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| [Introduction] [Ayurvedic Literature] [ Medical Education ] [Medical Practice] |
| In ancient India, one could become a physician by following any one of the following procedures: he could learn the art and science of it from a teacher by living and working with him in his house ; he could go to a guru-kula where the students lived together with the teachers in the schools situated in the forests away from human habitation ; he could join one of the medical centres located in the larger cities such as Taxila, Kasi (Varanasi) and Nalanda.
Taxila situated about 20 miles west of Rawalpindi (now in Pakistan) was the most important seat of learning in ancient India dating from the sixth century B.C. It attracted students from all corners of India, viz., from Rajagriha, Mithila, Kashi, Ujjain, Kuru, Koshala etc. Its fame had spread far and wide in foreign countries; students from there were said to come here to learn. The medical school there enjoyed a special reputation, but all arts and sciences could be studied under the most eminent professors.
Nalanda was another center of learning which flourished from the fifth to twelfth century A.D.
Great care was taken in the selection of the candidates for admission in these centers of learning. The most capable teachers were on the selection committee whose members were called Dwara Pandits, i.e., those who guarded the entrance. A candidate belonging to the family of physicians was preferred. The age at the time of admission to medical studies was 16.
The students were taught theory as well as practice of medicine, equal importance being given to both.
Practical training of a student had three objectives: (1) preparation of medicines, .(2) training in surgery, and (3) examination of the patients. The student learnt the art of preparing flower juices and intoxicating liquors. Concocting different herbal combinations, making medicines using sugarcane or clarified butter (ghee), reducing to ashes stones, minerals and the like, preparing combination of minerals and herbs, combining and isolating minerals, making new compounds of minerals and extracting the alkalies out of the minerals. He was also trained in planting, grafting and general care of plants, as also recognizing different herbs and when and how to cut and preserve them.
For practical training in surgery, different surgical procedures were taught on different objects : incisions were taught by making cuts on gourds (pushpaphala, alavu), watermelon, cucumber; excisions were demonstrated by making openings in the body of a full water bag or in the bladder of a dead animal or in the side of a leather pouch full of slime or water ; scraping was taught on a piece of skin on which the hair has been allowed to remain ; venesection (vedhya) was taught on the vein of a dead animal, or with the help of a lotus stem ; probing and stuffing was taught on. worm-eaten wood, on the reed or bamboo, on the mouth of a dried alavu, (gourd) ; extracting was taught by withdrawing seeds from the kernel of a vimbi, vilva or jack fruit, as well as by extracting teeth from the jaws of a dead animal; evacuating was taught on the surface of a shalmali plant covered over with a coat of bee's wax ; suturing was taught on pieces of cloth, skin or hide; bandaging or ligaturing by tying bandages round the limbs and on a full-sized doll made of stuffed linen ; tying up a severed ear lobe (karna-sandhi) was demonstrated on a soft severed muscle or on flesh, or with the stem of a lotus lilly ; cauterising or applying alkaline preparations (caustics) was demonstrated on a piece of soft flesh ; the art of inserting syringes and injecting enemas into the region of the bladder was taught by asking the student to insert a tube into the mouth of a gourd (alavu).
After the period of training was over, there was an examination consisting of theory as well as practicals. An example of a practical examination is found in Jivaka's biography. Here Atreya asked his pupils "to go to the pine hill and fetch from it that which is no remedy." While other students did bring certain things, Jivaka came back empty-handed, saying there was none that was not a remedy for one disease or the other. Jivaka was declared successful. Theoretical examination was conducted by asking the candidate to explain a page from a manuscript. This particular page was lifted out by means of a rod; hence this test came to be known as shalaka test. Degrees were awarded to the successful candidates at a special ceremony (samavartana), during which they were charged with the following oath:
Acting at my behest, thou shalt conduct thyself for the achievement of the teacher's purpose alone, to the best of thy abilities.
If thou desirest success, wealth and fame as a physician and heaven after death, thou shalt pray for the welfare of all creatures beginning with the cows and Brahmins.
Day and night, however thou mayest be engaged, thou shalt endeavour for the relief of the patient with all the heart and soul. Thou shalt not desert or injure thy patient even for the sake of thy life or thy living. Thou shalt not commit adultery even in thought. Even so, thou shalt not covet others' possessions. Thou should not be a drunkard, or a sinful man, nor shouldst thou associate with the abettors of crimes. Thou shouldst speak words that are gentle, pure and righteous, pleasing, worthy, true, wholesome and moderate. Thy behaviour must be in consideration of time and place and heedful of past experience. Thou shalt act always with a view to acquisition of knowledge and the fullness of equipment.
No persons who are hated of the king or who are haters of the king or who are hated by the public or who are haters of the public, shall receive treatment; similarly those that are of very unnatural, wicked and miserable character and conduct those who have not vindicated their honour and those that are on the point of death, and similarly women who are unattended by their husbands or guardians shall not receive treatment.
No offering of meat by a woman without the knowledge of her husband or guardian shall be accepted by thee. While entering the patient's house, thou shalt be accompanied by a man who is known to the patient and who has his permission to enter, and thou shalt be well-clad and bent of head, self-possessed, and conduct thyself after repeated consideration. Thou shalt thus properly make thy entry. Having entered, thy speech, mind, intellect and senses shall be entirely devoted to no other thought than that of being helpful to the patient and of things concerning him only. The peculiar customs of the patient's household shall not be made public. Even knowing that the patient's span of life has to come to its close, it shall not be mentioned by thee there, where if so done, it would cause shock to patients or to others.
Though possessed of knowledge, one should not boast very much of one's knowledge. Most people are offended by the boastfulness of even those who are otherwise good and authoritative.
There is no limit at all to which knowledge of Ayurveda can be acquired; so thou shouldst apply thyself to it with diligence. This is how thou shouldst act. Again thou shouldst learn the skill of practice from another without carping. The entire world is the teacher to the intelligent and the foe to the unintelligent. Hence knowing this well, thou shouldst listen and act according to the words of instruction of even an unfriendly person, when they are worthy and such as bring fame to you, and long life, and are capable of giving you strength and prosperity.
Before a qualified physician could start practice, he had to have the permission of the king. This was to safeguard the people from the nuisance of the quacks.
*Source: A Concise History of Science, Atma Ram & Sons
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Swaveda - Background - Ayurveda - Medical Education
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