Chapter IV: The Medicine of the Hindus (2)

The student of surgery had many curious contrivances for acquiring manual dexterity. He practised the art of making incisions on wax spread out on a board; on flowers, bulbs, and gourds. Skins or bladders filled with paste and mire were used for the same purpose. He practised scarification on the fresh hides of animals from which the hair has not been removed; puncturing, or lancing the vessels of dead animals; extraction on the cavities of the same, or fruits with large seeds; sutures were made on skin and leather, and ligatures and bandages on well-made models of the human limbs. Fourteen kinds of bandages are described by Vágbhatta. The cautery was applied by hot seeds, burning substances, or heated plates and probes. Frequently this treatment was used for headaches and for liver and spleen disorders. It was chiefly employed, however, as with the Greeks, for averting bleeding by searing the mouths of the divided vessels. The early Hindus could extract stone from the bladder, and even the fœtus from the uterus. They must have been bold operators, many of their operations being actually hazardous. It is a subject deserving of inquiry how they lost the information and skill which they once possessed in so high a degree. The books of medicine and surgery to which reference has been made are undoubtedly most ancient, and it must be remembered were considered as inspired writings. Professor Wilson says: “We must infer that the existing sentiments of the Hindus are of modern date, growing out of an altered state of society, and unsupported by their oldest and most authentic civil and moral, as well as medical institutes.”

Many surgical operations which we consider triumphs of our modern practice were invented by the ancient Hindus. They were skilled in amputation, in lithotomy (as we have seen), in abdominal and uterine operations; they operated for hernia, fistula, and piles, set broken bones, and had specialists in rhinoplasty or operations for restoring lost ears and noses. It was a common custom in India for a jealous husband to mutilate the nose of his suspected wife, so that surgeons had opportunities to practise this branch of their art. The ancient Indian surgeons invented an operation for neuralgia which was very similar to the modern division of the fifth nerve above the eyebrow. Veterinary science was understood, and ancient treatises exist, says Hunter,[275] on the diseases of elephants and horses.

The best era of Hindu medicine was from 250 B.C. to 750 A.D. Its chief centres were found in such Buddhist monastic universities as that of Nalanda, near Gayá.[276] Hunter thinks it probable that the ancient Brahmans may have derived their anatomical knowledge from the dissection of the sacrifices; but there is no doubt that the true schools of Indian medicine were the great public hospitals which were established by Buddhist princes like Asoka, famous for his rock edicts, B.C. 251-249. Amongst the fourteen injunctions inscribed by this enlightened sovereign, the first was the prohibition of the slaughter of animals for food or sacrifice, and the second was the provision of a system of medical aid for men and animals and of plantations and wells on the roadside.[277]

Probably King Asoka’s were the first real hospitals for general diseases anywhere established, as the institutions connected with the Greek temples were not exactly hospitals in our sense of the term; they were more like camps round a mineral spring or spa. The Buddhist physicians would have in these merciful institutions abundant opportunity for the continuous study of disease.

Whatever may have been the condition of ancient Hindu anatomy and surgery, in modern times both have now fallen to the lowest point. Dislocated joints are replaced and fractured limbs set by a class of men similar to our bone-setters which are found in all nations. Certain of the Mohammedan doctors—_Hakeems_—sometimes bleed and couch for cataract in a clumsy manner. The village _Kabiráj_ knows but a few sentences of Sanskrit texts, but he has “a by no means contemptible pharmacopœia,” says Hunter. The rest consists of spells, fasts, and quackery.

Physicians (_Vitians_ or _Vydias_) being Sudras are not allowed to read the sacred medical writings (_Vedas_); these are guarded with religious awe by the Brahmins; they are permitted, however, access to certain commentaries upon the professional sacred books.

When we reflect on the high position which the science and art of the Hindus had attained in very ancient times, it is surprising that we have apparently learned little or nothing from them in connection with the healing art. Max Müller believes that there was an ancient indigenous Hindu astronomy and an ancient indigenous Hindu geometry. Probably the first attempt at solving the problem of the squaring of the circle was suggested, he thinks, by the problem in the Sutras how to construct a square altar that should be of exactly the same magnitude as a round altar. It is scarcely conceivable that so patient and shrewd a people as the Hindus, a people at once so observant and so profoundly speculative, should not have kept pace with the other enlightened nations of the world in the study of medicine and surgery. The vegetation of India is so rich in medicinal herbs that its _Materia Medica_ could hardly be equalled in any other country; so that both by intellect and by location the Hindus should be amongst the foremost professors of the art of medicine. On the contrary, however, the West has everywhere to instruct the East in the medical sciences; and the young Brahmins who flock to the medical schools and universities of Europe find that they have everything to learn from us in this direction. Is this an evidence of arrested development, a retrogression in civilization due to conservatism and a paralysis of the power to keep pace with the world’s advance consequent on the influences of religion and custom? Probably it is. All the medicine of the Hindus is empiricism; their systems exclude anatomy and surgery, without which, as Prof. H. H. Wilson observes,[278] “the whole system must be defective.... We can easily imagine that these were not likely to have been much cultivated in Hindustan, and that local disadvantages and religious prejudices might have proved very serious impediments to their acquirement.”

As compared with other ancient nations, Egypt, Chaldæa, Greece, and Rome, we are at considerable disadvantage in the attempt to discover what was known and practised of the healing arts in the remoter ages. We have no papyri like the “Book of the Dead” or the great medical papyrus of Ebers; we have no inscriptions on such ancient monuments as Mesopotamia has preserved for us; we have no Sanskrit treatises to be compared for their antiquity and scientific interest with those which have come down to us from ancient Greece.

Max Müller says[279] that “few Sanskrit MSS. in India are older than 1000 after Christ, nor is there any evidence that the art of writing was known in India much before the beginning of Buddhism, or the very end of the ancient Vedic literature.”

Then, again, the Hindu treatises on medical subjects, whether fables or facts, have hitherto been little noticed by Sanskrit scholars.[280]

The subject is not of general interest, and a man would need to be not only a perfect Sanskrit scholar, but a physician as well, who should attempt such a task as the translation of these treatises in any useful manner. Although ancient India has little to show us in the way of actual written documents and inscriptions, it must not be supposed for a moment that she is deficient in ancient poetry and other works which have been preserved through the ages by the marvellously developed memory of her Brahmins and religious teachers. The ancient Vedic hymns, the Brâhmanas, and probably the Sutras, were handed down from before 1000 B.C. by oral tradition. Every, the minutest precaution was taken that not a word, not a letter, not an accent even should be omitted or altered; and Max Müller tells us “this was a sacred duty, the neglect of which entailed social degradation, and the most minute rules were laid down as to the mnemonic system that had to be followed.”

The people of India believe that small-pox is under the control of “the goddess Mata,” in whose honour temples abound and fairs are held, where thousands of women and children attend with offerings. The declivities of most of the numerous conical hills present either a reddened stone or temple devoted to “Mata,” with most probably an attendant Brahmin priest. Nearly every village has its goddess of small-pox in the immediate locality, and in many places a large piece of ground is esteemed holy and dedicated to “Mata.” The people do not pray to escape the affliction, unless in seasons when it occurs with more than ordinary violence. They do, however, petition for a mild visitation. But even the loss of an eye does not appear to be viewed as a very serious calamity! “Is there not another eye sufficient for all our purposes?” questioned one of these stoical philosophers. “If it were the leg or hand, it would be different, but an eye is immaterial.”[281]

“The small-pox goddess stands with two uplifted crooked daggers, threatening to strike on the right and left. Before her are a band of executors of her vengeance. Two of them wear red grinning masks, carry black shields, and brandish naked scimitars. White lines, like rays, issue from the bodies of the others, to indicate infection. On the right there is a group of men with spotted bodies, afflicted with the malady; bells are hung at their cinctures, and a few of them wave in their hands black feathers. They are preceded by musicians with drums, who are supplicating the pity of the furious deity. Behind the goddess, on the right, there advances a bevy of smiling young women, who are carrying gracefully on their heads baskets with thanksgiving-offerings, in gratitude for their lives and their beauty having been spared. There is, besides, a little boy with a bell at his girdle, who seems to be conveying something from the right arm of the goddess. This action may possibly be emblematic of inoculation.”[282]

Another small-pox deity of India described by Mr. Dubois, a missionary,[283] is Mah-ry-Umma, who is supposed to incarnate herself in the disease. The natives, when vaccination was first introduced, objected to the practice for fear lest the goddess should be offended, as to prevent the small-pox would imply an objection to her becoming incarnate amongst them. The difficulty was overcome by the suggestion that the vaccination was a mild form of disease by which the goddess had chosen to visit her votaries, so that she might be worshipped with equal respect.

“Even Siva is worshipped as a stone, especially that Siva who will afflict a child with epileptic fits, and then, speaking by its voice, will announce that he is Parchânana, the Five-faced, and is punishing the child for insulting his image.”[284]

Surgeon-General Sir W. J. Moore, in an article on “The Origin and Progress of Hospitals in India,”[285] says that we may form a very good opinion of the condition of the whole of India in ancient times by recalling what was the state of medical relief in most of the native States previous to the institution of medical relief and sanitation in British districts.

“Recently, in the Native States, there might be witnessed disease proceeding unchecked and uninterfered with, to a degree which certainly would not be allowed at present in civilized Europe. And especially was this evident in surgical disease, as illustrated by the following extract from an official document:[286]—

“‘In former reports I have mentioned the extreme ignorance displayed by native “hukeems” or “vaids” of surgical principles. As a rule, all surgical disease is either wrongly treated, or let alone until treatment is unavailable by these uneducated practitioners. Their errors of omission and commission are not so easily ascertained in their medical, as in their surgical, practice. But in the latter, there is a glaring ignorance, not only from things requisite not being attempted, but from things unnecessary being performed, leading to the serious injury and often to the death of the patient. Thus, during my last tour, I saw at one village, an open scrofulous sore of the neck with the carotid artery isolated, and apparently on the point of giving way. At another village I witnessed an advanced cancer rapidly killing a man. In another place a woman had remained for days with a dislocated jaw, which was easily put _in situ_. Other forms of dislocation and fracture neglected are almost daily sights. At Bikaneer I amputated the leg of a man who eight months before fell from a camel; the bones of the leg protruding through the skin of the heel, and the foot being driven half-way up the front of the leg, _in which position it had been permitted to heal_! At the same place a woman was rapidly sinking from the results of extensive sinus of the breast, following abscess, and which only required free incisions for the restoration of health. I also saw a man dying of strangulated hernia, without the slightest idea of or attempt at relief on the part of the native practitioners. And so on, throughout almost the whole range of surgery, I have from time to time witnessed the most lamentable results from the malpractices, or from the absence of practice on the part of the Native Doctors.’

“As mentioned in the above extract, the errors of omission and commission are not so easily ascertained in medical as in surgical cases. But the great majority of those stricken by disease, such as inflammations and fevers, derived as little benefit from medicine as did the Romans when, according to Pliny, physicians were banished from the Imperial City during many years. For few indeed of the higher class and comparatively better educated ‘hukeems’ or ‘vaids’ would minister to the poor who were unable to pay their fees; and of the populations of India the great majority are and always were poor. Steeped in continually augmenting superstition and ignorance, if the poor received medical aid at all, it was from the hands of the equally ignorant and superstitious village ‘Kabiraj,’ who, unlike their more noble Aryan predecessors, did not even ‘draw physic from the fields,’ although they may have used a charm, such as a peacock’s feather tied round the affected part! If the poor got well, they got well; and as most diseases have a tendency to terminate in health, many did recover. If a fatal termination resulted, it was attributed to _nusseeb_ or destiny, or the gods were blamed. Insane persons, if harmless, were allowed to ramble about the streets; if violent, they were chained in the most convenient place. The jails of the Native States were also in an unparalleled unsanitary condition, for no medical aid whatever was provided; as Coleridge said of Coldbath Fields, these jails might have given His Satanic Majesty a hint for improving Hades. Fatalism combined with ignorance, and a consequent utter unbelief in any measures of sanitation, resulted in the absence of all measures of precaution during epidemics of contagious disease. During the prevalence of small-pox, children might be seen by scores, in every stage of the disease, playing or lying about the streets. During an epidemic of cholera, not one precautionary measure was ever adopted—except by the wild Bheels, who invariably moved, leaving their villages for a time for the open jungle; thus forestalling the most approved method of preventing cholera adopted for British troops, viz., marching away from the infected area.

“Not only were there no hospitals proper, or contagious hospitals, or asylums for the insane, but neither were there any asylums for lepers. Regarding the latter, difference of opinion would appear to have existed among scientific investigators, then as now, as to whether leprosy is a contagious disease or not. Then as now, in some parts of the country, lepers were permitted to live among the people; in other localities they were thrust out from the towns or villages, generally forming a little colony on the adjoining plain. This expulsion of lepers from the towns and villages, then as now, was not so much the result of fear of contagion, as the Brahminical dread of contact with impurity. Then as now, these outcasts lived miserably in mud or grass huts, obtaining food by begging. When tired of life, or when being old or disabled their relatives were tired of keeping them, they often submitted to ‘sumajh’ or burial alive. But they more frequently threatened to perform ‘sumajh’ with the view of extracting alms from the charitable, who were induced to believe that the death of the leper would be credited to them, unless they bought off the sacrifice. ‘Sumajh,’ or leper burial alive, has been practised comparatively recently in more than one of the Native States.

“The Native principalities are now much more advanced in most respects than they were only a few years back. By coming into contact with the progressive civilization of adjoining British districts, the Governments of Native States were forced to advance; for they felt their existence would be imperilled. And this advance was most materially assisted by the successful endeavours made by the Indian Government to secure the better education of the young Indian princes and nobles. The Imperial Government also, and especially under Lord Mayo, enunciated care for the sick as one of the most urgent duties of the feudatory rulers of India. Owing to such measures, aided by the personal influence of the Political, and the assistance of the Medical Officers attached to the Native Courts, a hospital or dispensary has, amongst other features of civilization, been established at every large capital; while in some States ramifications of such central establishments have rendered the people almost as well off, in the matter of medical relief, as those in British territory. As it will not be necessary to refer again, except incidentally, to the Native States, I may here remark that all the medical institutions are supported at the cost of the Durbar or Government of each State. They are, as a rule, superintended by the European Medical Officer attached to the Political Residency, aided by native assistants.

“Although the recent condition of the Native States represents what formerly prevailed all over Hindustan, it must not be understood that the people were devoid of charity; only the charity of the well-to-do classes did not take the form of medical relief. In the absence of a qualified medical profession recognised by the State, the confidence felt in the physic of the ‘vaids’ and ‘hukeems’ was something akin to the faith of Byron, who without any such excuse designated medicine as ‘the destructive art of healing.’ Moreover, the organization of hospitals was not understood, and the necessary discipline of such establishments was foreign to the habits and ideas of the people. The poor (who now throng the hospitals of India), having had no experience of the advantages of such institutions, would probably not have resorted thereto had hospitals and dispensaries been opened under native control. So suspicious were the people on the first opening of a hospital in one of the Native States, that sweetmeats, of which they are very fond, were ordered to be given daily to each patient, as an encouragement to attend! So in former times the charitable preferred spending their money in sinking wells, in constructing _serais_ or rest-houses for travellers, in endowing temples, and in feeding the poor, particularly Brahmins. In this manner, enormous sums have been disbursed and are still expended, especially in food for the destitute. This laudable charity of the Indians, although often confined to their own caste people, and to occasions of family festival, is one of the reasons why it has never been thought necessary to establish any system of poor-law relief in British India. Of late years native charity has been often directed towards building and endowing medical institutions, and many Indian gentlemen have given most liberally for such purposes.”