Medicine in AntiquityPart 2

Prof (Col) Dr RN Basu

• Therapeutics in Ayurveda

• As per aurvedic therapeutic procedure there are five recorded procedures. These are:

• Various kinds of massage

• Anointment with oil, and

• Yoga

• Drugs came from well known plants

• Example:

• Senna was prepared from cassia and was used by vaidyas for two thousand years

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• Surgery

• Charaka and Sushruta achieved considerable success in surgery

• Even transplant surgery was contemplated

• Example:

• Transplant of testes from ram was thought of as a cure of impotence

• Ayurvedic treatise mentions about:

• Caesarean section

• Lithotomy

• Couching the cataract

• Tonsilectomy

• Amputations, and

• Plastic surgery

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• These surgical traditions of Ayurveda posed considerable challenge to Western practices

• In ancient India, the aurvedic surgeons attained considerable success without undertaking any dissection of human body

• Sushruta taught that the human body must be studied by direct observation

• This essential knowledge was required for practicing medicine and surgery

• At that time, there was religious prohibition for dissecting human body

• Sushruta’s innovative ways and methods could circumvent these barriers

• The physicians could study the minutest details of human body

• Whether later physicians practiced Sushuta’s method was not known

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• Ayurveda was equated with Hindu system of medicine

• Apart from Hinduism’s influence on Ayurveda, it also came under Buddhist influence

• There was no separate Buddhists’s system of medicine

• They were using the Ayurvedic system of medicine to treat patients

• Many Buddhists scholar enriched Ayurveda by their positive contribution

• Among them name of Nagarjuna was prominent

• He developed methods to purify many medicinal preparations to make them non-toxic

• During Buddhist prominence, a famous university near Patna was set up. This was the Nalanda university

• It was claimed that Nagarjuna was associated with Nalanda University

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• Unani medical system

• Muslims made noteworthy contribution in the field of medicine

• The Muslim rulers introduced unani system of medicine in India

• The word unani is an Indian version of Greek medicine Ionia

• Unani system was founded by Hippocrates

• This system was based on humoral theory

• According to humoral theory, there are four humours

• These are:

• Blood (dam or khun)

• Phlegm (balgham)

• Black bile (al-mira assawda)

• Yellow bile (al-mira as-safra)

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• According to Hippocrates system, health depended on balance between these humoral elements

• Any change in the balance brings about changes in body and health

• Hakim is a title by which unani physicians are known in India

• There are two major categories of hakim

• Some come from Arabian peninsula or Persia

• They were employed by Indian Govt. on contract basis

• Some of them settled down in India, rest returned to their country

• Muslim rulers patronised the unani medical system in India

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• Gradually unani medicine became the main mode of treatment for the urban elite

• Mughal empire established many hospitals, clinics and other medical units

• Emperor Akbar (1556-1606) was the pioneer in this regard to build hospitals in many parts of Delhi and Agra

• Later Aurangzeb also had set up hospitals in many provinces and smaller towns

• Ayurveda somewhat lost its prominence during this time because of lack of patronage from the rulers

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• Ayurvedic texts were translated into Arabic by the physicians like Avicenna

and Razi Sempion.

• Both of them quoted Indian Ayurvedic texts and established Islamic medicine

"Unani System”

• By the 13th,Century Unani system of medicine was firmly established mainly in

Delhi, Aligarh, Lucknow and Hyderabad.

• During Mughal period and subsequent years Ayurveda declined due to the lack

of state support.

• With the advent of the British in the 18th Century Ayurveda system was revived

in India along with Western system of Medicine.

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• Siddha

• It is a traditional medical system in India

• It is of Dravidian origin and its entire literature is in Tamil

• Its origin is traced to Shaiva tradition

• According to the tradition, Lord Shiva conveyed the knowledge of medicine to Parvati

• Parvati was Lord Shiva’s wife

• This knowledge was passed on to Nandi

• Finally, the knowledge was given to Siddhas

• Siddhi mean that achievement of objective after long penance

• Those who have attained Siddhi are Siddhas

12https://www.infinityfoundation.com/mandala/t_es/t_es_tiwar_siddha.htm

• According to tradition there were 18 Siddhars

• They were:

• Nandi, Agasthiyar, Thirumular, Punnakkeesar, Pulasthiyar, Poonaikannar, Idaikkadar,

Bogar, Pulikai isar, Karuvurar, Konkanavar, Kalangi, Sattainathar, Azhuganni, Agappai,

Pumbatti, Theraiyar and Kudhambai, but the Agasthiyar (Agastya)

• Among them Agasthiyar was most prominent

• He was the originator of Siddha medical system and also of Tamil language

• During the period of Ramayana, he settled down in South India

• Origin of every tradition in South India is traced back to Agastya

13https://www.infinityfoundation.com/mandala/t_es/t_es_tiwar_siddha.htm

• The basic concepts of the Siddha medicine is the same as that of Ayurveda

• Siddhars believed that a healthy soul can only be developed through a healthy body

• Intense yogic practice was an important part of Siddha medicine

• According to the Siddha medicine various physiological and psychological functions of the body are attributed to the combination of seven elements: • first is saram (plasma) responsible for growth, development and nourishment;

• second is cheneer (blood) responsible for nourishing muscles, imparting colour and improving intellect;

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• the third is ooun (muscle) responsible for shape of the body;

• fourth is kollzuppu (fatty tissue) responsible for oil balance and lubricating joints;

• fifth is enbu (bone) responsible for body structure and posture and movement;

• sixth is moolai (nerve) responsible for strength; and

• the last is sukila (semen) responsible for reproduction.

• Siddha medicine also has similarity with Ayurveda

• The physiological components of the human beings are classified

as Vatha (air), Pitha (fire) and Kapha (earth and water).

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• Western Medicine• Europeans introduced Western medicine in India

• The Christian missionaries were very active in promoting the Western system

• During the British colonial rule, for army’s interest, some Indians were given training in Western medicine

• A Native Medical School was opened in 1822 in Kolkata• 20 students were admitted

• A committee in 1833 found the condition of medical training was defective

• Immediate closure of the school was recommended

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• The committee also recommended formation of a Medical college for

Indians with Western system of medical training

• The medium of training recommended was English

• On the recommendation of the Committee, a Government Order No.28

of 28th January 1835, Medical College of Bengal was established.

• This day is still celebrated as the Foundation day of the Calcutta Medical College.

• A small hospital consisting of 20 beds was established on 1st April

1838. In 1840 a large Hospital for women was founded with 100 beds

to afford instruction in Midwifery

17H Roy. History of Medicine with Special Reference to India. Available at http://www.histopathology-india.net/history_of_medicine.htm. Accessed 10 Oct 2018

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MEDICAL COLLEGE BENGAL : Est 1835

• Women in Medicine

• In the year 1847 Elizabeth Blackwell from U.S.A. became the first women to graduate from Geneva Institute.

• "Women’s Medical College of Philadelphia“ was founded In 1850

• In UK Elizabeth Garatte in 1865, completed the course from Middlesex Hospital

• But the Board of Management did not allow her to take the examination.

• She obtained the Diploma of Society of Apothecaries in 1865 and opened an out-door dispensary named "Garatte Hospital“

19http://www.histopathology-

india.net/history_of_medicine.htm. Accessed10 Oct 2018

• In 1870, Elizabeth Garatte obtained the M.D. degree of Paris.

• In 1876, Sophia Jex Black received the degree from Edinburgh University,

• It had to be withdrawn due to social disturbances.

• Madras Medical College trained four women doctors fully trained according to the regulations, in 1878

• In Bengal, this question was first raised in the year 1876 and

• Response was favorable from Lt. Governor Richard Temple,

• It was not translated into action

• In 1881, it was reconsidered and the Government took a liberal view

• The matter was facilitated and even a scholarship of Rupees 20 was paid to every woman student of medical college

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• In Bengal, Mrs. Kadambini Ganguly was the first native lady graduate of the Calcutta University in 1887.

• Mrs. Ganguly went to England and became a Licentiate in Medicine and Surgery.

• During the year 1925 to 1931 very few lady students were admitted to the Medical College.

• For lady students, it was compulsory to stay in Swarnamoyee Hostel.

• Most of the Hostel students were Anglo-Indians, Christians, Brahmos, Parsis and so on.

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• Classical• Until recently, Western historians generally ignored China

• Work of some scholars, however, placed the Asian science and medicine in its proper perspective

• These works have helped in redefining the place of Asian contribution in medicine

• Traditional Chinese medicines and healing techniques have gained a significant place in Western world today

• China has kept its traditional medicine alive in folk lores as well as in mature and respected forms

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• Contd.• Since 1970’s, Chinese archaeologists discovered a golden past history

• Ancient tombs contained magnificent wall paintings and manuscripts• These were written on bamboo or silk

• China’s history was blurred in centuries of warfare and chaos

• Emperor Shih Huang-ti wanted total reorganisation in order to eliminate all unacceptable historical traditions• He ordered destruction of all old manuscripts and much of historical traditions

were lost

• Before the unification done by Ch’in in 221 BCE very little survived

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• Contd.

• Huang Ti reigned for about 100 years

• He was the last legendary emperor

• He gave his people the wheel, the magnet, an astronomical observatory, the calendar, the art of pulse measurement, and the Huang-ti Nei Ching (The Inner Canon of Yellow Emperor)

• The canon inspired and guided Chinese medical thought for over 2500 years

• Like many ancient texts, the inner canon was also corrupted by addition, deletion and misprints

• The existing text is very ancient and may be of the first century BCE

24LN Magner. A history of medicine, 2nd Ed. Taylor & Francis, Bota Racon

• Contd.

• Old texts that were buried with their owner during 2nd century BCE have been recently recovered in Mawangdui, Hunan in 1970s

• These have provided new insights into Chinese medical thoughts

• Therapeutics in older texts included medicinal drugs, exorcisms, magical and religious techniques and surgical operations

• Acupuncture was the major therapeutic technique mentioned in the Inner Canon

• This was not mentioned in the Mawangdui manuscripts

• The conversation between Emperor Huang Ti and his health minister explores the medical philosophy based on the balance of yang and yin

25LN Magner. A history of medicine, 2nd Ed. Taylor & Francis, Bota Racon

• Contd.

• The terms yin and yang represent the pairs of opposits

• These opposits represent the dualism of cosmos

• Yin is characterised as

• Female, dark, cold, soft, earth, night and empty

• Yang is characterised as

• Male, light, warm, firm, heaven. Day, full and so forth

• Yang and yin are relational concepts

• Their characteristics are exhibited in comparison to other entities and states

26LN Magner. A history of medicine, 2nd Ed. Taylor & Francis, Bota Racon

• Contd.• Chinese medicine knew about the blood circulation long before Willium

Harvey was credited with the discovery of circulation of blood

• As per Cinese medical philosophy, disease is caused due to imbalance between yang and yin

• As described in Inner Canon, the yin and yang and the five phases are closely related to the • Fve “firm organs” like heart, spleen, lungs, liver, kidney, and

• Five “hollow organs” like gall bladder, bladder, stomach, large intestine and small intestine

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• Acupuncture and Moxibustion• Acupuncture is about 2500 years old

• In this, needles are inserted in some specific parts of the body

• Moxibustion is a related technique• In this burning tinder made from the powdered leaves of Artemesia vulgaris

(नागदोना, নাগদানা)is applied to specific parts of the body

• This may be more ancient than the art of needling

• Acupuncture has been accepted in the West but moxibustion has been ignored

• It is claimed that moxibustion is not painful

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• Food lore

• In Chinese medicine properties of some food was used for treating diseases

• Some beliefs were also associated with some food

• Tea

• Use of tea illustrates the overlap between food and drug

• Use of tea as medicine is almost 6000 years old

• Its food value is low but it contains many active alkaloids

• Modern medicine is also now recognising the importance of food for causation and remediation of some diseases

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• Surgery• It remained mostly outside the domain of Chinese medicine

• This could be due to reluctance to mutilate the body • There was lac of dissection based anatomical knowledge

• This hindered development of surgery

• Forensic medicine however became quite sophisticated• The text “The Washing Away Wrong” is considered as the world’s first treatise on

forensic medicine

• Chinese scholars defend the lac of surgical practice by saying that preventive and therapeutic advancement made surgery unnecessary

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• Contd.• Hua t’o was a famous Chinese surgeon

• He invented anaesthetic drugs, medicinal bath, hydrotherapy and medical gymnastics

• He was a master acupuncturist and a brilliant diagnostician

• He could cure migraine with a single needle

• He was executed by Emperor Ts’ao Ts’ao because Hua t’o prescribed trephining instead of acupuncture for his intractable headache• Thinking that it was a plot for his assassination

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• Greek History of Medicine

• Very little historical material is available to determine the early history of Greek medicine

• As a result an impression has been gained that unlike Indian, Chinese and Egyptian medicine, emerged suddenly

• Intellectual traditions established in ancient Greece provided the foundation of Western philosophy, science and medicine

• The early history of Greece can be divided into two periods:

• The Mycenaean – from 1500 BCE to the catastrophic fall of Mycenean civilization about 1100 BCE

• Dark ages from about 1100 to 800 BCE

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• Contd.• Greek medicine was portrayed by Homer in his epic poems Illiad and

Odyssey

• Greek medicine was an ancient and noble art

• Apollo was the most powerful of the God physicians• Apollo could cause epidemic disease as a form of punishment or restore and heal

the wounded

• People worshiped Apollo in his famous temple of Apollo at Delphi

• In Illiad the skilful physician was praised as a man more valuable than many others

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• Contd.

• Modern Western medicine traces its origins to the rational, scientific tradition associated with Hippocrates

• Classical Greek physicians traced their art to Asclepius

• Asclepius was the Greek God of medicine

• Asclepius was the son of Apollo

• The sons of Asclepius were also warriors and healers

• Their special talents were futuristic

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• Hippocrates and the Hippocratic Tradition• Hippocrates (ca. 460-360) has become synonymous with the phase

“Father of Medicine”

• Hippocratic tradition established medicine as an art and science

• One of the most important and characteristics expressions of Hippocrates medicine is found in the text “On Ancient Medicine”• It maintains that nature itself has strong healing forces

• The purpose of the physician was to cultivate techniques that would work in harmony with natural healing forces

• This is to restore body to a harmonies balance

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HIPOCRATES

1. LN Magner. A History of Medicine, 2nd Ed. Taylor & Francis, Boca Raton

2. MN Islam. Chinese and Indian Medicine Today. Springer, Zhuhai, China

3. P Distelzweig, B Goldberg, ER Ragland, Ed. Early Modern Medicine and

Natural Philosophy. Springer, Notre Dame, USA

4. V Nutton. Ancient Medicine. Routledge, London

5. A Winterbottom, F Tesfaye, Ed. Histories of Medicine and Healing in the

Indian Ocean World, Vol 2. Palgrave, Macmillan

6. B Debroy, D Debroy, The Rig Veda. Books for All, Delhi

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