicable knowledge of later medical tradition was based. Subsequently teaching and application ensued, where formerly prophetic experience of an inexpressible all-in-one of insight and fullness of meaning had prevailed.”⁵ Zimmer points out that according to Hindu medicine “ ‘it is impossible to fathom the causes of all worlds and of all beings’—why in every detail they are as they are: their hidden law—‘this is the secret of the gods . . . and that which cannot be thought out should be left to itself.’ This attitude implies that one rests satisfied with the juxtaposition of description and observation, of sifted experience and speculative synthesis.”⁶ The philosophical concept of fate is introduced into medicine: "The power of our decisions, their determining might [as Karma] is evidenced by the color of our hair, the shape of our nose, the diseases we suffer, the successes we gain, the length of our life, and the maturity of our understanding."⁷ Besides, Zimmer analyzes the Yoga technique of respiration in minute detail: he shows how "all the gods within our body" are made subservient to the human will. He elaborates on the parallel between medical teaching and the teaching of the Buddha. While Spinoza speaks *more geometrico*, the Buddha speaks *more medici*, as a practitioner.⁸ In his review of the translation of a play, *The Bliss of the Life-monad or Soul*, Zimmer finally clarifies the attitude of the average Hindu toward the medical art. His confidence in medicine is great. Yet the value of medical care is measured by man's higher destination. The sound body is,

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⁵ *Ewiges Indien*, pp. 118 f.; cf. 81.

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⁶ *Indische Sphären*, pp. 68 f. As the book on elephant medicine

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⁷ *Indische Sphären*, p. 74.

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⁸ *Op. cit.*, pp. 233 (cf. below, pp. 32 ff.); 237; 106 ff.; 123 ff. [191 f.].

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had formulated it, the unreconciled combination of opposite features is characteristic of the Hindu picture of the world, and the specific content of the Hindu attitude toward life is infinitely more important for the development of Hindu medicine than any trends inherent in medical thought itself (pp. 178 f.).

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and ought to be, made the instrument of spiritual experience through which one becomes conscious of the indestructibility of one's true self, of that part within man which is behind his individuation.⁹

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⁹ Frankfurter Zeitung, Jan. 23, 1938 (Literaturblatt); cf. below, pp. 61 ff.

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Almost simultaneously with these studies Zimmer published two articles on psychotherapy.¹⁰ India practises both, medicine of the body and medicine of the soul. But, while the former lies in the hands of the lay physician, the latter is practised by the priest; it is enshrined in the ritual that governs every act of life. Varying according to the various types of men—there is a hierarchy of rituals as there is a hierarchy of castes—, these ceremonies aim at the prevention of the sickness of the soul, they aim at a macrobiotics of the soul, just as lay medicine is concerned with a macrobiotics of the body, "the knowledge of the perfect and long life."¹¹ Thus, the "Guru," or housepriest, teaches the mother through a ritual, "the giving

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¹⁰ Indische Anschauungen über Psychotherapie in Zentralblatt für Psychotherapie, VIII, 1935, pp. 147 ff. (translated into English in Prabuddha Bharata, 1936, pp. 177 ff.); Umrisse indischer Seelen-Führung, quoted above, p. xxx, n. 8.

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¹¹ Seelen-Führung, p. 59.

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away of the fruit,” how to bear the separation from her child once it has grown up. The ritual begins “ at about the fifth year of the child’s life and ends when the son enters the circle of adult life.” It represents “ the unrelenting demand made by life and the outer world which can only be satisfied through sacrifices. The woman must, therefore, symbolically sacrifice to him [the Guru] the things that she most cares for, not only once but repeatedly through the years.” ¹² The limitation of this dietetics of the soul consists in that it does not make allowance for the development of the individual. As a compensation for the strict adherence to the community, enforced by the chain of rituals that fetter the masses, the system of Yoga represents the complete detachment of the few from all human bonds.¹³

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¹² *Prabuddha Bharata*, p. 179. In agreement with such an interpretation of the ritual as a kind of religious psychotherapy, the famous or notorious Kāmasutra is to be explained as a dietetics of the psyche in the erotic sphere (*ibid.*).

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¹³ *Op. cit.*, pp. 187 f.

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It was on account of the research just referred to that Zimmer was invited to give the Hideyo Noguchi Lectures, and it was with all these results already reached that he set out to prepare

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them. Nevertheless he found the work hard. A *publicum* which he read in the summer of 1937 had made him fully aware of the difficulty of the subject. In connection with our first discussion of the matter, he wrote that it was necessary to unearth all the details; otherwise the picture would remain incorrect. The two great encyclopedias, Caraka and Suśruta, had to be translated chapter by chapter. “An evaluation is a difficult though stimulating problem. The situation seems similar to that of occidental medicine which was carried on in the late ancient fashion until, in the ‘Biedermeier,’ modern medicine came into existence, based on chemistry and the natural sciences. Yet it would be . . . wrong to apply modern standards. . . . Age-old experience and intuition demand their rights even though one should refrain from romantic idealization. . . . Only by conquering the material step by step . . . can one hope to grasp the presuppositions which are explicitly and implicitly indicated and which serve to explain the entire style of thought and its inherent interrelations.” ¹⁴

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¹⁴ Letter, spring, 1938. I quote so extensively because these considerations might be of value for future students of Hindu medicine.

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While preparing his manuscript Zimmer became fascinated by another point of view. After a renewed perusal of Sigerist's *Great Doctors* he resolved to set the achievements of Hindu medicine against the background of Western medicine: " thus the story becomes plastic and amusing."¹⁵ And he actually proceeded in this manner in his lectures of 1940, which dealt with medical tradition and the human body, with the physician and his concept of dietetics, and with diseases and cures. Afterwards, he himself realized that the new scheme was inferior to that which he had originally envisaged. It prevented him from exhibiting his peculiar gifts, his original insights. That is why he wished to rework his manuscript for publication. This, to be sure, proved to be an unhappy decision, insofar as he was not allowed to conclude his revision. Yet in some respects it was fortunate, for the finished parts are, at least in my opinion, an infinitely better and much more stimulating presentation, both for the general reader and for the scholar.

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¹⁵ Letter, Fall, 1939.

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The book, as it now stands, first deals with the oldest Vedic tradition, the medical gods, the

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literary evidence, the general significance of medicine, the education and career of the physicians, the hospitals, the implications of medical wisdom, signs and names of diseases (ch. I). Next, the relationship between macrocosm and microcosm is analyzed, the doctrine of the life force and of breath, the theory of the humors and of the body, the teaching of anatomy and physiology are discussed (ch. II). It is safe to say, then, that the book, though fragmentary, covers most of the important aspects of Hindu medicine. For the majority of questions, and for the most intricate ones, we have Zimmer’s answers in their final form.

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How he intended to go on after having outlined the doctrine of generation, I have been unable to find out. But the second chapter certainly was planned to be not much longer.¹⁶ Moreover, it was to close with a short comparison of Hindu and Greek medicine. Zimmer’s opinion on this subject luckily can be deduced from his notes of a lecture

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¹⁶ The letter that came with chapter I states that the second chapter would be almost as long as the first. The letter which accompanied the manuscript of the second chapter says that that which was sent “is the greater part of chapter II.”

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given before the New York Academy of Medicine in the winter of 1942.¹⁷

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¹⁷ Cf. above p. x, note 2. The title of the lecture is "The influence of Hindu medicine on Greek medicine." I follow Zimmer's line of reasoning as closely as possible. For another interpretation of this problem, cf. A. M. Esser, *Berliner Medizinische Wochenschrift*, 1935, pp. 600 f.

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What is the relation between Hindu medicine and Greek medicine? A priori an influence of the one on the other even in early times seems not impossible. Quite apart from the dependence on Indian thought attributed by later tradition to men like Pythagoras, Empedocles, and Plato, it is a fact that Greek physicians in the sixth century B. C. lived at the court of the Persian kings to whose empire India belonged. Indian troops were among those whom Xerxes led against Greece in 480 B. C.¹⁸ These facts imply that there must have been an interchange between the two civilizations. But the uncertainty of the chronology of Hindu medical writings makes it difficult to determine the exact nature of any mutual influence. Is it permissible to assume that the old codifications of medical magic of the Aryan immigrants and their

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¹⁸ There follows an interesting digression on the mistake made by ancient geographers who identified Egypt with India.

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Brahmin priests fall into the first half of the first millennium B. C., and that they contain elements which go back even farther? On the other hand, if Caraka wrote in the first century A. D. and Suśruta in the fifth, it would be quite justifiable to assume that Hellenistic medicine shaped their thoughts, just as Hellenistic astronomy and art gained influence on Hindu civilization.¹⁹

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¹⁹ For the chronological problems involved, cf. below, pp. 46 ff.

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Turning to the content of medical teaching, one finds astounding parallels. The Hindu theory of the six essences or qualities or flavors (rasa) is strikingly similar to the corresponding Greek concepts (glyky, liparon, stryphnon, halmyron, pikron, drimy). But, whereas in Hindu medicine these qualities form the basis of dietetics and pharmacology, this is not true of Greek medicine.²⁰ Furthermore, Hindu and Greek physicians concerned themselves with the theory of humors. In India originally, that is before 700 B. C., the number of humors appears to have been restricted to three, while the fourth one, blood, was added later in the works of Caraka and Suśruta. The assumption of an influence of Greek medicine on that of the

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²⁰ On the subject of dietetics, cf. also below, note 30.

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Hindus, at least in this particular instance, seems the more plausible since the fourth humor was never as important as were the other three. Yet the four-humor theory, in Greek medicine, came to the fore at the time of Galen and his successors, while previously its rôle had been insignificant.²¹ Even more important, the Hindu interpretation of the various humors differed considerably from the Greek one. This can be shown of bile, and even more clearly of wind or breath.²² Finally, Hindu medicine did not recognize diseases of the brain; the brain was not regarded as the central organ of thought and consciousness. Thus, the truly startling discoveries of the Greeks were not accepted by the Hindus, and the coincidences, upon closer inspection, also reveal great discrepancies. It is, therefore, safer to suggest an "independent parallel growth and development of ideas, as they could easily come about with regard to the same

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²¹ Since in his lecture Zimmer referred to me as the one from whom he adopted this rather unorthodox view, I think it better here, too, to acknowledge my own responsibility.

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²² Cf. the elaboration of these topics below, pp. 134 ff. The content of the New York lecture is identical with the corresponding sections of the book.

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subjects and problems.”²³ The possibility of an exchange of details must of course be admitted and needs further investigation. Generally speaking, however, “the more archaic system of the Hindus apparently was incapable of influencing Greek medicine and, in turn, remained outside the impact and spread of the Hellenistic achievements.” Notions seemingly kindred are in the last analysis different, and the whole style and character of the two medical systems differ likewise.

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²³ Even in the case of the Greek Pneumatic School, Zimmer does not find any influence of Hindu theory. ²⁴ The nineteen pages preserved (cf. above, p. ix) consist of eleven pages of text and eight pages of notes. The letter accompanying chapter I says that the third chapter would be shorter than the first chapter.

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To turn now to the third chapter: here Zimmer intended to start with a discussion of Hindu materia medica, which as “the foundation of countless prescriptions, forms the most impressive bulk of India’s therapeutical wisdom.”²⁴ Anyone who is not a trained botanist or pharmacologist, and a specialist in the subtropical flora, will find it hard to understand the complex prescriptions that are given. Even for Hindu experts it is extremely

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difficult to identify all the plants mentioned.²⁵ One may say, however, that the prescriptions bear a general resemblance to the traditional pharmacopoeia of Western medicine, as it prevailed before the rise of modern pharmacology and experimental chemistry. An enormous variety of widely differing ingredients were mixed into a kind of arcanum:²⁶

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²⁵ A footnote corroborates this statement by reference to the translation of Caraka Saṃhitā by Avinash Chandra Kaviratna (Part XIV, notice, pp. II-III).

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²⁶ As examples a footnote quotes two prescriptions against disturbances of the wind from "The Āyurvedic System of Medicine, or an Exposition in English of Hindu Medicine, as occurring in Charaka, Suśruta, Vāgbhaṭa and other Authoritative Works in Sanskrit Ancient and Modern, by Kaviraj Nagendra Nath Sen Gupta, vol. I, 1919, vol. II, 1925, Calcutta" (II, p. 400).

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The specific nature of the single drugs compounded into arcana, though they were described as to their flavors, virtues and so forth, remained to a large extent wrapped in mystery; there existed no technique of experimental tests by which the effects of the drugs might be determined. The efficacy of the drugs was more or less a matter of faith, based on ancient usage and previous experience, as such methods prevail among shepherds and old women; yet the doctors professing Hindu or mediaeval medicine had passed examinations and were of the educated and intel-

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lectual classes. Similarly, the wizard, the priest, and the medicine man represent the intellectuals of the primitive age.

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Such a pharmacology by its very nature must be conservative. No item can be omitted once it has been approved by tradition, since it may be just this particular factor that brings about success. If the old mixture proves ineffective, new ingredients are simply added. It is in this way that "the amazing intricacy of traditional recipes comes about in the course of time." Tradition is a burden that grows "more and more cumbersome, not to be lightened by any speculative effort, but apt to be rendered still more ponderous through theorizing, and a certain sophistication." The stubborn adherence to tradition which guided Hindu pharmacology like "a sort of Ariadne's thread," is also the main source of the shortcomings of all traditional knowledge, in so far as it deals with the visible and tangible realm of things and not with the soul and its highest goal, transcendent reality, wisdom and truth beyond the sciences. Traditional medicine and science, outside the pale of modern research, possessed no method for critically sifting by the test of experiment the various resources offered by minerals, vegetables and animals in the way of drugs. The achievement of

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modern research and laboratory experiment, which Paracelsus had in mind centuries in advance, did not dawn upon Hindu medicine.

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Of course, it is possible that behind traditional usage “ there lurks secret truth from which modern research might take its flight toward a new insight.” It has happened over and over again that the knowledge of old women on the basis of scientific investigation was proved to be correct.²⁷ “ Mother India and her aged daughter, traditional medicine with its treasure of materia medica ” may represent the old woman’s true knowledge. One may expect even better results from an examination of Hindu remedies than from that of Western prescriptions. For the latter dealt with items imported from the Mediterranean “ and had gone stale before they reached the mediaeval customer.” Their notions had become estranged from their original background and context through various migrations:

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²⁷ For exemplification Zimmer refers to William Withering's recognition of the effect of digitalis on the heart, to the dysentery cure through a raw apple diet used by German soldiers in 1915 and proved adequate by A. Heisler and E. Moro.

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Hindu materia medica holds a much sounder position. From early times, even before the relatively late invasion of the Aryan tribes in the second millennium B. C., it has grown and matured in the soil of India. It has profited by an uninterrupted contact with the men for whom it was meant, and the products offered by India's soil. During its long development it has accumulated the ever renewed experiences of India's inhabitants, using the resources of their environment for the purpose of healing. With its remarkable insight into the influences of regions and seasons, diet and climate, it records the instinctive and subtle adjustment of the people of India to the peculiarities of her trying climate. Traditional as it is, and overlaid with speculative and systematizing superstructures, it contains the treasure of the " old woman's " experience. " Cowherds and hermits," Suśruta says, " hunters and other people living in the wild forest, those who live on roots, give evidence of the healthy effect of herbs." They supply the medical man with the raw material of materia medica and with the knowledge of the time-tested ways of using it. " Goatherds, shepherds and cowherds," says Caraka (I, 1), " who frequent the woods, and those who live in the woods, know plants by name and sight; but besides knowing the name and appearance of these plants, one should know how to apply them (prāpti). He who knows how to use and combine them (yoga), possesses the knowledge of their essence (tattva-vid). That knowledge charac-

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terizes the true physician (bhiṣaj), and he who knows how to apply them according to consideration of time and place, and with due regard for the nature of the individual patient, ranks as a master-physician.” These are the stages, which, in Hindu medicine, link up mastery in science with primitive intuition into nature’s resources and secrets.

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And Zimmer ends with the statement:

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Rather tardily science enters the scene, and, with the growth of organic chemistry, explains on what basis the divine plant and kindred substances are entitled to their mythical reputation. Man would have starved and perished, failing to outlive the hardships of the stone age, had he waited for the scientific dietician to explain why he should stick to certain food-stuffs and drugs discovered in his environment, why he should stick to this drink or that, in order to overcome some trouble of soul or bowels.

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Traditional belief, unable to analyze and criticize its own experience, stands dumbfounded, if asked its reasons for adhering to its materials or for giving free rein to ideas which do not appeal to the modern mind. It can but point to its real experiences and fanciful formulae; these reflect a combination of inspiring intuitions, beneficial feats of autosuggestion, and actual results which may be corroborated later by tardy science.

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Its experiences and discoveries, however, spring

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from that same genius of intuition and native curiosity which, from the dawn of civilisation, served to guide man in gaining control over his environment; it has the same source as the spirit active in modern scientific methods and technology.

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Many problems of Hindu materia medica might be cleared up by Western botanists and doctors, were they to work on the spot with the assistance of Hindu medical men, and with the people of the countryside, foresters, shepherds, peasants, who supply Hindu doctors with the needed drugs. The particular values of many of these ingredients might be determined by the careful identification of single items of the invariably complex recipes, and by ascertaining the proper action of each separate item.

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Whether these statements on pharmacology were to be enlarged, or what other subjects were to be treated next, it is impossible to say. A batch of pages containing what seem to be final corrections, though not numbered or retyped, deal with diet and the cure of diseases. These topics were also discussed in the lectures of 1940. I shall try to reconstruct from the few corrected pages and from the original manuscript the main outlines of Zimmer’s views.²⁸

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²⁸ Zimmer seems to have worked out the various subjects independently; no transitions are indicated. I have re-arranged the

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Diet is an important part of Hindu medicine, not only as regards the sick but also as regards the healthy. India, with its peculiarly trying climate, is haunted by epidemics and infectious diseases. From these conditions results the extreme instability of human life which is reflected in the common Hindu outlook on human existence and forms the background of the pessimism voiced by the Hindu philosophers. It also determines the specific task of the Hindu doctor. Caution is the watchword: "By an elaborate system of dietetics Hindu medicine teaches man how to keep fit, how to deal carefully with the individual amount of life strength with which his organism has been endowed, how to reach old age, how to enjoy a long and healthy life."²⁹ A balance of the humors is needed and can be established primarily through a proper diet "corresponding to the age of the individual and to the type of organism, whether it is a bilious or a phlegmatic one, or one in

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²⁹ For Hindu medicine as macrobiotics, cf. above, p. xliii.

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thirty-three corrected pages (cf. above, p. ix) in an order that deviates from that in which they were found. The manuscript of 1940 could not be found in its entirety. Even those parts that are preserved are sometimes marked "erledigt," and have already been integrated into the book

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which wind prevails.” An elaborate doctrine of the virtues of all food stuffs is evolved; their qualities are determined by the experiences of the organism in tasting and digesting them. Through their “saps” or “flavors” these various substances are related to the individual substances of the humors, and “a detailed system of the affinities to be traced between these saps and the three humors constitutes the foundation of Hindu dietetics and therapy.”³⁰

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³⁰ The lecture of 1940, after enumerating these saps (6 in number), gave a sort of descriptive catalogue listing all kinds of meats and vegetables and other ingredients of human diet, including medicinal herbs, fruits, roots, and minerals which are fit for medicaments. Two of the corrected pages analyze “the main points to be considered with regard to ordinances about the diet of the healthy and the ailing [are] summed up by Caraka (III, 1, 2) under eight headings.” Three others add that the treatment of particular diseases should be based on the principle *contraria contrariis* (Caraka, I, 10), enumerate the two kinds of poison also used therapeutically and note that 600 purgatives based upon six kinds of vegetable produce are described by Caraka (I, 4).

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As for the causes of diseases, an upset digestion is the foremost among them. Food that is not completely dissolved is regarded as a powerful poison (Caraka, VI, 15). A common cause of many kinds of disorders is the disregard for the basic rules of a carefully controlled diet, as summed

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up by Caraka under the eight headings dealing with the proper use of food, drinks and drugs.³¹

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³¹ Cf. preceding note.

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Taking up the diseases and their cures themselves Zimmer first discusses those caused by foreign bodies, by worms and vermin. Such animals found within the human body are described and classified by Caraka (III, 7). Any cure should proceed along the lines indicated for all kinds of treatment, first by removing the worms through cleansing (samśodhana); next by counter-attacking and "smashing" (vighāta) the matter from which they spring; then through "appeasing" it (samśamana); and lastly by eliminating the cause (nidāna) of the disturbance.

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The fact that the Hindus believe that "the worms " spring from its [the body's] very life substance" gives occasion for a digression that is very characteristic of Zimmer's way of thinking:³²

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³² The English wording of this quotation and of some of those that follow has been slightly changed.

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Even Hegel in his Natural Philosophy, which, by the way, is the weak spot within his encyclopedic doctrine, makes the following bold statement: "it is, however, an erroneous hypothesis to assume that

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tapeworms within the human organism originate from eggs of animals that have been swallowed.” On the contrary, once some part of the organism “no longer acts as a mere moment or element of the whole but becomes ascendant,” that is, once it separates itself from the rest and becomes independent,—a state of affairs that in the case of the humors is described by the Hindu physician as “infuriated” (kupita)—“this separation may lead, e. g. in the case of ‘separated digestion’ (a disturbance of the stomach and of the intestines), even to the generation of animals within the bowels. Moreover, every animal has occasionally worms in its heart, its lungs or its brain.”

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It is partly due to Hegel’s conservative attitude, partly to his romantic view of nature in general, that he could advocate this traditional theory that had been challenged by his contemporaries. What his statement actually means is this: the body is being punished for having failed to subordinate its antagonistic elements or moments to a superior and more perfect whole that enables it to function without disturbance—in other words, for having failed to conform to the dialectical rules of Hegelian philosophy and logic which mirror the very laws of nature.

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According to Hindu cosmology and science, it is characteristic of the living principle that being endowed with an unlimited power of self-transformation it manifests itself in the innumerable forms of matter, be they minerals, vegetables, or animals. It is this

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idea that has again and again assumed command over natural philosophy and that traditional Western learning has in common with Hindu medicine. For the assumption of a living principle constitutes an important check on materialistic views, such as for instance the concept of dietetics, as it was understood not so long ago, and according to which food was considered as dead matter, mere fuel that serves to heat the machine of the living organism,—a very limited view indeed, where food is evaluated solely on the basis of its content of fat and albumen. A boundless vision of life, on the other hand, acts as a kind of romantic counteragent against merely mechanistic theories; it has inspired the detailed and exact investigations of modern scientists who believe that we cannot expect to keep alive by feeding exclusively on devitalized and sterile substance.

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Hindu medicine is based on the idea of a universal living force that pervades everything, the atoms of the elements as well as the higher organisms of men and animals. Whenever Western science has turned toward a monistic principle in order to counterbalance a drift toward over-specialization that threatens to atomize the whole of nature and to hide its broader aspects behind the vast masses of detail, it has met Hindu medicine half-way. At that moment Hindu lore with its semi-mythical method of intuitive speculation appears as a kind of early twilight that preceded the height of the scientific day. It seems to represent

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a pictorial script in which certain lines are indicated that may serve as a guide for modern thought, which with its own critical method attempts to take up and to solve certain problems that are as old as the hills.

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After this digression, individual diseases due to the humors are discussed. The first is elephantiasis. Its description by Suśruta (II, 12) is unsatisfactory from the modern point of view:

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Still, Suśruta’s diagnosis of elephantiasis contains the pertinent comment pointing out the fact that the disease is mostly prevalent in regions where much stagnant water is to be found, an insight that does credit to the subtle gift of observation so conspicuous in Hindu medicine.

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Next, jaundice is dealt with. The chapter that is devoted to this disease in Caraka’s compilation (VI, 16)

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shows what skill classic Hindu medicine, in the course of one millennium, has achieved in diagnosing and treating this and similar maladies as compared with the archaic method of the Vedic period cited above.³⁸

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³⁸ Cf. below, pp. 3 ff.

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One general comment also deserves mention:

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How far an illness may be curable or may tend to be fatal is thought to depend on how far it has penetrated into the different layers of the organism which are continuously built up through metabolism, the sequence of transformations through which the life-sap passes.

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As long as the disease affects only the three or four first stages into which the life-essence of the organism is gradually transformed, blood, skin and flesh, it may be conquered. If it reaches the subsequent stages of metabolism, the more vital and subtle transformations of life substance, namely the bones, marrow and semen, the disease is beyond cure. That is why Hindu medicine insists on early treatment. The morbid matter which at first upsets blood, skin and flesh will invariably reach the more vital layers of the organism through the very alchemy of nature which constantly refines these primitive transformations into the higher ones.

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There follow a short remark on skin diseases (Suśruta, II, 5), a somewhat longer account of abscesses or tumors (Suśruta, II, 9), and finally a section on insanity (Caraka, VI, 9).

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The latter illness lies on the borderline of the natural and the supernatural. For it is to be explained either by a disturbance of the organism—the "incensed" elements overflowing into the

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special canals which carry the subtle mind-stuff—or by the influx of superhuman powers:

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The physician may diagnose a patient as being seized by some god, if, departing from his normal behavior, he adopts in any way the attitude of a divine being—if his glance is mild and placid, his demeanor grave, haughty and unwrathful. In this case the patient does not seem to need sleep; his perspiration and excretion are scanty; his person emits an auspicious odor, and his face looks like a full-blossomed lotus flower. All these are features of the gods: they never grow tired, their subtle bodies do not perspire, nor do they partake of the substantial food of earthly beings; hence the auspicious odor of their persons.

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A patient seized by a goblin (yakṣa) exhibits the various characteristics of that kind of spirit. He laughs frequently, weeps and falls asleep. He is fond of dancing, singing and music. He likes to recite and to tell stories; he longs after food and drink, is fond of bathing, garlands, incense and aromatic substances. His eyes are suffused with blood. He quarrels with Brahmins and doctors and talks to himself.

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A patient invaded by a demon who, roaming by night, devours men and feeds on raw meat, enacts the rôle of this monster (rākṣasa). He never sleeps, refuses food and drink, is fond of swords and knives, of blood and raw meat, and likes garlands of red flowers. His attitude is threatening and reviling.

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In this manner the physician may diagnose what particular kind of superhuman being has got hold of the madman. Prayers, formulae and offerings, to propitiate the intruder, form part of the treatment, if there is any hope. In case the madman, in an act of rage, turns his hand against others or against himself, there is no cure.

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And this observation leads to the remark that

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the popular religious teachings of the Purāṇas and the theories of the medical texts proper agree as to the divine and demonic character of diseases, those in particular whose symptom is fever. The popular compilations, in fact, draw upon the learned texts for their chapters on diseases and healing; what they tell the lay-folk whom they address could as well figure in a medical textbook.

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Fever, for instance, in Brahmavaivarta-purāṇa (Brahmakhaṇḍa, 16, 24 ff.), is described as the most dreadful and irresistible of all diseases, and the origin of other diseases. It is looked upon as a fierce demon with three heads, three legs, six hands and nine eyes. He appears in a terribly deformed shape. His cruelty of nature is counterbalanced by his devotion to Śiva, the supreme lord of destructive forces, demons and spectres; for this reason he is reckoned a great saint. His father, Indigestion, in turn originates from the three humors.

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All diseases, on the other hand, are the sons of

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Death, who in Hindu mythology is a female figure. Her daughter is Decrepitude. Among the means for warding off this powerful daughter of Mother Death, Puranic popular medicine prescribes exercise, walking in the spring season, occasional intercourse with a young girl, regularity in diet, anointing the head and the soles of the feet with oil, covering the body with cooling sandal paste against the heat of the sun, avoiding exposure to the rains, and to the sun in autumn, warm baths in summer, and so forth.

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This much I was able to rescue from Zimmer’s notes and outlines and from his original manuscript.³⁴ Before I leave the reader to study the book itself, I shall adduce some general considerations which I found on two pages of the lectures of 1940. If I am not deceived by my memory, Zimmer concluded the Noguchi course with these remarks. I like to fancy that with them he would also have concluded his book: ³⁵

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³⁴ The appendices, intended to illustrate the entire scope of Hindu medical teaching (Letter of 1942, cf. above, p. ix), were too fragmentary to be included.

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³⁵ Together with the pages from which I quote I found a short note, marked "Conclusion III", which outlines considerations similar to those given on the preceding pages. Unfortunately they are incomplete and can therefore not be used.

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If one looks back now with somewhat mixed and contradictory feelings at the main characteristics of Hindu medicine, one comes to realize how many misunderstandings, if not actual harm, have been caused by the attempt to weave its various features into a logical and systematic pattern. The faulty result of such a procedure implies a warning that that which pleases human reason may be worlds apart from the course that nature takes in weaving its strangely intricate web of devices by which it produces a living organism or brings about the collaboration of the various organs necessary for the continuation of the living process or for its defense against harmful influences. The human mind due to its very faculty of reasoning is apt to fall short of its goal: to grasp what might be called the reality of things, an objective that seems forever to be receding from its grip, even despite the fact that reason at the same time has acquired an ever-increasing hold over nature. The persistent advance into the region of the unknown, into the no-man's land of scientific research, finds its own limitation in the power of reason that is apt to overreach itself by trying to systematize and to simplify the intricate ways of nature.

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As for Hindu medicine, the human mind, starting with primitive experience and acute observation of nature and its resources, was caught in its own net. Medicine remained isolated from the other, subsidiary sciences that should constantly check and criticize its

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own methods and results. In this way, it lacked the power by which to free itself from the net of its own imperfect achievements.

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This negative impression, however, is counterbalanced by the unchallenged reputation that Hindu medicine has enjoyed throughout the centuries. Even today Hindu students of medicine who have been trained in Western critical research get their inspiration from the wealth of information and from the serious endeavor of their ancient predecessors. They feel that if they would succeed in penetrating the primitive experiences and insights that lie buried beneath the huge building of abstract theories, they might be able to contribute new aspects and methods to our present-day knowledge of health and of preventive medicine. The authoritative character of the ancient teaching remains an amazing fact not to be taken lightly or to be disposed of on the ground that it sprang from the naive and primitive archaic mind. Moreover, it must be remembered that Hindu medicine throughout the centuries remained faithful to its ancient tradition. For the prestige and success of the medical profession and its representatives, the actual results in restoring health or saving and prolonging life, which in India were not computed by statistics, are far less important than their consistency with the general outlook on life characteristic of the various epochs. To be sure, the physician is expected to do his utmost in treating diseases of every kind, even to

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work miracles, if he is really competent. Still, it is first of all his moral assistance that is of value to his patient. It is his attitude towards the ailing individual and towards society that really matters, if medicine wishes to receive the credit that it needs in order to pursue its task. As long as medicine is in agreement with the general ideals, views, prejudices and superstitions of its own time and civilization, its actual achievements or shortcomings are of minor importance. They may be left to be discussed by the inner circle of experts who are aware of the limits of their own art.

Linked texts (6)

Carakasaṃhitā — Agniveśa (Āyurveda) & Caraka, Sanskrit
Suśrutasaṃhitā — Suśruta & Nāgārjuna (siddha/alchemist), Sanskrit
Brahmavaivartapurāṇa — Vyāsa, Sanskrit
Kāmasūtra — Vātsyāyana Mallanāga, Sanskrit
Hastyāyurveda — Pālakāpya, Sanskrit
Mātaṅgalīlā — Nīlakaṇṭha (Mātaṅgalīlā), Sanskrit