The Greatest Benefit to Mankind: A Medical History of Humanity. Roy Porter

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СКАЧАТЬ dating from 1767, describes the practice and states that it was widespread in Bengal. No trace of inoculation appears, however, in any Sanskrit medical text. The disease was undeniably identified in Ayurvedic writings, where it is called the ‘lentil’ disease, but again the link between theory and practice is tenuous. It seems that techniques recorded in texts, though still related in the learned tradition, fell into disuse, while new developments were widely practised without being inscribed in approved medical learning.

      In this light it is easy to fall into the trap of assuming that the Ayurvedic tradition was static and ‘timeless’ – that later texts did no more than to elaborate a coherent and comprehensive set of teachings set out, once and for all, in the Caraka Samhita and the Susruta Samhita. This supposition is given some support by the fact that these two texts do present themselves as unchanging bodies of knowledge; moreover, it is in line with native and foreign stereotypes of India as the fountain-head of eternal truths. But while the canonical texts present the appearance of homogeneity, research into the development of Sanskrit Ayurvedic literature has revealed that numerous authors dissented from orthodox viewpoints. In the course of time new diseases were reported and identified. From the sixteenth century syphilis (known as ‘foreigners’ disease’ in Sanskrit) was described in texts (mercury, brought to India by Islamic physicians, was used to treat it); and from the eighteenth century writings embraced disease descriptions evidently borrowed from western medicine.

      There were also innovations in diagnostics. Close attention to urine, and techniques for its inspection, stem from the eleventh century. Before the thirteenth century there is no mention of pulse examination in Sanskrit texts, but it subsequently developed into a key diagnostic method. A technique called ‘examination of the eight bases’ (astasthanapariksa) – the routine diagnostic method for examining the patient’s pulse, urine, faeces, tongue, eyes, general appearance, voice and skin – emerged in the sixteenth century. Novel prognostic techniques also came into use. For example, from about the same time, a procedure was taught whereby a bead of oil was dropped on the surface of a patient’s urine. The remaining span of his life was read from the way the oil spread.

      In therapy, a discernible shift lay in the rise of standardized compound medicines (yoga). Consisting of a large number of ingredients, yoga is regularly described in terms of its specific effectiveness against a particular ailment; this brings into question the conventional western view that Ayurvedic medicine was invariably holistic.

      Though Ayurveda is the most familiar tradition of indigenous Indian medicine, others have flourished in the subcontinent, notably the Siddha system of the Tamils and the Yunani medicine of Islam. Other assorted therapies are also visible, from folk medicine and shamanism to faith-healing and astrology.

      In south India, the form of medicine evolved in the Tamil-speaking areas was dissimilar in certain aspects to Ayurveda. Known as Siddha medicine (Tamil: cittar), this was basically an esoteric magical and alchemical system, presumably heavily influenced by tantric ideas. It was characterized by a greater use of metals, in particular mercury, than in Ayurveda, and prized a substance called muppu, credited with possessing great powers for physical and spiritual transformation. Pulse taking was highly valued for diagnosis. The semi-legendary founders of Siddha medicine include Bogar, who is said to have journeyed to China, teaching and learning alchemical lore, and Ramadevar, who supposedly travelled to Mecca, teaching the Arabs the arts of alchemy.

      From earliest times, Ayurvedic medicine handled and treated a range of children’s maladies, blaming them on the evil influence of celestial demons (graha, seizer), believed to attack children. The Sanskrit term graha was subsequently used to mean ‘planet’, and although grahas are clearly described as celestial beings in the Susruta Samhita, later rites for planetary propitiation are targeted at the same types of influence. Indian astrology and religious ordinances contain texts for placating heavenly bodies, as well as astrological prognostications regarding such matters as pregnancy and the sex of unborn children, dream interpretation, sickness and death. According to an early and significant legal work, ‘one desirous of prosperity, of removing evil or calamities, of rainfall [for farming], long life, bodily health and one desirous of performing magic rites against enemies and others should perform sacrifice to planets.’

      A work exemplifying the close relationship between medicine and astrology as therapeutic systems is the Virasimhavaloka by Virasimpa, written in AD 1383, probably in Gwalior. It deals with diseases from three points of view: astrology, religion, and medicine. The body parts are matched to the constellations and planets in an intricate scheme of influences and associations, and it is the astrologer’s task to read this pattern of symbols to understand the patient’s problem before advising remedies such as charms, expiations, prayers and herbs.

      The Bower manuscript, one of the oldest surviving Indian works, contains a text on divination by dice. It reveals the outlook of a fifth-century healer interested in the therapeutic powers of garlic, in elixirs for eternal life, in the treatment of eye diseases, herbal medicines, butter decoctions, aphrodisiacs, oils, the care of children, and spells against snake-bites, as well as divination.

      NEW ARRIVALS

      Islam brought new medical practices to India, having a major impact after the eleventh-century Turco-Afghan invasions of Gujarat, and becoming entrenched especially around Lahore, Agra, Lucknow and Delhi. These were known as Yunani Tibb – Yunani (or unani) being an Indian representation of the word ‘Ionian’. Yunani medicine derives in large part from Galenic medicine as interpreted in Ibn Sina’s Al-Qanun fi’l-tibb [Canon], and continues to flourish in India today. It is practised by hakims (physicians) in rural areas especially and is advocated among those who wish to embrace a distinctively Islamic medicine.

      Yunani medicine and Ayurveda have interacted to some degree, especially in materia medica. Though the primary languages of Yunani medicine are Persian and Arabic, there are also certain Sanskrit texts. Yunani postulates four basic humours, as distinct from Ayurveda’s three, and it has more of an orientation towards treatments in hospitals. The major difference between them is their clientèle. Broadly, Yunani physicians treat Muslim patients, and Ayurvedic physicians treat Hindus.

      In the first half of the sixteenth century Portuguese settlers came to Goa. The first medical book printed in India was the Coloquios dos Simples, e Drogas he Cousas Mediçinais da India (1563) [Colloquies on the Medical Simples and Drugs of India] by Garcia d’Orta (1490–1570). D’Orta had gathered his material from local physicians, and the signs are that there was a free exchange of medical ideas at that time between the Portuguese and the Indians. Relationships however declined, and after 1600 the Portuguese introduced restrictions which in effect banned Hindu physicians in Goa.

      Dutch East India Company officials showed great interest in the natural history and medicines of the Malabar coast where they traded and settled. Heinrich van Rheede (1637–91), the Dutch governor, published between 1686 and 1703 a work containing nearly 800 plates of Indian plants. Paul Herman’s (1646–95) herbarium and Museum Zeylanicum provided major sources for Linnaeus’s Flora Zeylanica (1747).

      The British arrived around 1600. Facing unfamiliar and severe health problems, East India Company traders were keen to learn from the local vaidyas and hakims, and Indian doctors were curious about British surgery, since the art had lapsed among vaidyas. It was observed by Sir William Sleeman (1788–1856) that ‘the educated class, as indeed all classes, say that they do not want our physicians, but stand much in need of our surgeons.’

      British physicians were initially prompted to adopt Indian methods by the problems involved in shipping medical stores from Europe. In time, however, they grew increasingly critical of the crudeness of indigenous drugs and contemptuous of what they saw as the shortcomings of Indian medicine. With characteristic ethnocentricity, East СКАЧАТЬ