Charaka Samhita and Sushruta Samhita

by Nayana Sharma | 2015 | 139,725 words

This page relates ‘Ritualism in the Medical Texts’ of the study on the Charaka Samhita and the Sushruta Samhita, both important and authentic Sanskrit texts belonging to Ayurveda: the ancient Indian science of medicine and nature. The text anaylsis its medical and social aspects, and various topics such as diseases and health-care, the physician, their training and specialisation, interaction with society, educational training, etc.

Ritualism in the Medical Texts

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We have attempted to tabulate different therapeutic approaches adopted in the Saṃhitās in respect of some of the principal diseases. The following table helps to indicate the diseases for which magical and religious management is prescribed. Rational treatment here includes pharmacological and surgical measures as well as external therapies.

Disease	Rational treatment	Invocation of deities and religious rites	Magical practices
Fever/Jvara^[1]	√	√^[1]
Haemorrhage/ rakta pitta^[3]	√	-	-
Phantom tumour/gulma^[4]	√	-	-
Obstinate urinary disorders/ prameha^[5]	√	-	-
Skin disorders/kuṣṭha^[6]	√	√^[7]	-
Glycosuria/ madhumeha^[8]	√	√	√^[9]
Tuberculosis/ rājayakṣmā^[10]	√	√	√
Psychological disorders/unmāda^[11]	√	√	√
Epilepsy/ āpasmāra^[12]	√	√ (for exogenous type)	√ (for exogenous type)
Phthsis/ kṣata kṣīṇa^[13]	√	-	-
Oedema/śvayathu^[14]	√	-	-
Obstinate abdominal diseases/udararoga^[15]	√	-	-
Piles/ arśa^[16]	√	-	-
Sprue/grahaṇī^[17]	√	-	-
Anaemia/ pāṇḍuroga^[18]	√	-	-
Asthma/śvāsa and hiccup/hikkā^[19]	√	-	-
Bronchitis/kāsa^[20]	√	-	-
Diarrhoea/atīsāra^[21]	√	-	-
Emesis/chardi^[22]	√	-	-
Herpes/visarpa^[23]	√	-	-
Morbid Thirst/tṛṣṇā^[24]	√	-	-
Poisoning/ viṣa^[25]	√	-	√
Alcoholism/ madātyaya^[26]	√	-	-
Wounds and ulcers /vraṇa^[27]	√	-	√ (for exogenous types)
Reverse movement of wind in the abdomen/ udāvarta^[28]	√	-	-
Dysuria/ mūtra-kṛcchra^[29]	√	-	-
Heart diseases/hṛd roga^[30]	√	-	-
Rhinitis/ pratiśyāya^[31]	√	-	-
Diseases of the head/ śiroroga^[32]	√	-	-
Diseases of the mouth/ mukharoga^[33]	√	-	-
Anorexia/aruci^[34]	√	-	-
Diseases of the ear/ karṇagataroga^[35]	√	-	-
Diseases of the nose/ nāsāgataroga^[36]	√
Eye diseases/netra roga^[37]	√	-	-
Injuries to the eye/nayanābhighāta348	√	-	-
Hoarseness of voice/svara- bheda^[38]	√	-	-
Spasticity of thighs/ūrūstambha^[39]	√	-	-
Diseases caused by vāyu^[40]	√	-	-
Vata-rakta/ gout^[41]	√	-	-
Gynaecological disorders/yoni- vyāpat^[42]	√	-	-
Impotence/klaibya^[43]	√		√^[44]
Menorrhagia/pradara^[45]	√
Abortion and miscarriage^[46]	√	-	-
Fractures and dislocations^[47]	√	-	-
Urinary calculi/aśmarī^[48]	√	√	-
Fistula/bhagandara^[49]	√	-	-
Foetal malpresentation/ mūḍagarbha^[50]	√	√	-
Abscess/vidradhī^[51]	√	-	-
Sinusitis/nāḍī^[52]		-	-
Glandular swellings /granthi, apacī, arbuda, galagaṇḍa (goitre)^[53]		-	-
Elephantiasis/ ślīpada^[54]		-	-
Paediatric diseases / bālagraha^[55]		√	√
Worm infestation/ kṛmiroga^[56]		-	-
Gastroenteritis/ visucikā^[57]		-	-
Alopecia/khālitya, greying of hair (pālitya), etc.^[58]		-	-

From the above table it is clear that magical practices and religious rites are advocated in difficult diseases: fever, consumption, insanity, epilepsy, poisoning and children’s diseases, particularly where it is perceived that the patient has been seized by some external agencies.

Despite the deference to magico-religious elements, the position of medicine in the Saṃhitās is not secondary to ritualism. There are subtle assertions of the effectiveness of medicine over charms and spells. This is brought out by the prescribed line of treatment for cases of poisoning. Caraka lists twenty four therapeutic steps of which the first and second are incantation and ariṣṭa.^[59] Ariṣṭa can imply an amulet potentiated with mantras or a simple tourniquet. Recitation of mantras is regarded as the best measure to counteract the effects of poison.^[60]

Suśruta, on the other hand, recommends tying the tourniquet consecrated with mantras as the primary measure, acknowledging the infallible power of words of the great sages. The text then goes on to explain why medication becomes necessary despite the authority of the sages. The human agency is not infallible; consequently, incorrect chanting and wrong pronunciation can render the incantation ineffective. Consequently, it is advisable to employ agada or anti-venomous medicine in all cases.^[61] Suśruta, hereby, in an understated way, sets forth the case for the reliability of medicine vis-a-vis sacred utterances. This conviction is also evident in the descriptions of effectiveness of the medicinal formulations; they are capable of reviving the near dead^[62] and are hardly ever unsuccessful.^[63]

Again, the same text says: The poison gets completely eliminated with the removal of blood by venepuncture. Hence, blood-letting should be resorted to as the best remedy (paramā krīyā) in snake bites.^[64] Suśruta, hereby, in an understated way, sets forth the case for the reliability of medicine vis-a-vis sacred utterances. This conviction is also evident in the descriptions of effectiveness of the medicinal formulations; they are capable of reviving the near dead^[65] and are hardly ever unsuccessful.^[66]

There is no doubt that perspective of the medical authors is brahmanical considering the importance given to Vedic rites and rituals, and the significance of brāhmaṇas in social etiquette. It is also striking that brahmanical rituals are completely insignificant in graha/bhūta afflictions with the exception of seizure by the deities which requires oblations in the sacred fire.^[67] All the necessary ritual measures are to be taken by the physician. The physicians did not see the role of religion and magic as worthless and outside their own area of interest. This is not to say that medicine relied heavily upon theurgy. Even in external seizures, theurgic practices supplemented clinical therapies. In fact inclusion Bhūtavidyā in the texts is indicative of the recognition of the clinical aspect of these afflictions by the ancient physicians and that they are not entirely supernatural in nature.

The dependence on ritualism is not even throughout the treatises. It is also noteworthy that ritualistic aspect is conspicuously lacking in the entire section of Śālākyā Tantra of the Uttara-tantra of Suśruta’s compendium. Though this section deals with difficult eye surgeries involving damage to the eyeball, nowhere do we find reference to invocations to deities or prayers to brāhmaṇas and physicians which we do in other surgeries. Prayers, supplications, sacrificial offerings and magical practices do find a place in therapeutics but in a supplementary role.

Footnotes and references:

[1]:

Caraka Saṃhitā Cikitsāsthāna 3; Suśruta Saṃhitā Uttaratantra 39.

[2]:

Prayers and magical practices are recommended particularly in intermittent fever/viṣama jvara (Caraka Saṃhitā Cikitsāsthāna 3.292-315) and exogenous fever/āgantu jvara (Caraka Saṃhitā Cikitsāsthāna 3.317-318).

[3]:

Caraka Saṃhitā Cikitsāsthāna 4; Suśruta Saṃhitā Uttaratantra 45.

[4]:

Caraka Saṃhitā Cikitsāsthāna 5; Suśruta Saṃhitā Uttaratantra 42.

[5]:

Caraka Saṃhitā Cikitsāsthāna 6; Suśruta Saṃhitā Cikitsāsthāna 11-12.

[6]:

Caraka Saṃhitā Cikitsāsthāna 7; Suśruta Saṃhitā Cikitsāsthāna 9-10.

[7]:

Not mentioned in Suśruta Saṃhitā Cikitsāsthāna 9-10.

[8]:

Suśruta Saṃhitā Cikitsāsthāna 13.

[9]:

Invocation of Kṛṣṇa while administering tuvaraka oil; Suśruta Saṃhitā Cikitsāsthāna 13.26.

[10]:

Caraka Saṃhitā Cikitsāsthāna 8; Suśruta Saṃhitā Uttaratantra 41.

[11]:

Caraka Saṃhitā Cikitsāsthāna 9; Suśruta Saṃhitā Uttaratantra 41.

[12]:

Caraka Saṃhitā Cikitsāsthāna 10; Suśruta Saṃhitā Uttaratantra 61.

[13]:

Caraka Saṃhitā Cikitsāsthāna 11;

[14]:

Caraka Saṃhitā Cikitsāsthāna 12;Suśruta Saṃhitā Cikitsāsthāna 23.

[15]:

Caraka Saṃhitā Cikitsāsthāna 13; Suśruta Saṃhitā Cikitsāsthāna 14.

[16]:

Caraka Saṃhitā Cikitsāsthāna 14; Suśruta Saṃhitā Cikitsāsthāna 6.

[17]:

Caraka Saṃhitā Cikitsāsthāna 15.

[18]:

Caraka Saṃhitā Cikitsāsthāna 16; Suśruta Saṃhitā Uttaratantra 44.

[19]:

Caraka Saṃhitā Cikitsāsthāna 17; Suśruta Saṃhitā Uttaratantra 51.

[20]:

Caraka Saṃhitā Cikitsāsthāna 18; Suśruta Saṃhitā Uttaratantra 52.

[21]:

Caraka Saṃhitā Cikitsāsthāna 19; Suśruta Saṃhitā Uttaratantra 40.

[22]:

Caraka Saṃhitā Cikitsāsthāna 20; Suśruta Saṃhitā Uttaratantra 49.

[23]:

Caraka Saṃhitā Cikitsāsthāna 21; Suśruta Saṃhitā Cikitsāsthāna 17.4-17.

[24]:

Caraka Saṃhitā Cikitsāsthāna 22; Suśruta Saṃhitā Uttaratantra 48.

[25]:

Caraka Saṃhitā Cikitsāsthāna 23; Suśruta Saṃhitā Kalpasthāna 1.34-85; 2.40-55; 3.6-17; 5.3-86; 7.32-65; 8.42-138.

[26]:

Caraka Saṃhitā Cikitsāsthāna 24; Suśruta Saṃhitā Uttaratantra 47.

[27]:

Caraka Saṃhitā Cikitsāsthāna 25; Suśruta Saṃhitā Cikitsāsthāna 1-2.

[28]:

Caraka Saṃhitā Cikitsāsthāna 26.5-31; Suśruta Saṃhitā Uttaratantra 55.

[29]:

Caraka Saṃhitā Cikitsāsthāna 26.42-76; Suśruta Saṃhitā Uttaratantra 59.

[30]:

Caraka Saṃhitā Cikitsāsthāna 26.77-103; Suśruta Saṃhitā Uttaratantra 43.

[31]:

Caraka Saṃhitā Cikitsāsthāna 26.134-157; Suśruta Saṃhitā Uttaratantra 24.

[32]:

Caraka Saṃhitā Cikitsāsthāna 24.158-186; Suśruta Saṃhitā Uttaratantra 25.

[33]:

Caraka Saṃhitā Cikitsāsthāna 26.187-214.; Suśruta Saṃhitā Cikitsāsthāna 22.

[34]:

Caraka Saṃhitā Cikitsāsthāna 26.215-220; Suśruta Saṃhitā Uttaratantra 57.

[35]:

Caraka Saṃhitā Cikitsāsthāna 26.221-229; Suśruta Saṃhitā Uttaratantra 20.59.

[36]:

Suśruta Saṃhitā Uttaratantra 22-23.

[37]:

Caraka Saṃhitā Cikitsāsthāna 26.231-262; Suśruta Saṃhitā Uttaratantra 9-18.

[38]:

Caraka Saṃhitā Cikitsāsthāna 26.283-290; Suśruta Saṃhitā Uttaratantra 53.

[39]:

Caraka Saṃhitā Cikitsāsthāna 27. Vātika diseases includes a wide range of disorders, such as facial paralysis, lock jaw, convulsions, sciatica, etc.

[40]:

Caraka Saṃhitā Cikitsāsthāna 28; Suśruta Saṃhitā Cikitsāsthāna 4.

[41]:

Caraka Saṃhitā Cikitsāsthāna 29; Suśruta Saṃhitā Cikitsāsthāna 5.

[42]:

Caraka Saṃhitā Cikitsāsthāna 30.63-127.

[43]:

Caraka Saṃhitā Cikitsāsthāna 30.191-204.

[44]:

For impotence caused by abhicāra or black magic; Caraka Saṃhitā Cikitsāsthāna 30.195.

[45]:

Caraka Saṃhitā Cikitsāsthāna 30.227-228.