Procurement of medicinal drugs

The Saṃhitās provide meagre information about the mode of procuring such a vast array of substances. Care had to be taken to collect vegetable drugs according to the principles of deśa-sampat (from appropriate habitat), kāla-sampat (in the appropriate season), guṇa-sampat (when they are enriched with excellent attributes) and bhājana-sampat (stored in appropriate containers) in order to ensure their potency.^[1] Knowledge of plants as well as soil types is essential for the herb gatherer. Prior to collection of plants, the soil needs to be examined for its properties. Soil has its own characteristics derived from the pañcamahābhūtas or the five natural elements (earth, water, fire, air and ether); one of the elements predominates in a particular type of soil which in turn determines the properties of the plants.^[2] Caraka instructs that medicinal plants should be gathered from two types of eco-zones - jāṅgala–deśa (dry land) and sādhāraṇa-deśa (neither dry nor wet)^[3] which implies that those from ānūpa (marsh land) are not preferred. Land that is fertile,^[4] even, free of debris, close to water sources,^[5] and not demarcated for any religious or public purpose^[6] is considered ideal. Caraka prefers soil that is unctuous (snigdha), black (kṛṣna) or golden–hued (suvarṇa-varṇa) and sweet to taste (madhura)^[7] while Suśruta recommends black, white or red soil.^[8] Mature plants that are rich in rasas and unspoiled in every way are best suited for medicinal purposes.^[9]

Our two medical authorities do not concur on the appropriate season for collecting vegetable drugs which are derived from various plant parts-bark, leaf, flower, fruit, root, tuber, gum, latex, sap, etc. Caraka favours collection of different parts in different seasons: fresh branches and tender leaves in rainy season and spring; roots in summer or late winter; bark, rhizomes and latex in autumn; heartwood (sāra) in early winter; flowers and fruits in the appropriate season.^[10] Suśruta argues that as the world is either saumya (dominated by the cold principle) or agneya (dominated by the hot principle), saumya herbs are collected in the cold season and the agneya ones in hot weather.^[11] Rather than the time, Suśruta gives primacy to soil properties in determining action of vegetable drugs. Thus, purgative drugs are to be collected from soil predominant in qualities of pṛthvī and ambu; emetic drugs from soil having qualities of agni, ākāśa and vāyu; and doṣa alleviating drugs from soil rich in ākāśa.^[12] Besides, there is no predetermined time for plants or trees like palāśa, all parts of which are useful. All seasons are suitable for gathering such vegetable drugs.^[13]

Undoubtedly, the gathering of vegetable drugs entailed a good grounding in knowledge of plants and soils. The texts are silent on the qualifications of individuals employed for this purpose but we may presume the involvement of medical students of teaching physicians in this task or the employment of assistants with requisite knowledge by the non-teaching ones. In case of certain drugs knowledge alone is not deemed sufficient. The much treasured soma plant which is not easily available is said to be are invisible to persons deficient in moral virtues. Those who insult physicians and brāhmaṇas (brāhmaṇadveṣiṇa), the impious (adharmiṣṭha), the ungrateful (kṛtaghna) and the indolent as well individuals who are condescending of medicines (bheṣajadveṣiṇa) are never successful in procuring the rare drug.^[14] It may be conjectured that moral excellence and adherence to societal norms is essential for persons employed for gathering soma. Though the texts do not throw any light on the qualifications of medicinal drug-collectors, we have some information from the Tirumukkūḍal Inscription of Vīrarājendra Cola (dated to 1069 C.E.) inscribed in the precincts of Śrī Veṇkaṭeśa Perumāl temple. The record shows that the ātula salai or hospital attached to the Vedic college had two staff members to collect herbs and firewood and prepare medicines.^[15] It may be inferred that since they prepared medicines as well, they were probably trainee physicians.

Herb gatherers often had to fall back on cowherds, sages, hunters and those moving about in forests and subsisting on a diet of roots and tubers for help in identification of herbs.^[16] Cakrapāṇidatta holds them as experts in this field.^[17] Forest dwelling tribes may not have just helped in identification but could have possibly supplied some of the necessary items. By way of illustration we may consider the example of the extract of the khadira tree (Acacia catechu), which is of crucial importance in the treatment of skin disorders (kuṣṭha).^[18] It considered a panacea for all such disorders.^[19] The process of obtaining the extract, the khadira-sāra, from the roots of a mature tree as described by Suśruta is rather laborious and time consuming.

The extract of the khadira tree is obtained from its roots. A mature unmutilated tree growing in good soil is selected and the soil around it is dug up to expose the roots. An incision is made in the central root which is hollowed out and an iron pot placed beneath it. The soil around the tree pasted with mud and cowdung is then lighted so that the extract flows into the pot. When it is known that the pitcher is full, it is removed. The extract is then strained and used as required.^[20]

There is no doubt that this process not only requires several hands but also the knowledge of obtaining the extract. We may presume that organizing the entire process of extraction would be possible only for the well-to-do physicians. Others would be dependent on other sources-one probability being supplies by forest tribes. British ethnographical surveys of the 19^th and the early 20^th centuries record that tribes like the Khairaha in the United Provinces, the Khairwārs in Chotanagpur, the Khaircūra in the Central Provinces and Khairi in Bengal, who take their name from the khair or catechu tree, were engaged in boiling wood for catechu.^[21] Therefore, the probability of tribes who engaged in the production of such forest products may not be ruled out. Many other components of the Āyurvedic materia medica must have been obtained through forest dwellers. Even in the 19^th century that collection of silk, cocoons, lac, catechu, gums and other jungle products were the only industries of the dwellers in the forest.^[22]

Our texts also throw up the possibility that drugs were not necessarily procured by the physician at all times; rather the patient could also make efforts to obtain the same. When Caraka says in the event of an emergency a poor man should take the prescribed drugs available to him without caring to collect all the rare medicaments in advance,^[23] it seems to indicate individual initiative in drug collection. According to Suśruta, a person who has no regard for medicine (bheṣajāpamānī) is unsuitable for rasāyana for his inability to secure the genuine drug.^[24] Had the obligation of procuring drug been of the physician alone, the authenticity of the drug would not be an issue at all. As we have noted above, there is the belief that ambrosial plants like soma and its varieties are not visible to those who do not respect medicine. Consequently, it appears that patients could take the initiative of securing drugs particularly if they happened to be rare.

It is interesting that the habitats of the vegetable drugs do not find mention in the texts; the only exception here is the celestial drug soma and its several varieties. Suśruta advises that they should be searched in the rivers, the mountains, lakes, forests and hermitages.^[25] The mountains mentioned in this context stretch across the Indian sub-continent: Himālayas, Arbuda (Mount Abu),^[26] Sahya (the Sahyādri), Mahendra (the Eastern Ghats or a part),^[27] Malaya (the portion of the Western Ghats beyond the Nilgiris),^[28] Śrīparvata (range of hills in Telengana),^[29] Devagiri (modern Devagiri-Daulatabad or a hill near Mathurā^[30] or a part of the Arāvali range^[31] Devasaha (unidentified), Pāriyātra (the western part of the Vindhyas),^[32] and Vindhya.^[33] Some varieties are hydrophytes occurring in the river Sindhu (Indus), the Devasunda and the little Mānasa lakes.^[34] The last named is situated in Kashmir but the location of Devasunda is not known. The occurrence of soma and similar restorative plants appears to be rare; hence, the need to specify their places of occurrence accompanied their description which is not available in case of other category of drugs. Their rarity becomes more plausible when we consider that these drugs are declared invisible to persons of undesirable character traits and to those who are deficient in virtue.

The cultivation of medicinal herbs is known from some ancient Indian sources. It was a common practice to encourage the cultivation and storage of plants of medicinal value.^[35] According to the Arthaśāstra, they are grown between rows of crops, on marshy land and in pots. It would not be wrong to assume that the royal physicians obtained some the necessary vegetable drugs from such herbariums. Kauṭilya stipulates that rooms for wares and medicines (bhaisaijyagṛham) should occupy the north-western part of the city.^[36] D.V.S.Reddy is inclined to interpret bhaisaijyagṛham as medical stores or dispensary.^[37] The government stores stocked medicines as well as items of utility to physicians-all kinds of fats, grains, sugar, salts, metals, hides, tendons, poisons and horns.^[38] Care had to be taken to replenish old stocks.^[39] Aśoka’s Second Major Rock Edict outlines the steps taken for medical care of men and animals. “Medicinal herbs whether useful to man or to beast, have been brought and planted wherever they did not grow; similarly, roots and fruits have been brought and planted wherever they did not grow.”^[40]

Several substances of animal origin are included in the ancient materia medica. They include milk, bile, fats, marrow, blood, flesh, faeces, urine, skin, semen, bone, ligament, horn, nail, hoof and hair of domesticated and wild animals, honey, lac and snake venom. Gorocana^[41] or purified ox or cow bile finds its use in processing some compounds. Drugs are first soaked in the bile, then crushed and processed as needed.^{[42] [43]} Eight varieties of animal urine are generally used: of sheep, goat, cow, buffalo, elephant, camel, mare and ass.^[44] The milk of the same animals are used with the exception that human milk is included in place of milk of the ass.^[45] In case of excessive blood loss, the patient is given fresh animal blood to drink as in rakta-pitta.^[46] Fresh goat liver is also given in rakta-pitta.^[47] It may also be mentioned that all the parts of the cow from the horns to hairs, hooves, ligaments and hide are used for medicated smoking in shortness of breath.^[48]

Other than domesticated animals, we may mention some faunal derivatives from wild animals to indicate the vast array of drugs mentioned in the Saṃhitās.

• Bile of peacock,^[49] boar,^[50] iguana, lizard, mongoose, wild cat, deer,^[51] mongoose, elephant and bear^[52] and fish.^[53]
• Dung of domesticated animals finds its use in consumption^[54] and prameha or urinary disorders.^[55]
• Dung with skin, hairs, fat, urine, blood, bile and claws of lion, tiger, bear, wild cat, leopard, porcupine are used in the treatment of graha, all mental disorders and epilepsy.^[56]
• Tiger claw finds its use for treating poisoning.^[57]
• Leopard skin and elephant hide are mentioned as cures for kuṣṭha.^[58]
• Bristles of Porcupine^[59]
• Bones of heron, camel and donkey are required in the cure of urinary stone;^[60] Alkalis are prepared from the bones of horse, pig, ass and camel for urinary disorders.^[61]
• Crab, dried fish, dried meat and worms are used for emetic fumigation.^[62]
• Crocodile eggs are required in preparation of an enema recipe.^[63]
• Eggs of pea-hen, hill-partridge (gonarda), swan and sārasa are mentioned in a recipe for enema.^[64]
• Use of poisons, such as, venom of black cobra or alternatively vegetable poisons is noticed in duṣyodara (abdominal distension).^[65]
• Black cobra in its burnt form is used for leucoderma.^[66]
• The skin of cat, mongoose, rat and deer are turned into bags for fomentation.^[67]
• Conch shell, pearl, oyster and samudraphena (cuttlefish) are used for controlling excessive bleeding after blood-letting.

It is evident from the above brief overview that many of faunal derivatives, especially from the wild had to be obtained from hunters and forest-dwellers.

Blood-letting is an important practice in Ayurveda for curing diseases caused by vitiated blood, for which cow horns, leeches and gourd instruments are required. The cow horn prepared for this purpose is known as singi, practiced in Punjab today by the camars. The camars are an occupational caste of tanners and menial labourers of Northern India. They remove carcasses of cattle and consume its meat. Surgeons also had to arrange for collection and storage of leeches used in blood-letting. For this purpose only non-venomous species inhabiting clean and clear water are used. Here again, there is no further information on the persons employed but it is noteworthy that gathering leeches was not a respectable profession in colonial India. In the late nineteenth and early twentieth centuries, a few Muslim families of Central India (Burhanpur) were involved in the breeding and application of leeches to patients. Known as Jokhāra, they married among themselves for no other Muslim would marry them. In other parts of India this work was done by sweepers and sometimes by their women. In Gujarat the Jokhāras are a branch of the Hajjam or the Muhammadan barber caste.^[68] As barbers they must have carried out blood-letting or minor surgical procedures.

Other than floral and faunal drugs, the Saṃhitās also incorporate metals and minerals in formulations. These include gold, silver, copper, bell metal (kāṃsya), iron, tin, lead,^[69] mercury (sutara),^[70] silica, red arsenic (manaḥśilā),^[71] gems,^[72] salts,^[73] red chalk (gairika)^[74] and collyrium (añjana).^[75] Suśruta includes alkalis, such as yavakṣāra, svarjikākṣāra, etc., for use in cauterization.^[76] It is interesting to note that the properties of metals, gems and alkalis have been discussed in the chapter on dietetics (annapānavidhi).^[77]

Although the two Saṃhitās embody a huge body of knowledge on medicinal substances, the authors did not consider this materia medica to be exhaustive. The physician is by no means circumscribed in his choice of drugs to those mentioned in the texts; he is advised to use his own discretion in the selection of appropriate drugs,^[78] and is also at liberty to add herbs of similar nature to a formulation.^[79] Besides, when the prescribed rare drugs are unavailable, he is advised to treat with the one readily available, and if anyone drug in a group is harmful, it should be replaced with a suitable one.^[80] It is therefore, considered necessary that the physician will use his discretion in formulating remedies for the patient. Drugs with similar properties have, therefore, been classed together keeping in mind the seasonal availability, rarity or suitability to the patient. It may have depended on th patient’s financial status as well.

Footnotes and references:

[1]:

Caraka Saṃhitā Kalpasthāna 1.7.

[2]:

Suśruta Saṃhitā Sūtrasthāna 36.4.

[3]:

Caraka Saṃhitā Kalpasthāna 1.9.

[4]:

Areas with pits, ant hills and saline soil are unsuitable. Caraka Saṃhitā Kalpasthāna 1.9.

[5]:

Suśruta Saṃhitā Sūtrasthāna 36.3.

[6]:

These areas include cremation ground, prayer ground (devayajanāgāra) and place of assembly (sabha) or where sacred tomb (caitya) is located. Caraka Saṃhitā Kalpasthāna 1.9.

[7]:

Caraka Saṃhitā Kalpasthāna 1.9.

[8]:

Suśruta Saṃhitā Sūtrasthāna 36.3.

[9]:

Suśruta Saṃhitā Sūtrasthāna 36.3.

[10]:

Caraka Saṃhitā Kalpasthāna 1.10.

[11]:

Suśruta Saṃhitā Sūtrasthāna 36.5.

[12]:

Suśruta Saṃhitā Sūtrasthāna 36.6.

[13]:

Suśruta Saṃhitā Sūtrasthāna 36.11.

[14]:

Suśruta Saṃhitā Cikitsāsthāna 29.32; Suśruta Saṃhitā Cikitsāsthāna 30.28-29.

[15]:

S. Basu Majumdar, “Medical Practitioners, Medicines and Medical Institutions in Epigraphs”, pp. 24-25.

[16]:

Suśruta Saṃhitā Sūtrasthāna 36.10.

[17]:

Cakrapāṇidatta on Caraka Saṃhitā Cikitsāsthāna 23.11-13.

[18]:

Suśruta Saṃhitā Cikitsāsthāna 9.66/2-67/1.

[19]:

Suśruta Saṃhitā Cikitsāsthāna 6.19.

[20]:

Suśruta Saṃhitā Cikitsāsthāna 10.13.

[21]:

R.V. Russell, The Tribes and Castes of the Central Provinces of India, Vol.III, London, 1916, pp.430-431.

[22]:

William Crooke, The North-Western Provinces of India: Their History, Ethnography and Administration, London, 1897, p.18.

[23]:

Caraka Saṃhitā Sūtrasthāna 15.19.

[24]:

Suśruta Saṃhitā Cikitsāsthāna 30.4.

[25]:

Suśruta Saṃhitā Cikitsāsthāna 30.40.

[26]:

N.N. Bhattacharyya, The Geographical Dictionary of Ancient and Medieval India, New Delhi, 1999, (first published 1991), p.72.

[27]:

Pargitar holds that it is a portion of the Eastern Ghats between the Mahānadī and the Godāvarī. N.N. Bhattacharyya, The Geographical Dictionary of Ancient and Medieval India, p. 210.

[28]:

N.N. Bhattacharyya, The Geographical Dictionary of Ancient and Medieval India, p. 213.

[29]:

S. Kapoor, (Ed.), Encyclopaedia of Ancient Indian Geography, New Delhi, 2002, Vol. 2, pp.620-621.

[30]:

N.N. Bhattacharyya, The Geographical Dictionary of Ancient and Medieval India, p.118.

[31]:

S. Kapoor (Ed.), Encyclopaedia of Ancient Indian Geography, New Delhi, 2002, Vol. 1, p. 233.

[32]:

S. Kapoor (Ed.), Encyclopaedia of Ancient Indian Geography, Vol.1, p.245.

[33]:

Suśruta Saṃhitā Cikitsāsthāna 29.27-28.

[34]:

Suśruta Saṃhitā Cikitsāsthāna 29.28-30.

[35]:

D.V.S. Reddy, Glimpses of Health and Medicine in the Mauryan Empire, Hyderabad, 1966, p.5.

[36]:

Arthaśāstra II.4.14.

[37]:

D.V.S. Reddy, Glimpses of Health and Medicine in the Mauryan Empire, p. 88.

[38]:

Arthaśāstra II.4.27.

[39]:

Arthaśāstra II.4.28.

[40]:

R. Thapar, Aśoka and the Decline of the Mauryas with New Afterword, Bibliography and Index, New Delhi, 2002 (Sixth impression), p. 251.

[41]:

Caraka Saṃhitā Sūtrasthāna 1.69.

[42]:

Caraka Saṃhitā Sūtrasthāna 3-7.

[43]:

It is used in the treatment of skin diseases (Suśruta Saṃhitā Cikitsāsthāna 9.64) and in epilepsy (Suśruta Saṃhitā Uttaratantra 61.24/2- 25/1).

[44]:

Caraka Saṃhitā Sūtrasthāna 1.92-104.

[45]:

Caraka Saṃhitā Sūtrasthāna 1.105-113; Suśruta Saṃhitā Sūtrasthāna 1.50-59.

[46]:

Suśruta Saṃhitā Uttaratantra 45.28.

[47]:

Suśruta Saṃhitā Uttaratantra 45.28.

[48]:

Suśruta Saṃhitā Uttaratantra 51.52.

[49]:

Suśruta Saṃhitā Cikitsāsthāna 9.26.

[50]:

Suśruta Saṃhitā Kalpasthāna 5.71 (in antidotal formulation).

[51]:

These are used in nasal insufflations, eye salves and sprinkling in graha afflictions and epilepsy; Suśruta Saṃhitā Uttaratantra 60.40.

[52]:

These are used in epilepsy; Suśruta Saṃhitā Uttaratantra 61.24/2-25/1.

[53]:

These are used in graha seizures and epilepsy; Suśruta Saṃhitā Uttaratantra 60.45.

[54]:

Suśruta Saṃhitā Uttaratantra 41.49.

[55]:

Suśruta Saṃhitā Cikitsāsthāna 11.11.

[56]:

Suśruta Saṃhitā Uttaratantra 60.49-50.

[57]:

Caraka Saṃhitā Cikitsāsthāna 23.190; Caraka Saṃhitā Cikitsāsthāna 27.38.

[58]:

Suśruta Saṃhitā Cikitsāsthāna 9.16.

[59]:

Suśruta Saṃhitā Uttaratantra 50.20.

[60]:

Suśruta Saṃhitā Cikitsāsthāna 7.18.

[61]:

Suśruta Saṃhitā Cikitsāsthāna 11.10.

[62]:

Suśruta Saṃhitā Cikitsāsthāna 40.4.

[63]:

Caraka Saṃhitā Siddhisthāna 12.18(6).

[64]:

Caraka Saṃhitā Siddhisthāna 12.17.

[65]:

Suśruta Saṃhitā Cikitsāsthāna 14.8.

[66]:

Suśruta Saṃhitā Cikitsāsthāna 9.17.

[67]:

Suśruta Saṃhitā Cikitsāsthāna 4.17.

[68]:

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

[69]:

Suśruta Saṃhitā Sūtrasthāna 46.326-329.

[70]:

Suśruta Saṃhitā Kalpasthāna 3.14.

[71]:

Caraka Saṃhitā Sūtrasthāna 1.70.

[72]:

They include pearl (muktā), coral (vidruma), diamond (vajrendra), ruby (vaidūrya) and quartz (sphaṭika). Suśruta Saṃhitā Sūtrasthāna 46.329.

[73]:

Suśruta mentions ten types of salts: Suśruta Saṃhitā Sūtrasthāna 46.313-321.

[74]:

Caraka Saṃhitā Sūtrasthāna 1.70.

[75]:

Caraka Saṃhitā Sūtrasthāna 1.70.

[76]:

Suśruta Saṃhitā Sūtrasthāna 46.322-325.

[77]:

Suśruta Saṃhitā Sūtrasthāna 46.313-330.

[78]:

Suśruta Saṃhitā Cikitsāsthāna 1.76.

[79]:

Suśruta Saṃhitā Cikitsāsthāna 1.135.

[80]:

Suśruta Saṃhitā Cikitsāsthāna 1.136-137.