History of Indian Medicine (c): Shramanic Phase

Scholars were only able to ascertain two phases of medicine in ancient India–the Vedic phase and the classical phase of systematic and empirical Āyurveda. The latter was represented by the classical medical treatises (such as the Caraka Saṃhitā, the Suśruta Saṃhitā, and the Bhela Saṃhitā), which are dated in the centuries around the turn of the Common Era.^[1] As mentioned, the Vedic phase of Indian medicine was characterised by the religious and magical approach, while the classical Āyurvedic system was empirical and rational. There was an obvious difference between these two traditions, suggesting a significant development of Indian medicine during the intervening period from approximately the ninth century Before Common Era to the beginning of the Common Era. This interval has no known medical texts that have come to us.^[2] Medical records, nonetheless, have been noticed in early Buddhist literature (the early discourses and disciplinary texts) belonging to this period, which show close similarities to those of the classical Āyurvedic literature. This reveals a continual development of the medical knowledge and practice. It also points out the significant role of the wandering ascetics, especially Buddhist monks, in this gap of Indian medical history (Wujastyk 1993, 758;2003a, 396-397; Zysk 1991, 4-6).

The medical development in this intervening period between Vedic medicine and Āyurveda has been well illuminated by Zysk (1991), after his careful examination of Vedic sources and early Buddhist literature. According to Zysk’s noteworthy study, the healers in this epoch–as mentioned earlier–possessed ritualistic skills for healing and knowledge of medicinal substances. They were respected by society and were able to gain good livings. However, they were looked down upon by the elite class of brahmins, and were excluded from sacrificial activities due to their contact with impure people. They were marginalised and disparaged by the priestly order, as evidenced in the Vedic literature such as the Vedas and the later Brāhmaṇas. These physicians might have wandered to practise healing and to learn new knowledge and remedies, as well as to discuss and exchange what they knew with other physicians, like those knowledge-seeking wandering ascetics. ^[3] They could easily be accepted by the communities of wandering ascetics, for these heterodox communities would not defame their philosophies, practices, or associations with different social groups of people while engaging in healing. They could associate freely with the ascetics, and even became indistinct from them. With the wandering ascetics, the physicians could share their medical knowledge and skills. In this way, the medical lore would have thrived within the śramaṇ-ic communities. Amongst these communities, Buddhist monks, compared with other wandering ascetics such as the Jains and the Ājīvakas who practised self-torture and paid no care of the physical body, would have been more receptive to such medical lore because they followed the doctrine of the Middle Path (Pāli: majjhimā paṭipadā; Sanskrit: madhyamā pratipad) that teaches the avoidance of extremes (such as self-torture and sensual indulgence). These physicians could join and stay with the Buddhist groups, and exchange their knowledge with the monks (some of whom may have been physicians).^[4] Such medical lore therefore could have accumulated amongst the members of the Buddhist community. Hence, a large body of the new empirical and rational medical knowledge could have developed among the Buddhist monks (and nuns), and could have been preserved in the Buddhist literature (including the Vinaya Piṭaka) (Zysk 1991, 5-6, 21-27, 37, 39; 1996, xiiixvi).

Zysk’s influential theory–that the physicians became more associated with the wandering ascetics due to being socially marginalised and this resulted in a large corpus of new medical information being preserved in the communities of ascetics, especially the Buddhist community–is supported by the fact that there is a high degree of similarity between the medical information found in early Buddhist literature and that found in classical Āyurvedic texts. By comparing the medical facts in Buddhist texts and those in classical Āyurvedic texts, Zysk (1991, 73 ff.) has noticed well-categorised medicinal substances of food, herbs, salts, etc. in Pāli Buddhist literature and which are found in similar lists of substances in the Āyurvedic sources. Some treatments also show resemblances between the two sources. In addition, eight causes of illness mentioned in the Pāli texts (e.g. the Saṃyutta Nikāya (Saṃyutta Nikāya) IV. 230-231) find parallel information in the Āyurvedic system,^[5] as pinpointed by Zysk (1991, 30-31). All these, therefore, point to the likelihood that the medical lore in Āyurveda–at least part of it–may have been developed from the Buddhist and other śramaṇ-ic communities, as advocated by Wujastyk (1993, 758; 2003a, 397; 2005, 1410).^[6]

Another piece of evidence supporting Zysk’s proposition comes from an ancient Greek account. It is recorded, in Geography, composed by Strabo, an ancient Greek philosopher and historian in early first century Common Era, that a Greek ambassador to India, Megasthenes, at the time of Emperor Aśoka (reign 268-232 Before Common Era), had noted two kinds of philosophers: the brahmins (brachmanes; βραχμᾶνες) and the wandering ascetics (sarmanes; σαρμᾶνες).^[7] According to this account, there was a kind of physician belonging to the group of wandering ascetics. These physicians were similar to the ascetics in living and they practised medicine with both medicinal substances and magical rituals/objects (Majumdar 1960, 275). This evidence supports the close relationship between the physicians and the wandering ascetics, and the probable involvement of the ascetics in the development of ancient Indian medicine.

The intervening gap in the history of ancient Indian medicine–between the religious and magical medicine of the Vedic phase and the systematised and empirical medicine of the Āyurveda–has now been investigated and explained by scholars’ research. By examining the social situation of the healers, the medical material preserved in Buddhist literature and the foreign records, it is believed that the śrāmaṇas played a significant role in the development of Indian medicine. The physicians at this time, being marginalised by the priestly order, wandered around to practise healing and to gain new medical knowledge. Due to their association with the śramaṇas, a lot of such new empirical medical lore has been developed amongst the śramaṇas and kept in their records especially the early Buddhist Vinaya literature.

Footnotes and references:

[1]:

For more descriptions on the Āyurvedic phase and the classical medical texts, see the following Section 2. 3.

[2]:

Scholars have indicated a “paradigm shift” from Vedic medicine to Āyurvedic medicine in this period, and the absence of medical literature for this epoch. See Basham 2004, 500-501; Filliozat 1964, 188; Mazars 2006, 6-7; Zysk 1991, 3-5; 1996, xiv.

[3]:

According to Warder (2000, 32-34), the wandering ascetics tended to be empirical and rational. They attempted to search for explanations for the universe and the life, by their own efforts of investigation and reasoning, rather than following the orthodox teaching of Brahmanism. They were more interested in natural sciences such as astronomy, mathematics, and medicine.

[4]:

There are accounts in the Vinaya revealing that some monastic members had medical knowledge and practice and they were healers. In the Mahāsāṃghika Vinaya, an account of a monk-physician treating his fellow monks is found in Taishō Tripiṭaka 1425. 316c3-13. Another record in this Vinaya tells us that a nun was skilful in healing others’ illnesses (Taishō Tripiṭaka 1425. 531a3-18).

[5]:

These eight causes of disease mentioned in the Pāli texts will be discussed in Chapter Three of this thesis. In brief, they are the three bodily humours (wind, bile, and phlegm), the combination of the three humours, seasonal change, wrong behaviour, assault, and effect of one’s previous deed.

[6]:

Wujastyk (2005, 1410) boldly states: “Structured systematic thought about medicine in India can first clearly be detected in sayings of the Buddha.” This statement, in fact, aptly points out that the Buddhist literature should be the first document of the systematic mode of Indian medicine, and highly likely be the origin of Āyurveda.

[7]:

Thanks to Professor Halkias for providing these two Greek terms.