Chapter 20 - Introduction to Cikitsa-Sastra (medicinal literature)

The origin of the science of medicine or Ayurveda can be traced in India, like the origin of the many other kinds of sciences, to the Vedas, particularly, the Atharvaveda which has hymns in it for curing diseases, bhaisajyani, and for increasing the life-span, ayusyani. There is mention of the twin divine physicians Asvinau with wonderful healing powers. In one of the hymns they are said to have supplied a leg to one Vispala: vispalayai jangham adattam, the earliest reference in Sanskrit literature to transplantation of limbs. The simple folk in India in early periods, as the people elsewhere, had nurtured a belief that diseases are the handiwork of demons or evil spirits and that their cure is possible by warding them off by recitation of Mantras or performance of magic rites. This belief continued long after the period of the Vedas for we have even in the well-developed treatises on Ayurveda a section on treatment of diseases caused by demons. Tradition recognizes Ayurveda, also called Vaidyasastra, the science of the doctor, as an upanga, a sub-auxiliary of the Atharvaveda which preserves the ancient knowledge of embryology and hygiene. There is a legend in India of the Ocean of Milk having been churned by gods and demons. For medical science the importance of the legend lies in the appearance from the said

Ocean, along with others, of Dhanvantari, the mythical physician, typifying the yearning of the ancient Indians for a physician with extraordinary healing powers. Tradition also associates Dhanvantari with Vikramaditya as one of his nine jewels. Whether the two are identical is open to question. The Ayurveda is called astanga, of eight limbs or topics, which are major surgery, minor surgery, healing of diseases, children's diseases, toxicology, elixirs and aphrodisiacs. Patanjali in his Mahabhasya, in the context of the scope of the use of word, mentions Ayurveda along with Purana, Itihasa and Vakovakya thus attesting to its antiquity. It appears that treatises on specific topics called Tantras or Kalpas were composed first. Later comprehensive treatises called Samhitas, which dealt with all the eight topics referred to above, made their appearance. The sage Atreya is usually mentioned as the founder of Ayurveda. The Buddhist tradition records the name of one Jivaka, a pupil of Atreya who specialized in children's diseases.. The Vinaya pitaka and other Buddhist texts show a wide knowledge of elementary medical science, surgical instruments and hot baths, etc. The earliest of the treatises on medical science in India is the Carakasamhita, the compendium of Caraka, a court physician of Kaniska whose wife he helped in a critical case. The work, as it is available now, is not the work of Caraka alone, for it was revised by one Drdhabala who added the last two chapters to it besides contributing seventeen out of twenty-eight or thirty chapters of its Book VI. A native of Kashmir, Drdhabala, ascribed to the eight century A.D. was the son of Kapilabala and apart from carrying out the revision of the Carakasamhita as mentioned above, is credited with the revision of a number of Tantras of Agnivesa, a pupil of Punarvasu Atreya, a fellow student of Bheda or Bhela whose Samhita on that score is taken by some to be older than that of Caraka. The Carakasamhita is divided into various sections, called Sthanas each dealing with n Foundation

certain specific topics: the Sutrasthana with remedies, diet and the duties of a doctor; Nidanasthana with eight chief diseases; Vimanasthana with general pathology and medical studies; Sarirasthana with anatomy and embryology; Indriyasthana with diagnosis and prognosis; Cikitsasthana with special therapy and the Kalpa and the Siddhisthanas with general therapy. The next great name in the field of Indian medical science is that of Susruta, described in the Mahabharata as the son of Visvamitra. The famous Nagarjuna is said to have worked on his text. His fame had spread even beyond the confines of India, to Cambodia in the East and Arabia in the West in the ninth and the tenth centuries A.D. as evidenced by the literary tradition of those countries. He was commented upon by Jaiyata, Gayadasa and Cakrapanidatta who had also commented upon the Carakasamhita and whose commentary on Susruta was supplemented by Dallana in the thirteenth century A.D. One Candrata had revised his text on the basis of the commentary of Jaiyata. His work has six sections which, except the last one, the Uttaratantra, clearly a later addition, carry the same titles as does the Samhita of Caraka. Its Sutrasthana deals with general questions, imparting also the information that the author (Susruta) was the pupil of King Divodasa of Varanasi. The Nidanasthana concerns itself with pathology, Sarirasthana with anatomy and embryology, the Cikitsasthana with therapeutics and the Kalpasthana with toxicology. The next important work is the Bhelasamhita which carries the same divisions as does the Carakasamhita. As regards osteology, a third version of the system of Atreya in addition to those of Caraka and Bhela is found in the Yajnavalkya and Visnu Smrtis and the Visnudharmottara and the Agni Puranas. Vagbhata, another great name in Indian medical tradition, is recognised to be posterior to Susruta. Interestingly, there are two writers of this name, both claiming the same parentage in CC-0. Por, the Astangasangraha and the Astangahrdayasamhita. Satya Vrat

From the fact that one of the two is called Vrddha Vagbhata, the Elder Vagbhata, it would appear that both were different persons and it is possible that they might have shared the same descent. The Elder Vagbhata or Vrddha Vagbhata was the son of Simhagupta and the pupil of the Buddhist Avalikhita. The younger Vagbhata appears to have made use of the work of his elder namesake in a mixture of verse and prose while the work of the former is in verse. did to Other works on medical science include the Rugviniscaya of Madhavakara, an important text on pathology, the Siddhiyoga or Vrndamadhava of Vinda, a text giving prescriptions for a number of ailments from fever to poisoning, the Cikitsasarasangraha of Cakrapanidatta, a text on therapeutics, and the Cikitsamrta of Malhana, a work on general medicine. The Samhita of Sarngadhara is commented upon by Vopadeva, son of the physician Kesava and a protege of Hemadri (13 th century A.D.) who also wrote a Satasloki, a work on powders, pills and the use of the pulse in diagnosis. Numerous other works on medicine came to be written in later centuries, the more noteworthy of them being the Cikitsakalika of Tisata (fourteenth century), the Bhavaprakasa of Bhavamisra (sixteenth century) and the Vaidyajivana of Lolimbaraja (seventeenth century). There also appeared large numbers of monographs on different diseases including the one on the diseases of plants, the Vrksayurveda of Surapala. Apart from herbs, the kasthausadhas, prescribed as medicines, the texts on Ayurveda record a number of other preparations with effective curative properties. They are the bhasmas of various metals especially of gold and silver. The treatment extended itself even to the use of quick-silver (parada) in its various formulations, and sulphur and other acids for treating malignant diseases. The effectiveness of the medication is ensured with its accompaniment, the anupana, milk, butter milk, curd, the decoction (kvatha) and so on, The treatment also

rests on certain types of diets to be taken for certain periods, the kalpas, to subsist on milk alone or curd alone for twenty-one days or forty days and so on. The ancient Indians had achieved a high degree of accuracy in diagnosing the ailment by feeling the pulse, a tradition that has come down to the present-day. They had evolved a theory of the three humours, the Vata (wind), Pitta (bile) and Kapha (phlegm) the disturbance of which is the cause of the disease. Efforts have, therefore, to be made to keep them on an even keel which can be done by proper health care. Ayurveda is the science of good health and not only the curing of diseases. anal to 1971