A Short History of Aryan Medical Science/Chapter 8
CHAPTER VIII.
HINDOO WRITERS ON ÆTIOLOGY, DIAGNOSIS AND TREATMENT.
AFTER considering the Institutes of Medicine under the head of Sutrasthana, the early writers on Indian Medicine devoted their thought and attention to the investigation of the causes and symptoms of diseases, which they call Nidana. Among the Hindoo writers, Madhava has investigated at length the causes and symptoms of the largest number of diseases in all their varieties. To this head Sushruta has devoted sixteen chapters treating of the classification, causation, and symptoms of diseases, such as diseases caused by wind, haemorrhoids, urinary calculi, fistulae, diseases of skin, urethral discharges, abdominal tumours, abortion and unnatural labours, abscesses, erysipelas, carbuncles, tumours, scrotal tumours, fractures, and dislocations, diseases of the male organs of generation, diseases of the mouth, and minor diseases. Sharngdhara enumerates eighty principal diseases caused by wind, forty by derangements of bile, twenty by abnormalities of phlegm, and ten by faulty conditions of blood. Sushruta traces all diseases to one or other of the following seven causes : — (a) corrupt semen virile or ovum of the father and mother respectively, causing leprosy, etc. ; (b) indulgence in forbidden food by the mother during pregnancy, or the non-fulfilment of any of her desires during that condition, causing blindness, etc., to the child ; (c) the derangement of humours in the body, causing fever, etc. ; (d) accidents, as fall, snake-bite, etc. ; (e) variations in the climate, causing cold, etc. ; (f) superhuman agencies ; (g) nature, as hunger, etc.
Harita reduces the number to three, and says that diseases are caused by Karma, or by the derangement of the humours, or by both. Karma is the unavoidable consequence of good or evil acts done in this or in a past existence. "Misery and happiness in this life are the inevitable results of our conduct in a past life, and our actions here will determine our happiness or misery in the life to come. When any creature dies, lie is born again in some higher or lower state of existence, according to his merit or demerit." So there are certain diseases which are supposed to be the fruits of evil deeds done in a former state of existence. Harita declares that a murderer of a Brahman will suffer from anaemia, a cow-killer from leprosy, a regicide from consumption, and a murderer in general from diarrhoea. One committing adultery with his master's wife will suffer from gonorrhoea, and the violator of his preceptor's couch from retention of urine. A backbiter will suffer from asthma, a misleader from giddiness, a cheat from epilepsy, one who occasions or procures abortion from liver complaint, a drunkard from skin diseases, an incendiary from erysipelas, and one prying into another's secrets will lose the sight of one eye. Diseases caused by Karma may be cured by propitiatory rites, expiating ceremonies, and tranquillising efforts. If the rites do not cure the diseases, the patients have the assurance that they will at least check the further progress of the maladies in the life to come !
The treatment of diseases caused by humours forms part of Chikitsa, or the therapeutic branch of Hindoo medical science. The Aryans have treated and prescribed remedies for different diseases, such as : — Diseases of the abdominal glands ; abdominal tumours (of eight varieties) ; abortions (of six kinds) ; abscesses (of six kinds) ; anaemia ; anorexia ; apoplectic diseases ; asthma ; blood and bile affections ; carbuncles (of nine varieties) ; cardiac diseases ; cholera ; colic (eight forms) ; convulsions ; cough ; cranial diseases ; cystic affections ; diabetes (eight types) ; diarrhoea (of seven varieties) ; dropsy ; dysentery (of five kinds) ; dyspepsia ; ear diseases ; ectropium ; enteric catarrh ; entozoa ; epilepsy (four varieties) ; erysipelas (of nine kinds) ; diseases of the eye, cornea, eye-balls, eye-lashes, eye-lids ; diseases from excessive drinking ; diseases caused by excessive thirst ; fevers (twenty-five types) ; fistulse (of eight sorts)rj'iractures (eight forms) ; general debility ; gonorrhoea (twenty varieties) ; hiccough ; insanity (of four kinds) ; insensibility (of four kinds) ; jaundice ; diseases of the lens ; diseases of the male organs of generation caused by Shuka or water-leeches (of twenty-four varieties) ; mental debility ; minor diseases (sixty sorts) ; diseases of the mouth (of seventy-four kinds) ; nose affections ; paralysis (various forms) ; phlegm affections ; piles (six forms) ; pustules and sores caused by urethral discharges (ten varieties) ; rheumatism ; scrotal tumours (of seven kinds) ; skin diseases (eighteen forms) ; swellings (of nine sorts) ; sympathetic diseases ; traumatic affections of the eye-ball; tumours ; ulcers (fifteen varieties); unnatural labours ; diseases of the urinary organs; urinary calculi (of four kinds) ; virile debility ; vomiting ; warts ; diseases of wind ; worm diseases (of twenty-one varieties) ; wounds (of eight kinds) ; and miscellaneous diseases. Diseases of women form the subject of a separate chapter; infantile ailments and nursing are treated under the head of Kaumarbhritya ; and symptoms and treatment of diseases supposed to be caused by superhuman powers are described under Bhootavidya.
The treatment of poisons and their antidotes come under the head of Kalpa. Poisons are of two kinds, namely : Sthavara, vegetable and mineral poisons ; arid Jangama, animal poisons. Datura, arsenic, and others are Sthavara poisons, and are cured by emetics, purgatives, errhines, collyria, and antiphlogistic treatment. Jangama poisons include venoms of such animals as insects, scorpions, spiders, lizards, serpents, mad dogs, foxes, jackals, wolves, bears, tigers, etc. Various antidotes are prescribed for different bites. Both kinds of poisons are used therapeutically by the Hindoos. Sometimes one poison is used as an antidote against another — Vishasya visham aushadham — as the dictum is — by administering a Sthavara poison to one suffering from the effects of a Jangama poison, and vice versa. A curious antidote is suggested by one writer, who says that the beating of a kettle-drum, besmeared with a preparation called "Ksharagad," before a person under the influence of poison, has the power of effecting a cure !
In diagnosing a disease, the Hindoo physicians have been guided from an early date by physical signs afforded by inspection, palpation,* [1] percussion, auscultation, olfaction and degustation. Certain ancient writers take exception to the last, but others do not, and expect the physician to employ every one of his five senses, if necessary, in arriving at a correct conclusion regarding the seat and nature of a malady. The physician is required to note the patient's appearance, eye, tongue, skin, pulse, voice, urine, and faeces. The examination of the pulse is, however, considered the most important of all, as furnishing the best criterion of the phenomena and progress of disease, and it is the one usually depended upon by the native doctors. In order to know the precise character of the pulse, the radial artery at the wrist is usually chosen. In case of a male patient, his right pulse is generally felt, and in case of a female the left. In feeling the pulse the physician is to note its compressibility, frequency, regularity, size, and the different impressions it produces on the fingers. If it feels like the creeping of a serpent or a leech, wind is supposed to be predominant. If it be jumping like a frog, or similar to the flight of a crow or a sparrow, it indicates the predominance of bile. When it strikes the finger slowly and resembles the strutting of a peacock, it shows that the phlegm is in excess. The pulse that suggests the running of a partridge is called delirium pulse. An irregular pulse indicates delirium tremens, and a pulse which is almost imperceptible, depressed, irregular, and extremely languid, is a precursor of death. Pulsations in one suffering from fever or amorous passions are quick, and in a healthy man they are of a medium strength and perfectly regular. The capriciousness of the pulse produces other modifications very curiously described. It is interesting to note the similarity between this description of the pulse as found in the ancient Sanskrit treatises, and the doctrine of the pulse taught by the famous physician Galen, " who is the greatest and the best authority in Europe on the subject. For all subsequent writers have simply transferred his teaching on this subject bodily to their own works" (Dr Berdoe). Galen speaks of pulsus myurus (sharp-tailed pulse, so called as it sinks progressively and becomes smaller and smaller, like a mouse's tail) ; pulsus formicans (ant-like pulse, being scarcely perceptible, like the motion of an ant) ; pulsus dorcadisans (goat-leap pulse, as it seems to leap like a goat) ; pulsus fluctuosus (undulating), etc. This would suggest that Galen derived his knowledge on the subject from the works of Indian writers.
It has already been stated that certain kinds of diseases are believed to be caused by
"Damned spirits all,
That in cross-ways and floods have burial."
The demon theory of disease, a prevalent feature in almost every popular creed, has some influence on the Hindoo writers of medicine, according to whom the malignant spirit, if wittingly or unwittingly provoked, enters the body of the offender, annoys him in various ways, and afflicts him with certain kinds of diseases. Harita describes ten kinds of demons. Their names are : Aindra, whose favourite resorts are monasteries, convents and shrines, manifests his mastery over a person by making him very emotional, or wild and furious ; Agneya, who frequents cross-roads and burial-grounds, and under whose influence the patient looks intensely terrible and angry ; Nairuti, who is found near ant-hills, and makes his victim either stand still or become violent ; Yama constantly seeks battle-fields and makes his victim excited ; Varuna haunts lakes and rivers, his victim looks like a dumb creature with watery eyes ; Maruta resides in whirlwinds, and the person possessed of him cries and shakes and feels otherwise excited ; Kubera makes his victim rash and conceited, exhibiting a passionate desire for ornaments ; Aishana has his abode in old temples, and under his influence the patient applies ashes to his body and moves about naked ; Grahaka dwells in empty houses and dry wells, and one possessed of him cares not to eat or drink or listen to any one; Pishacha is fond of dirty and unholy places, and his victim cries, sings, raves, and wanders naked like a madman.
Various kinds of medicinal and magical treatment are prescribed for demoniacal possessions. Sometimes amulets are tied round the neck of the patient. Here are specimens of four amulets generally used among the Hindoos for curing demoniacal and other diseases:—
The first figure in which some mystic letters are written is used for exorcising a devil, the second is used for piles, the third for quieting a weeping child, and the fourth for fevers.
- ↑ * Palpation, percussion and auscultation are not altogether modern. They are referred to in the works of Charaka. Atreya, in his interesting dialogue with his favourite pupil Harita, speaks with even more precision on the subject. His directions are all of a piece with those in any of our modern works.