Anatomy
Description of the human anatomy, as it appears in samhitas, is fairly rudimentary. Total number of bones, inclusive of teeth and nails in the body, according to Charaka, is 360, but according to Susruta, it is 300. Muscles of the body are just mentioned as fleshy masses. Heart was supposed to have only one cavity in it and ten vessels ran from it to different parts of the body. Mention of the structure or function of the brain is negligible. Though lungs are mentioned, they are not supposed to be concerned with breathing. Knowledge of marmas, the vital spots or centers where a hurt or injury could prove very dangerous, was widely prevalent.
Embryology
Indian physicians state certain views and record observations about the conception and development of the fetus in the uterus of the mother. Their views on the subject of embryology have not stood the test of time but what they observed themselves and recorded is substantially correct. Charaka and Susruta describe the gross development of the fetus during each month of pregnancy. These observations they must have made on the fetuses passed out in abortion cases.
Physiology
According to Ayurveda, the food which we take and also our bodies, are composed of five elemental entities (bhutas), namely, earth (prithvi), fire (teja), water (apa), wind (vayu) and ether (akasha). These five elemental entities in the body exist in the form of substances (dhatus), namely, rasa, blood, flesh, fat, bone, marrow and semen. Function of the food is to nourish these dhatus, maintain their equilibrium and sustain the digestive function. Food which is taken, is first converted into rasa and then in turn, into blood, flesh and other dhatus. During the process of digestion, a sweet reaction sets in. This gives rise to the production of foamy phlegm (kapha). A little later, when food is half-digested, sour reaction sets in and from the food in the intestine is produced a liquid substance called (pitta) (bile). Lower down in the intestine, the digested food is converted into a dry mass and during this process, a bitter and astringent reaction sets in, which gives rise to the production of wind (vata) . This is how the three above-mentioned dosas namely, kapha, pitta and vata are produced.
The three dosas perform very useful functions in the body. The role of wind (vata), which is of five types, is to provide active energy to perform the function of movements, inhalation and exhalation of breath, speech, throwing out of urine and faeces. pitta (bile) helps in digestion, provides heat to the body and gives good eye sight, good complexion, cheerfulness of mind and intelligence. kapha (phlegm) gives normal oiliness to the body, sprightliness to the joints and body, normal weight, sexual power, strength, capacity to bear or endure.
The three dosas may exist either in equilibrium or any one of them may predominate in a person. When in a person's constitution phlegm predominates, he has a body which is oily, smooth, delicate, clean and agreeable to look at. When bile predominates, the person is incapable of bearing heat, the body is dry and delicate. When wind predominates, the person has body which is dry, lean and small-sized. Possessor of a body in which different dosas are in equilibrium remains generally healthy.
Causation of Diseases
Excessive, deficient or faulty exposure of the senses (touch, taste, smell, hearing and sight), inclement weather conditions, misuse of intelligence such as is witnessed in taking improper diet, act on the three humours, namely, wind, bile and phlegm and lead to their dis-equilibrium which in turn reacts upon various substances (dhatus) of the body. This gives rise to the production of various diseases. This is called the tridosa theory. Diseases have been classified in various ways. The internal diseases are due to the predominance of any one of the humours and these may be easily curable, curable with difficulty and incurable. They may be accidental, caused by demons. They may be violent or mild.
The following interesting mythological story tells as to how consumption descended on human beings and animals. Daksha Prajapati, married his 27 daughters to the god Moon. Moon, however, loved only one of his wives and gave all attention to her. The other wives, in frustration, reported the matter to their father who rebuked his son-in-law for his unworthy monogamous habits. But it had no effect. Eventually, the father-in-law lost his temper and created a demon of consumption to eat away and destroy Moon. Moon, when he realised his predicament, promised to lead the desired married life and thus though saved yet remained liable to periodic progressive consumption. The demon of consumption descended on the earth to find his pray among human beings and animals.
Diagnosis
Charaka laid great stress on the proper examination of the patient and his environments with a view to arriving at the diagnosis of the diseases, before the treatment was prescribed. According to him, a physician who failed to enter the body of the patient with the lamp of knowledge and understanding could never treat diseases. The physician should pay heed to inducing causes, prodromal symptoms, constitution of the patient, the diseases which he is generally liable to suffer, age of the patient, his vitality, the season in which he got the disease and all other relevant factors while prescribing medicine, diet and routine for the patient to follow.
Prognosis
Prognosis of the patient suffering from any disease was made after keeping in view the physical state of the patient, diagnosis of the disease, the accompanying environment as well as the omens and the dreams which the patient had.
Materia Medica
Charaka's Materia Medica consisted chiefly of vegetable products, though animal and mineral products were also used. All these drugs were classified into 50 groups on the basis of their action on the body. The drugs were given in various forms such as powder, paste, infusion, decoction, pill, confection, roast, fermented, distilled, medicated and alcoholic drinks, medicated oils or ghee and inhalants as well as injections into the rectum, urethra and female genital organs. The aim of the drugs or other regimens was to help maintain or bring back normal balance between various dhatus and dosas.
Treatment
While proper drugs and diet are essential in bringing about a cure, they by themselves are not enough. There are other factors, too, upon which depends the success or otherwise of the treatment. Kasyapa Samhita describes all the factors upon which the outcome of the treatment depends. According to it, there are four pillars of treatment. When these four pillars have the requisite qualities, then a curable disease will not be left uncured. These four pillars are: physician, medicine, patient and attendant. Drugs and other therapeutic measures can be administered not only by mouth but through other routes also. Indian physicians administered liquid medicines into the rectum, the urethra and the vagina, and the inhalations and fumigations in the nose. They are applied dry and wet heat to the body by means of different ingenious procedures. Application of caustics, in many cases, was considered, as a better procedure than surgery. This was recommended in different skin diseases, haemorrhoids, fistula-in-ano, other fistulas, abscesses, mouth and throat diseases etc.
Alkalies were prepared from vegetable products, essentially from the ashes of the burnt wood of certain trees. The final product was of mild, medium or strong potency depending upon the need.
Cauterization (burning the part) was considered even better than the application of alkalies in certain cases. According to Susruta Samhita, a disease burnt with fire is cured for good and knows- no recrudescence: and diseases which ordinarily baffle the skill of a surgeon or a physician; and never prove themselves amenable to medicinal or surgical remedies, are found to yield to fire. Burning the part — cauterization- — is particularly prescribed in cases of tumors, fistula, swelling of testicles, elephantiasis, swollen glands, decolorisation of the skin, bad wounds or ulcers, ophthalmia, headache, haemorrhoids and other diseases. This was done by means of red hot iron of various shapes, burning medicinal sticks (varti) , cow's tooth (godanta) and different crystalline stones (surya kanta). Fluid substances like honey, syrup, oil and wax brought to a boiling point, were also used. The part could be cauterized in circles, points, lines or the whole surface depending upon various indications and contra-indications.
Indian physicians bled the patients suffering from abscesses, enlargement of the spleen, and inflammations of different parts of the body. This they did by applying leeches, by cupping, scarification or by cutting the superficial veins. Application of leeches was the safest method of letting out the blood, and caused no pain. This was used in infants and old people or those of timid nature, or where the patient was too weak to stand any operation.
Careful attention was given to recognizing whether an inflammation had suppurated or not, as successful treatment, according to them, depended largely upon that. Signs and symptoms of a suppurated abscess are described in great detail. An abscess was opened only when it had suppurated and was localized. The physician who opened an unsuppurated or unripe swelling out of ignorance, as well as a man who neglected a fully suppurated one, was looked upon as the vilest cliandala (low born) for his wrong or incorrect diagnosis.
Susruta Samhita describes 14 different types of bandages. Fifteen different materials were used for bandages, including the barks of the trees. Knots of the bandages were advised to be tied away from the wound. The students practiced tying the bandages over the dummies provided for the purpose.
There are certain wounds over which bandage is contra-indicated. These are leprosy wounds, those caused by burns, diabetic carbuncles, wounds caused by the bite of rats, alkali wounds, poisoned wounds, those having severe inflammation of the muscles, decaying wounds, spreading wounds and those at the anal region.
According to Susruta Samhita, a bandage plays a more important part than a medicinal plaster as regards its healing and curative efficacy, inasmuch as it materially contributes to the purification and healing of an ulcer and keeps the joint steady.
Management of fractures is dealt with elaborately in Susruta Samhita. Immobilization was provided by means of splints.
Susruta describes some of the major surgical operations with precise skill and steps. While only limited means were available at that time yet these operations look nothing less than marvels even, now.
In a case, where the abdomen has perforated and the intestines are protruding, as a result of injury to the abdomen, Susruta recommends that "they (the protruded intestines) be gently re-introduced into the abdominal cavity and placed in their original position. In case the intestines have perforated, according to some practitioners, large black ants should be applied to the perforated part. After they have firmly bitten the perforated parts with their claws, their bodies should be separated from their heads. After that the intestines should be rinsed with milk so as to remove any foreign body attached to them such as grass, dust, blood, cloth etc., and lubricated with ghee and gently pushed back into the cavity and reinstated in their original position.
Removal of the stone from the urinary bladder was practiced. To remove fluid from the abdomen, paracentesis was done. Craniotomy of the fetus was undertaken if the fetus died inside the uterus. In case of cataract, the lens was displaced in the vitreous.
Plastic Surgery
The surgical techniques of Susruta, which attracted the attention of the world most, were those which we now categorize under plastic surgery. Making a new nose or a new ear out of the flesh from the adjoining parts in cases where the original had been cut off, is described by Susruta. "For making a nose, the leaf of a creeper, long and broad enough to fully cover the whole of the severed or clipped off part, should be taken, and a patch of living flesh, equal in dimension to the preceding leaf, should be sliced off (from down upwards) from the region of the cheek, and after scarifying it with a knife, swiftly adhered to the severed nose. Then cool-headedly, the physician should tie it up with a bandage decent to look at and perfectly suited to the end for which it has been employed. The physician should make sure that the adhesion of .the severed parts has been fully effected, and then insert two small pipes into the nostrils to facilitate respiration, and to prevent the adhesioned flesh from hanging down. After that, the adhesioned part should be dusted with the powders of pattanga, yashtimadhuTcam and rasanjana pulverised together; and the nose should be enveloped in cotton and several times sprinkled over with the refined oil of pure sesamum.
"Clarified butter should be given to the patient for drinking and he should be anointed with oil and treated with purgatives after the complete digestion of the meals he has taken. Adhesion should be considered complete after the incidental ulcer had been perfectly healed. The nose should be again scarified and bandaged in the case of a semi or partial adhesion. The adhesioned nose should be tried to be elongated where it would fall short of its natural and previous length, or it should be surgically restored to its natural size in the case of an abnormal growth of its newly formed flesh."
Susruta's technique of making the new nose was being practiced in India till lately. Description of this operation was published in the Gentleman's Magazine, in 1794, and after that a leading surgeon of London, Joseph Constantine Carpue, published his results in 1816, which led to the world- wide publicity for the technique. Later on, many modifications of the technique were adopted and a new science of plastic surgery took birth.
Surgical Instruments
Susruta Samhita describes surgical instruments under two main heads : Blunt (Tantra) and Sharp (Sastra). There are 101 blunt instruments, each one having a specific name. They are divided into six categories as follows: 1. Cruciform (Swastika), 2. Forceps (Sandamsa), 3. Pick Lock-like (Tola), 4. Tubular, 5. Probes (Salaka), 6. Accessory instruments (Upayan'ra). There are 20 sharp instruments.
According to Susruta Samhita, a good instrument should have a well made handle, affording a firm grasp; it should be made of iron of good quality ; it should have a fine edge, a pleasant shape and a well finished point ; and it should not be dented (except the saw). It should not be bent, or broken or jagged, or too thick, or too thin, or too long, or too short.
For keeping the instruments properly, boxes or covers made of wood, silk, leather or wool were used, each instrument being properly separated from the other.
Toxicology
Effects of poisons, of vegetable or animal origin, on human body were studied extensively by Indian physicians in ancient times. For this aspect of medicine, they were famous throughout the world. The most renowned medical man in the kingdom royal physician was always an expert toxicologist. One of his main duties was to protect the king against being poisoned. He resided inside the palace compound and checked all the dishes served to the king. Whenever the king, with his army, went on a battle, it was the duty of the royal-physician to go with him and to keep a check on the kitchen. He also tested drinking water from tanks and wells to see that it was free of any poisonous matter that might have been put in by the enemy agents.
Veterinary Medicine
Animals received good medical care in ancient India. They were cared for because they were of paramount importance to the individual, the society and the king, in times of peace as in times of war. Upon cattle depended life in the homes for milk, as much as in the fields for agricultural operations. In the battle fields, many a time, victory depended upon the superior force of the elephants and the horses. Not only the physicians but also the kings and the princes, were well-versed in veterinary sciences. King Nala had a surname Ashvavit, i.e., one who is well-versed in the science and care of the horses. Nakula and Sahadeva, the twin sons of Madri, were taught by Drona the art of curing, training and managing the horses and the cattle. To Nakula is ascribed the work called Ashva-chikitsa, which is still extant. King Romapada, the contemporary of Dasaratha of Ayodhya, is known to have learned Gajayurveda or Hasti Ayurveda meaning the treatment of the elephants, from the sage Palakapya.
During those days, physicians treating human beings were also trained in the care of the animals. Indian medical treatises like Charaka, Susruta and Harita Samhitas contain chapters or references about care of the diseased as well as the healthy animals. There were, however, physicians who specialized only in the care of the animals or even in one class of animals ; the greatest of them all was Shalihotra, the father of veterinary sciences.
Shalihotra is described to be the son of a Brahmin sage, Hayagosha. He is said to have lived in Sravasti (modern Sahet-Mahet on the borders of Gonda and Bahraich districts in the Uttar Pradesh). Some other sources describe Salihotra to have lived in Salatur, a place near Kandahar. Shalihotra and Agnivesha are described to be the pupils of the same teacher; others say that Susruta was Shalihotra's pupil.
Shalihotra is known to have been a specialist in the treatment and other aspects of the horses. He composed a treatise called Haya-Ayurveda or Turangama-Sastra or Shalihotra samhita, a work on the care and treatment of the horses. True to Indian tradition, knowledge embodied in Haya Ayurveda is also said to have been revealed to Shalihotra by Brahma himself, the fountain head of all knowledge. Two other works, namely Asva-prashnsa and Asva-lakshana sastram are also attributed to Shalihotra.
Haya-Ayurveda was accepted as a standard work on the subject in ancient times. Some chapters of it have been quoted in Agni-Purana, and Matsya and Garuda Puranas also refer to this treatise. This work of Shalihotra was later translated into Persian, Arabic, Tibetan and English languages. The fame of Shalihotra and his work spread so much that in certain places the word Salotri still stands for a horse doctor. Some of the later authors have named their veterinary works after Shalihotra and others have based their work on his samhita.
Hasti- Ayurveda or Palakapya Samhita, composed by Palakapya, is devoted solely to the care and description of the elephants. It is divided into four sections and 152 chapters. It contains more than 10,000 verses or 20,000 lines and is almost as big as Oharaka Samhita. It gives detailed information about the anatomy, physiology, pathology of diseases, surgical and medical treatment, and care and diet of the elephants.
*Source: A Concise History of Science, Atma Ram & Sons |
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