4. Qualities of Physicians (in Ayurveda and Manasollasa)

srute paryavadatatvam bahuso drstakarmata | daksyam saucamiti jneyam vaidye gunacatustayam || ( carakasamhita sutrasthana . 9-6 ) According to Caraka, excellence in knowledge can be had by attending on preceptors and studying scriptures. Purity in a physician helps the patient by dint of its spiritual force. Reputation as infallible in prescribing medicines is also one of the qualities of a physician and then he says about medicine. Abundance, suitability, multiple form and potency, are the four qualities of medicament. 26 There are patients who are averse to the taking of the juice of a drug, some others in paste (kalka) form. Similarly, there are certain diseases where a medicament is required to be administered in a particular form. For example, decoctions form a special therapy in the treatment of fever. So it is necessary that the medicaments are amendable to preparations according to various pharmaceutical processes. Moreover, medicaments should be potent and free from infections and dampness. 24) duradhita visam vidya, ajirne bhojanam visam | visam gosthi daridrasya, vrddhasya taruni visam || (canakyasataka ) 25 ) pathyamapyamadhyajirne nasniyat || (canakyasutra ) 26) bahuta tatrayogyatvamanekavidhakalpana | sampacceti catusko'yam dravyanam guna ucyate | | carakasamhita - sutrasthana . 9-7

220 According to Manasollasa, medicine should be as follows: pakvamevausadham hanti dosam kosthasamasritam | apakvam na gunam kincit kurute tat sudharasam || Effective medicine only will act against the pathology in the body. Otherwise, there will be no improvement in the health condition. Caraka mentions four qualities in a patient. These are: Good memory, obedience, fearlessness and uninhibited expression. 27 Even though fearlessness and good memory are regarded as qualities of a patient, (for fear, anxiety and such other mental stresses, aggravate the disease), still sometimes shock and loss of memory are prescribed as positive treatment for patients. For example, one of the treatments prescribed for a patient suffering from insanity is that he should be got terrified actually by a snake (shock therapy), of course, with its teeth taken out as a measure of safety. (Present day electric shock therapy admistered on mental patients may be mentioned here.) In cases of fevers recurring at regular intervals, it is necessary to take measures to make him forget the occurrence of fevers. Manasollasa then proceeds to describe the features of physicians sastrasastravidovaidyanabhyasanipananapi | uhapohavivekajnan sudhahastan priyamvadan || 1.19.139. Such Vaidyas (physicians and surgeons) have to be appointed who are professional experts in physiology and surgery, skillful in experiments (medicine) and possessing good judgement and having a curative touch and soft spoken nature. 27. smrtirnirdesakaritvamabhirutvamathapi ca | jnapakatvam ca roganamaturasya gunah smrtah | | - carakasamhita - sutrasthana . 9-9

221 In Ayurveda, great emphasis has been laid upon the selection of proper medical text for study. Students and teachers of medicine should be of special nature as may be conducive to the study and practice of medicine. Ceremonies for the initiation of the students to the medical profession were invariably performed. Selection of the Medical Texts: A person desirous of adopting medical profession should, first of all, carefully select a suitable text on medicine, depending upon his competence to undertake light or serious type of work, his willingness for short term or long term results, his habitat and age. There are several such texts available for physicians. Only such texts having the following characteristic features are to be followed. Texts which are 1. 2. www atronised by great, illustrious and wise physicians, those texts which are great and popular and are followed by wise persons; pregnant with ideas and respected by reputed experts; 3. conducive to the intellectual growth of disciples of all the three categories, viz., highly intelligent, moderately intelligent and less intelligent; 4. free from defects of repetition, transmitted by seers and have well-knit aphorisms together with commentaries thereon in proper order; 5. Which have elegant ideas to convey; 6. free from vulgar and difficult expressions and have clear and unambiguous expressions; 7. Which convey ideas in an orderly manner; 8. Which primarily deal with the determination of real objects; 9. Which are free from contradictions;

222 10. Where there is no confusion relating to contexts; 11. Which convey ideas quickly; and 12. Which are equipped with definitions of etiology, symptomatology and therapeutics and illustrations. Selection of a Medical Teacher: An ideal preceptor is one who is well-grounded in scriptures, equipped with practical knowledge, wise, skillful, whose prescriptions are infallible, who is pious, who has all the necessary equipments for treatment, who is not deficient in respect of any of the sense organs, who is acquainted with human nature and the rationale of treatment, whose knowledge is not overshadowed by the knowledge of other scriptures, who is free from vanity, envy and anger, who is hard working, who is affectionately disposed towards his disciples and who is capable of expressing his views with clarity. A preceptor possessed of such qualities infuses medical knowledge into a good disciple as the seasonal cloud helps bringing about good crop in a fertile land. One should approach such a preceptor and respect him like fire, god, king, father and master with all care. After having obtained the knowledge of the entire scripture, through his blessings, one should strive again and again for achieving depth in scriptures, clarity of expression, comprehension of the various concepts and power of oration. Selection of a Medical Student : A person having the following qualities should be chosen as a medical student. 1. transquility; 2. generosity; 3. aversion to mean acts; 4. normal condition of eyes, face and nasal ridge; 5. thin, red and clear tongue;

223 6. absence of any morbidity in teeth, lips and voice; 7. perseverance; 8. freedom from vanity; 9. presence of intellect, power of reasoning and memory; 10. liberal mindedness; 11. birth in the family of a physician or the one having the disposition of a physician; 12. inquisitiveness for truth; 13. physical perfection; 14. unimpaired senses; 15. modesty and absence of ego; 16. ability to understand the real meaning of things; 17. absence of irritability; 18. absence of addictions; 19. good character, purity, conduct, love for study, enthusiasm and sympathetic disposition; 20. devotion to study; 21. uninterrupted taste for the theory and practice of the science; 22. absence of greed and laziness; 23. good-will for living beings; 24. obedience for all the instructions of the preceptor; and 25. devotion to the preceptor. Initiation of Study: During a favourable muhurta (a unit of time consisting of 48 minutes and named as Siva, Bhujanga, etc.) and an auspicious ksana (a division of the day used in astrological science), when the moon is auspicious by virtue of its conjunction with either of Pusya, Hasta, Sravana or Asvayuk constellations, in an auspicious day of the light fortnight of uttarayana (summer solstice) the disciple should come observing fast, after bath, wearing a saffron coloured cloth and with fragrant material in hand. He should also bring with him samidha (dry twigs used for offering oblation), fire, ghee, sandal wood paste, earthen jar filled with water, garlands, lamp, gold, ornaments of gold, silver, jewels, pearl, coral, silken garments, paridhi or sticks of palasa (Butea monosperma Kuntze) of one cubit in length for being placed in the four sides of homakunda (a rectangularly dug fire place for offering oblations), Kusa (Desmostachya bipinnata Stapf), fried paddy, sarsapa (Brassica nigra Koch), aksata (unbroken dehusked rice), white loose flowers and garlands, prepared out of them, food articles which promote intellect and sweet scented pastes.

224 When the disciple comes with the preparations mentioned above, the physician should get constructed a sthandila (an elevated lace of the shape of a square and of four cubits in size) in an even and pure place having slope towards the east or the north. The place should be smeared with cow dung, spread with kusa grass and provided with good border on all the four sides. This place should then be decorated with sandal paste, earthen jar, water, silken garments, gold, ornaments of gold, silver, jewels, pearls, corals and food articles. After performing homa, the student should be initiated to study. Physicians and their characteristics : In Ayurveda physicians are classified into three categories as follows: 1. Pseudo physicians; 2. Feigned physicians; and 3. Genuine physicians. Those who come to be known as physicians simply by virtue of the exhibition of the physician's box containing certain drugs, medical books, by bluffing and posing as physicians belong to the first category. They are ignorant of the science of medicine. They are simply counterfeits. Those who attribute their association to persons accomplished in wealth, fame and knowledge also come to be known as physicians, even though they are not so. Persons of this category are to be regarded as feigned physicians. Those who are accomplished in the administration of therapies and have insight as well as knowledge of therapeutics, are endowed with infallible success and can bring out happiness belong to the category of genuine physicians. Attributes of a good physician: Physicians who are born in noble families, well read, and have practical experience, who are skillful, pure,

225 whose medicinal prescriptions and surgical operations are infallible, who are self-controlled, who have all equipments and are endowed with healthy sense organs, who are acquainted with natural manifestations and those who have presence of mind are the saviours of life and destroyers of diseases. Such physicians are well-acquainted with the anatomy and physiology of the entire body, creation and growth of the body and origin and evolution of the universe. They are free from doubts regarding the etiology, premonitory signs and symptoms, actual signs and symptoms as well as management of diseases which are easily curable, curable with difficulty, and incurable. They are well-versed with the following : 1. Three principles of the science of life (viz. etiology, symptomatology and management of good and bad health); Fundamental principles and their elaboration; 2. 3. Three sources of drugs; 4. Thirty-five roots and fruits; four types of fat; five types of salt, eight types of wine, eight types of milk and six plants whose latex and bark are useful; 5. Various types of drugs used in five elimination therapies; 6. Twenty-two types of gruel; Thirty-two types of powders and ointments; 7. 8. Six hundred types of purgatives; 9. Five hundred types of decoction; 10. Factors responsible for the maintenance of positive health including diet, drug, regimen, residence, movement, sleep, rest, quantity, collyrium, inhalation, unction, washing, non-suppression of manifested urges, suppression of psychic urges, physical exercise and wholesomeness for examining the sense organs;

226 11. Knowledge of the four aspects of therapeutics having sixteen factors; 12. Determination of the nature of diseases; 13. Three pursuits of life; 14. Various actions of vayu; 15. Four types of unctuous substances prepared according to twenty four methods with drugs of various tastes, permutation and combination of which are of sixty-four types; 16. Various methods of preparation of drugs and therapies for fomentation and purgation; 17. Diseases of head, etc.; 18. Summary of diseases caused by permutation and combination of various dosas; 19. Ailments like carbuncle and abscess; 20. Three types of oedema and other diseases having swelling in one or the other part of the body; 21. Forty-eight types of diseases; 22. One hundred forty-types of diseases of nanatmaja variety (diseases caused specifically by one dosa); 23. Etiology, signs, symptoms and management of despisable individuals who are either very corpulent or emaciated; 24. Useful and harmful nature of sleep, sleeplessness and excessive sleep along with their etiology and management. 25. Six therapeutic measures like lightening therapy etc; 26. Signs, symptoms and treatment of diseases due to over nourishment; and under nourishment.

227 27. Diseases caused by the vitiation of blood, viz., intoxication, fainting and syncope alongwith their etiology, signs and symptoms and treatment by medicines and regimen; 28. Rules of dietetics, food preparations which are wholesome and unwholesome by nature; 29. The diet and regimen which are foremost in nature amongst their group; 30. Forty types of alcoholic preparations; 31. Determination of dravya (matter), guna (quality), karman (action), primary and secondary tastes; 32. Various types of incompatible food ingredients; 33. Ingredients of food and drinks classified into twelve groups along with their properties; 34. Properties of post-prandial drinks; 35. Nine factors required to be examined for determining the properties of food; 36. Digestive and metabolic processes; 37. Good and ill effects of wholesome and unwholesome food; 38. Diseases caused by the vitiation of various tissue elements alongwith their treatment in brief. 39. Ten resorts of life. They understand the eight sections of Ayurveda in their entirety along with the scope of the science. They have the power of grasping, retention and understanding of the text. They apply their knowledge so acquired for the treatment of diseases with a view to bringing the dhatus to their normal state after determining the stage of the disease, their own

228 ability and the properties of the drugs employed. They are imbued with memory, intelligence theoretical and practical knowledge. They nurture cordinal feelings exactly like the mother, father, brother and kin towards all creatures. Physicians having such qualities cure their diseases, and give life to patients.