Chapter 26 - State and Medicine

As the food, water and clothes make the primary necessity of every individual so also the healthful living occupies a very important place. Now in as much as public health depends upon every individual, it is no less dependent on the state also. Therefore it is, that medical aid forms an essential part in the administration of the State

For the preservation of health, the State has first to look after the sanitation of the country by laying down rules as to where the rubbish of garbage should be thrown, where and how the gutters and the drainage system should work, where and how the quality of food and drink as well as that of vegetables should be preserved and how the infections should be avoided. Kautilya suggests the following line in this behalf.

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“There are eight kinds of providential visitations. They are fire, floods, pestilential diseases, famine, rats, tigers, serpents and demons From these shall the king protect his kingdom”.

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“Whoever throws dirt in the street shall be punished with a fine of one-eighth of a Pana; whoever causes mire or water to collect in the street shall be fined one-fourth of a Pana. Whoever commits the above offences in the king’s road shall be punished with double the above fines Whoever excretes feces in places of pilgrimage, reservoir of water, water, temples and royal buildings shall be punished with fines rising from one Pana and upwards in the order of offences.”

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“From each house a water course of sufficient slope at a distance of 3 Padas or 1½ Aratnis from the neighbouring site shall be so constructed that water shall either flow from it in a continuous line or fall from it (into the drain). Violation of this rule shall be punished with a fine of 54 Panas.”

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“If a pit, steps, water-course, ladder, dung-hill or any other parts of a house offer or cause annoyance to outsiders, or in any way obstruct the enjoyment of others or cause water to collect and thereby injure the wall of neighbouring house, the owner shall be punished with a fine of 12 Panas. If the annoyance is voidance of feces and urine, the fine shall be double the above. The water course or gutter shall offer free passage for water, other wise the fine shall be 12 Panas.”

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“When a person sells rotten flesh, he shall either have his two legs and one hand cut off or pay a fine of 900 Panas.”

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“Such remedial measures as will be treated of hereafter, shall be taken against pestilences Physicians with their medicines, and ascetics and prophets with their auspicious and purificatory ceremonials shall also overcome pestilences. The same remedial measures shall be taken against epidemics”.

“With regard to cattle diseases, not only the ceremony of waving lights in cow-sheds shall be half done but also the worship of family gods be carried out.”

These being the preventive precautions and measures the state has secondly, to pay attention to the curative measures. For this purpose, the state has to establish and maintain hospitals, provide physicians—civil, military and veterinary, and surgeons, and algo nurses and midwives. The health of animals was as important to the state as that of the people and for that purpose, every effort was made to render medical aid to them also. There were hospitals for the aged, the poor and the helpless, the children and the animals, and maternity hospitals for the pregnant women.

[Kauṭilya Arthaśāstra]

“The king shall provide the orphans, the aged, the infirm, the afflicted and the helpless with maintenance. He shall also provide subsistence to helpless women when they are carrying and also to the children they give birth to”

The state took great pains in growing, preserving and dispensing medicinal herbs, and severe punishments were inflicted on those who injured or showed cruelty to plants or to animals.

[Kauṭilya Arthaśāstra]

“For causing pain with sticks etc, to minor quadrupeds, one or two Panas shall be levied; and for causing bleeding to the same, the fine shall be doubled.”

[Kauṭilya Arthaśāstra]

“For cutting off the tender sprouts of fruit trees, flower trees or shady trees in the parks near a city, a fine of 6 Panas shall be imposed, for cutting off the minor branches of the same tree, 12 Panas; and for cutting off the big branches, 24 Panas shall be levied. Cutting off the trunks of the same, shall be punished with the first amercement, and felling the same shall be punished with the middlemost amercement”.

Moreover every protection was offered to men and animals against poison, carnivorous animals and serpents.

[Kauṭilya Arthaśāstra]

“He shall protect agriculture from the molestation of oppressive fines, free labour, and taxes, herds of cattle from thieves, tigers, poisonous creatures and cattle disease.”

The state enacted laws for the sale of drugs, spirit and liquor, and for the post-mortem examinations and for the sexual contacts Kautilya mentions that:

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“On special occasions, people shall be allowed to manufacture white liquor, Arista used in diseases and other kinds of liquor.”

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“In death due to poison, the undigested portion of meal may be examined in milk Or the same extracted from the belly and thrown on fire may, if it makes ‘cita-cita’ sound and assumes the rainbow colour, be declared as poisoned. Or when the belly remains unburnt, although the rest of the body is reduced to ashes, the dead man’s servants may be examined as to any violent and cruel treatments they may have received at the hands of the dead.”

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“When in her own house, prostitute deprives her paramour of his enjoyment, she shall be fined eight times the amount of the fees, unless the paramour happens to be unassociable on account of disease and personal defects”.

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“If many or all of them (wives) are at the same time in menses, he shall lie with that woman among them after the menstrual bath whom he married earlier or who has a living son. In case of his concealing the fact of her being in menses or neglecting to lie with any of them after her menses, he shall pay a fine of 96 Panas. Of women who either have sons or are prous, or barren or bring forth only a dead child or are beyond the age of menstruation, none shall be associated with against her liking. If a man has no inclination, he may not lie with his wife who is either afflicted with leprosy or is a lunatic. But if a woman is desirous of having sons, she may lie with men suffering from such disease”.

The state levied tax on herbs and drugs, and prescribed punishments for abortion, poisoning, rape and sexual crimes.

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“Those that trade in cotton threads, clothes, copper, brass, bronze, sandal, medicines and liquor shall pay 40 Karas”.

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“No man shall have sexual intercourse with any woman against her will.”

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“When a senseless man has sexual intercourse with beasts he shall be fined 12 Panas, when he commits the same act with idols of goddesses he shall be fined twice as much”.

Even the kings honored the medical profession and according to circumstances they gave presents to the physicians and nurses, and rewarded them in cash and kind, after long and serious ilness, after victory in a battle and after a happy delivery.

Thus the first physician and his profession were highly regarded the and the state in no way lagged in helping them and thus contributed to the moral uplift and to the elightened condition of the state laws by making medical aid available in its true sense.