Chapter 27 - Quacks (Kuvaidya or Kuhaka)

At all times there have been quacks in every profession. But the most dangerous of them is the quack in the medical profession, as into his hands is entrusted the responsibility for life or for death. The society of the times depicted in Caraka, had a wholesome dread of the medical quack and these quacks must have been quite numerous considering elaborate manner Caraka describes them in, referring to their pretentious manners, speech and equipment Setting out the difference between the good and learned physician and the ignorant quack, Caraka declares that in the hands of the former, diseases melt away like the “fairy city” while in the hands of the quack hundreds of lives are lost.

At the time of Caraka, the conditions of society seem to have been very favourable for the existence and flourishing of quacks. They seem to have gone about decked in the conventional garments of physicians and to have displayed lavishly all the appurtenances of the medical profession Caraka refers to these quacks in varied circumstances, and the following extracts indicate the vehemence with which Caraka thought it necessary to condemn the quack and warn society against his attentions and mischief.

[Carakasaṃhitā Sūtrasthāna 1.127]

“Therefore the intelligent man, who desires health and long life, should not take any medicine prescribed by a physician who is a stranger to the art of application.”

[Carakasaṃhitā Sūtrasthāna 1.128]

“One may survive the fall of a thunderbolt on one’s head, but one cannot expect to escape the fatal effects of medicine prescribed by an ignorant physician.”

[Carakasaṃhitā Sūtrasthāna 1.131-132]

“It is better for the person who has put on the garb of the physician to quaff the venom of the cobra or to swallow heated iron balls than to extort food, drink or money from a man who is afflicted with disease and has sought his aid.” [Carakasaṃhitā Sūtrasthāna 9.14]

“If the other three factors being given, serious diseases, demanding attention and treatment, are sometimes seen to vanish like a city of illusion and at other times to get aggravated, the cause is to be found in the physician who is wise in the first instance and ignorant in the second instance”

[Carakasaṃhitā Sūtrasthāna 1.15-116]

“It is better for the quack to offer himself up in the fire than enforce his treatment on the patient. Like a blind man groping about with his hands in fearful uncertainty, or like a (rudderless) canoe left to the mercy of the winds, the ignorant physician proceeds in his work full of uncertainty and fear”.

[Carakasaṃhitā Sūtrasthāna 9.17]

“Emboldened by meeting with providential success in his treatment of a patient destined to survive (both the disease and his ministrations) the pretentions quack hastens to death a hundred others whose tenure of life is not so definite”.

[Carakasaṃhitā Sūtrasthāna 11.50]

“Regarding the three kinds of physicians, three kinds of medical practitioners are found in the world; firstly, the impostors in physician’s robes; secondly, the vain-glorious pretenders; and thirdly, those endowed with the true virtue of the healer”.

[Carakasaṃhitā Sūtrasthāna 11.51]

“Those who by parading their medical paraphernalia, books, models, smattering of medical texts and knowing looks acquire the title of physician, are the first kind, viz, the ignoramuses and impostors”

[Carakasaṃhitā Sūtrasthāna 11.52]

“Those who by laying claim to association with persons of established wealth, fame knowledge and success, while they themselves have none of these things, arrogate to themselves the designation of physicians, are the vain-glorious pretenders”.

[Carakasaṃhitā Sūtrasthāna 29.10-11]

“Those who putting on the garbs of physicians, thus gull their patients, just as the bird-catchers in the forest (gull) the birds by camouflaging themselves in nets, such persons, outcastes from the science of healing, both theoretical, and practical, of time and of measure, are to be shunned, for they are the messengers of death on earth.”

Having warned against inviting their services, Caraka goes to describe the ignorance and hollowness of these pretenders and of how they avoid the presence and contact of the really learned physician, lest they be found out.

The quacks of medicine as those of all other professions, possess only the externals of the profession, and try to impress the ignorant by a smattering of the professional clap-trap of maxims and platitudes. They never have access to the sources of the science, nor practice in the application of remedies. They learn to mouth a few seemingly wise slogans and catch-phrases and make a show of skill that they do not possess. They make up their lack of wisdom by braggadocia and bluster.

The following extracts from Caraka on these aspects of the quack are illuminating.

[Carakasaṃhitā Sūtrasthāna 29.12]

“The discriminating patient should avoid these unlettered laureates, who put on the airs of physicians for the sake of a living, they are like serpents that have gorged on air”.

[Carakasaṃhitā Sūtrasthāna 30.74]

“The men of little learning, the weaklings, are put into a flutter by the very sounds of the medical scriptures, like a bevy of quails at the mere sound of the bowstring”

[Carakasaṃhitā Sūtrasthāna 30.75]

“Sometimes an animal (which is not a wolf) taking advantage of the weakness of others of its kind, plays the wolf, meeting however with a real wolf, the creature reverts to its true nature”.

[Carakasaṃhitā Sūtrasthāna 30.76]

“In the same manner an ignoramus given to blatant displays, establishes himself as an exponent in the midst of others who are equally ignorant; meeting, however, with a true exponent, he is nonplussed”

[Carakasaṃhitā Sūtrasthāna 30.77]

“The ignoramus possessed of little learning (but full of pretentions) is like a pole cat hidden in its own bristles, what can such a one, comparable to a low-born idiot, say in a debate?”

[Carakasaṃhitā Sūtrasthāna 30.78]

“The physician should not engage in dispute with godly men, though they be of little learning, with a view to discomfit them; but one should not scruple to demolish by means of the eightmembered questionnaire, the others, who pose as experts”.

[Carakasaṃhitā Sūtrasthāna 30.79]

“The pretentious and obstreperous wiseacres are generally given to much and loose talk. The godly are generally fair-spoken and are circumspect and of few words”.

It is interesting to note that the term applied to such a charlatan and ignorant cheat in Sanskrit is a Kuvaidya or Kuhaka; the latter meaning a cunning or sinful man. The English term of ‘quack’ having the same or similar connotation suggests its evolution from the original ‘Kuhaka’:—

kuhakah shastrahinah paramavishvasakarako mayavi |

The English synonyms like pretender, charlatan etc, are reflected in this definition of the quack.

It is easy to infer the circumstances that gave rise to the abundance of quacks. The medical profession was among the professions held in great esteem in society. As we have already seen, the physician held, a high place in the society and was regarded as the guide and friend of the people. His emolumeuts in the profession were evidently considerable and aroused the envy of ambitious individuals who aspired for such a status but had not the equipment for it. Such naturally turned into quacks and acquiring the external accomplishments of manner, speech and professional catch phrases, imposed on the ignorant and gullible and made their fortunes. Such indeed are the quacks in every age, and the attention devoted by Caraka to them and their methods, and the passion with which he condemns their evil, are evidences of the prevalence in undesirable numbers of the members of this deceitful tribe

It is interesting to read Caraka describing the cunning tactics of the quack in snaring patients into his net, but, how he disappears at a critical stage of the patient:

[Carakasaṃhitā Sūtrasthāna 29.9]

“Tricking themselves out in the height of medical fashion, they walk the streets with a view to picking up practice. Immediately on hearing that somebody is ill, they swoop down on him from all quarters, and in his hearing speak loudly of their medical attainments. If a doctor is already in attendance on him, they make repeated mention of his failings. They try to ingratiate themselves with the friends of the patient by suave manners, knowing whispers and officiousness. They make it known that they accept little (by way of remuneration). On being entrusted with a case they look out on all sides repeatedly, trying to cloak their ignorance.

Finding themselves unable to check the course of 'the disease, they give it out that it is the patient himself who is wanting in the necessary appurtenances, in attendants and in self-control. When they realise that the patient is at death s door, they make themselves scarce and seek another neighbourhood. In the presence of uncultured people they brag about their adroitness in the most unadroit manner and like the ignoramuses that they are, they run down the learning of the savants. But if they sight a company of the learned, they slink away from a distance, like a roadster at the sight of a dark wood. If by any chance they happen to have conned a stray maxim, they constantly quote it in season and out of season. They can brook neither being questioned nor questioning others. They dread questions as ii they were the devil. People such as these, reck not for either teacher, disciple, co-student or disputant”.

We may conclude this study of the quack in the medical profession by the popular saying that obtained currency in much later times than Caraka wherein the quack is dubbed the elder brother of Yama, the god of death. In the West quacks are facetiously known as ‘The Arms of the Honourable company of Undertakers,’ which is akin in spirit to the Indian saying referred to above which runs thus:—

[...]

“Salutations to you, O, elder brother of Yama! Yama takes away, only our lives; but you take away our lives as well as our wealth.”

The institution of quackery flourishes wherever there is a rigorous standard demanded of the genuine man of the profession, which is not within the easy acquisition of all people Strenuous years of study and practice and then again approval by the state are needed for the profession. Naturally a host of impostors arise who secretly carry on their trade among the ignorant and the gullible. Caraka says that such quacks flourish and go about at large only at the connivance of the king (state). Thus a great responsibility rests on any civilized state i e., to see that such ignorant and pretentious cheats are not allowed scope to work havoc among the common people. The ancient state in India, judged by the secret methods of the quack as portrayed in Caraka, seems to have fulfilled its responsibility in this respect in a laudable measure.