Bhesajjakkhandhaka (Chapter on Medicine)

by Hin-tak Sik | 2016 | 121,742 words

This study deals with the ancient Indian Medicine (Ayurveda) in Early Buddhist Literature and studies the Bhesajjakkhandhaka and the Parallels in other Vinaya Canons. The word Bhesajja means “medicine” and is the sixth chapter of the Khandhaka, which represents the second book of the Pali Vinaya Pitaka. Other works consulted include the Bhaisajya-s...

Āyurveda–Brief History and Basic Principles

India has three major traditional medical systems: Āyurveda, Siddha, and Ūnāni.[1] Among these three, Āyurveda is the oldest and most well-known, and has a long history of at least two thousand years (Benner 2005, 3852). Āyurveda appears to have originated in the centuries around the turn of the Common Era, after the śramaṇ-ic phase as mentioned earlier in Section 2. 1. 3, and is marked with the emergence of some influential classical medical treatises which will be described later. These texts illustrate a highly systematised medical lore. Like the śramaṇ-ic medicine, classical Āyurveda is highly empirical and rational, and is different from the magico-religious approach of Vedic medicine. It can be regarded as a continuation of the śramaṇ-ic medicine, perhaps from as early as the epoch of the Buddha.

Dominik Wujastyk, a renowned Western scholar on Indian medicine, gives a succinct introduction on Āyurveda (2003b, xvii):

Ayurveda is a system of general medical practice which encompasses both preventive and prescriptive aspects. It consists of a great deal of excellent practical advice for the man in the street on almost every imaginable aspect of life, including cleaning the teeth, diet, exercise, morality, and so on … It also includes more specialized medical teachings on all aspects of diagnosis and therapy, aimed at the professional physician.”[2]

This system comprises both medical and philosophical knowledge–it not only covers medical aspects such as anatomy, physiology, pharmacology, toxicology, embryology, diagnosis, therapy and so on, but also philosophical doctrines such as the meanings and types of āyus (life), origin of the human being, concept of birth and death, medical ethics, medical training, qualities of physician, drugs, sick-attendant and patient, rules of medical debates and so forth (Wujastyk 2005, 1410).[3]

In this section, a brief outline of the history of Āyurveda (including the traditional claims and the scholarly findings) and the corpus of classical treatises will be concisely introduced. Basic principles of Āyurvedic medicine, such as the theories of pañcamahābhūta, tridoṣa, dhātu, mala etc., will be followed.

[1. Brief History of Āyurveda]

[2. Basic Principles of Āyurveda]

A brief history and the basic principles of Āyurveda have been described in this section. For the history, according to the Āyurvedic tradition, it is claimed to have come from the Vedic medicine and have arisen thousands of years Before Common Era. But this is not accepted by modern scholars, who consider that this medical tradition originated from śramaṇ-ic medicine and emerged in the few centuries before or after the turn of the Common Era. The arising of this tradition was accompanied by the appearance of the classical medical treatises, which illuminate the systematised medical doctrines and practices. The earliest texts were the Caraka Saṃhitā and the Suśruta Saṃhitā (believed to have been composed in the first few centuries of the Common Era), which represent two traditions which seem to have a common origin (likely to be the śramaṇ-ic medicine). The Caraka Saṃhitā tradition emphasises more on pharmaceutical remedies while the Suśruta Saṃhitā on surgical interventions.

The history of Āyurveda is well described in terms of the production of numerous medical texts, such as the “great three” (the Caraka Saṃhitā, the Suśruta Saṃhitā, and the Aṣṭāṅga Hṛdaya Saṃhitā), the “small three” (the Mādhavanidāna, the Śārṅgadhara Saṃhitā, and the Bhāvaprakāśa), and many others. There is a large variety of medical texts formed throughout the long Āyurvedic history: compendia, commentaries, summaries, manuals, dictionaries, and even dramatic genre. From these texts, Āyurvedic lore is shown not to be static, but continually changing with new knowledge and practice added to it.

Regarding basic principles, Āyurveda is the science or knowledge for longevity. Its main purpose is to cure illness and to prevent sickness, so that people can have long lives for fulfilling their goals. There are eight branches in Āyurvedic science, namely, internal medicine, general surgery, the branch dealing with diseases above the collar bones, paediatrics, the branch treating the possessed, toxicology, geriatrics, and that concerning aphrodisiacs.

Anatomical knowledge in Āyurveda inherited that of Vedic medicine. Physiology became well developed, comprising several important concepts: the five elements of earth, water, fire, wind, and space; the three humours of wind, bile, and phlegm; the seven tissue elements including chyle, blood, muscle, fat, bone, marrow, and semen; and the waste products such as urine, faeces, and sweat. The three humours are regarded as the major factors determining health or illness. When they are in balance, health is maintained;if they are out of balance (due to some causative factors such as diet, seasonal change, habitat, way of life, conduct, etc.), disease occurs at certain body part(s).

For clinical practice, diagnosis in Āyurveda is made by means of the six-fold examination (five senses and interrogation) on the patient’s pulse, bodily parts, excretions, and so on. It is then made by means of five criteria: aetiology, prodromal features, presenting features, therapeutic trials, and pathogenesis. New diagnostic skills have been added to Āyurveda during its long history. Treatments are of numerous modes–to correct any imbalance of the humours–such as medicinal drugs (of vegetal, animal, and mineral sources), the preliminary treatments (oiling and sweating), the five therapeutic actions (emesis, purgation, one or two types of enemas, nasal applications, and/or blood-letting), surgery, dietetics, and even magical remedies. Instructions for maintenance of health are important components of Āyurveda, and they pertain to personal hygiene, diet, exercise, daily activities, conduct, use of healthy substances or objects, adaptation to seasons and environment, and so forth.

The next section will be about modern biomedicine. Similar to this section, the history of modern medicine will be briefly described. Then the basic principles of biomedicine will follow. The provision of such information aims at facilitating readers to understand the modern interpretations of the drugs and treatments for diseases mentioned in the Chapter on Medicine in the coming chapters.

Footnotes and references:

[1]:

Siddha medicine is prevalent in southern India, and the Ūnāni medicine actually is the imported Graeco-Islamic medicine.

[2]:

The definition of the term “Āyurveda” will be provided later in Section 2. 3. 2, when the basic principles of this tradition are described.

[3]:

Medical concepts will be discussed later in this section. For more descriptions of the philosophical concepts mentioned in Āyurveda, see Roy 1986, 161-164 and Thakar 1992, 377-380.

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