Quackery: The “Fraudulent” Medical Practitioners

A discussion on the categories of physicians in ancient India would be incomplete without mention of those who were considered pretenders or fraudulent practitioners of medicine. Caraka categorises physicians into three types: quacks (bhiṣakchadmacara), pretenders or make believe physicians (siddhasādhita) and genuine ones (vaidyaguṇairyukta).^[1] The first two kinds are both imposters though their modus operandi is different.

The quacks deceive patients by exhibiting physicians” box containing certain drugs, manuscripts and leaves, thus, bluffing and posing as medical practitioners. They are ignorant of medical science. The second category consists of those who come to known as medical practitioners by claiming association with persons who have attained wealth, fame and knowledge. They too are not true physicians. Genuine practitioners possess theoretical knowledge, insight into the sciences, and proficiency in the administration of therapies. They are bestowed with success and bring happiness to patients.^[2]

The first category of healers (bhiṣakchadmacara) possesses the instruments but have no medical knowledge. The term siddhasādhita refers to one who has learned by practice without any textual knowledge. It appears that such censure is directed against folk healers with hands-on knowledge or possibly those who had acquired it as familial inheritance but did not actually undergo formal training at the established medical schools. Sūtrasthāna ruta declares practitioners who are good in practical work but neglect the texts owing to their arrogance and they are not respected in society as they have no theoretical knowledge. He is particularly harsh on such practitioners and severely castigates them by recommending their capital punishment.^[3] Such fraudulent practitioners may, in all likelihood, refer to small-time healers who practiced venesection, bone setting, tooth removal, etc. For instance, a few leech breeding Muslim families of Burhanpur in Central India during the colonial period applied leeches to persons suffering from boils, toothache, swelling of the face, piles and other diseases.^[4] For the medical authors they are as good as charlatans. The strong antipathy to folk healers possibly stems from their fear of subversion of their knowledge and formalized practice.

Fraudulent practitioners have come in for severe indictment in both our classical treatises. They are like bird catchers who are always on the wait to ensnare their prey. Completely devoid of textual knowledge, practical experience and time of administering therapies and their dosage, they are the harbingers of death and as dangerous as snakes satiated with the wind; hence they deserve to be shunned.^[5] A pretender who prescribes medicine to a patient in distress without knowing the principles is severely reproved as a sinner, who is incapable of virtuous acts and a messenger of death. Even conversing with such a person will lead a man to hell.^[6] Medicines which are like ambrosia in the hands of qualified practitioners may act like fatal weapons, thunder or poisons when prescribed by the ignorant.^[7]

As opposed to the genuine physicians, the prāṇābhisara or the “saviours of life, are the rogāṇāmbhisara, who are akin to thorns for they destroy life not the disease.^[8] Caraka describes the modus operandi of the charlatans. They move about from one street to another in the garb of physicians singing praises of their abilities. Once they come to know of someone’s illness, they lay siege by rattling off their accomplishments loudly from such position that the patient is forced to hear. In case a physician is already attending on him, they repeatedly find fault with him. They win over the friends of the patient by pleasing them, by secret communication or by doing favours, and by claiming nominal remuneration for their services. After winning the patient’s confidence, they cleverly examine him repeatedly so as to disguise their ignorance. If his condition does not improve, these fraudulent physicians put the blame of their failure on the patient-that he lacks equipment, attendants and self control. When the patient dies in their hands, they flee in some other garb.^[9] Only a close observation of this manner of trickery can elicit such a vivid description. It is further noted that such charlatans proclaim their ability in contradictory terms in a congregation of lay persons but take flight immediately when they come across an assembly of the learned. In case they have a smattering knowledge of some therapeutic formulae, they will never hesitate in quoting them without caring for the relevance to the topic. They do not like to be questioned nor do they care to ask questions of others. Their preceptors, disciples, classmates, or even their opponents in debates are unknown.^[10]

The animosity expressed for such healers may be attributed to disrepute to that would ensue to the medical profession particularly in case of failure to alleviate the patient’s condition. Their ignorance would have worsened the condition of some patients who then possibly sought a vaidya for consultation. By claiming nominal remuneration, they could attract many more patients thus harming the professional prospects of the āyurvedic physicians and surgeons. From above description it is evident that many healers moved about on the streets looking for patients. One of lost recensions of the Atharvaveda was of the Cāraṇa-vaidya śākhā which implies the existence of wandering medical practitioners. It has been suggested that they went from place to place and were approached by individuals in need of medical help.^[11] In Caraka Saṃhitā itself, there is hardly any reference to the itinerant nature of the medical profession. We are told that messengers approach the physician on behalf of the patient whereupon the physician makes a visit to his or her home. The practice of physicians seeking patients on the streets is referred to in the Mahāvagga, when Jīvaka was in Sāketa on his way home from Takṣaśilā to Rajagṛha. As he wanted to earn money, he asked the people: “Who is sick here, my good Sir? Who shall I cure?”^[12] Another reference occurs in a Jātaka story where we are told that some brāhmaṇas carry sacks filled with roots on their backs. They gather herbs, bathe and recite magical spells and are described as “physician-like”.^[13] Irrespective of whether these medicine men can be called quacks, we get the picture of different categories of medical practitioners in ancient India.

Footnotes and references:

[1]:

Caraka Saṃhitā Sūtrasthāna 11.50.

[2]:

Caraka Saṃhitā Sūtrasthāna 11.51-53.

[3]:

Suśruta Saṃhitā Sūtrasthāna 3.49.

[4]:

R.V. Russell, The Tribes and Castes of the Central Provinces of India, London, 1916, Vol. I, p.370.

[5]:

Caraka Saṃhitā Sūtrasthāna 29.10-12.

[6]:

Caraka Saṃhitā Sūtrasthāna 1.129-130.

[7]:

Suśruta Saṃhitā Sūtrasthāna 3.51.

[8]:

Caraka Saṃhitā Sūtrasthāna 29.8.

[9]:

Caraka Saṃhitā Sūtrasthāna 29.9.

[10]:

Caraka Saṃhitā Sūtrasthāna 29.9.

[11]:

S.N. Dasgupta, A History of Indian Philosophy, Vol. II, p. 284.

[12]:

T.W.Rhys Davids and H.Oldenberg, Vinaya Texts, Part II, Sacred Books of the East Series, Vol. XVII, Delhi, 1965 (Reprint), Mahāvagga VIII.8.

[13]:

Jātaka, Vol.4, No. 495.