Talk:Royal Physician and Hospital

Introduction

In ancient society, governance followed a monarchical system, with the king at the center, supported by a group of individuals including poets, artists, scholars, astrologers, priests, physicians, and statesmen. These individuals contributed to the king's intellectual and cultural interests and, in return, received his support and patronage.

Significance of the Royal Physician

Nizami-i-Arudi, a court poet of Samarkand, in his Persian book Chahar Maqala, has well said that the four clashes of experts are indispensable in a properly constituted court: secretaries of State, poet, astrologer, and physician. While the poet and others could be considered non-essential, the physician and the statesman were crucial. The physician was responsible for the king's health, and the statesman ensured the proper functioning of the government.

Out of these two, the physician was of the greater importance to the king as health is the basis of all happiness and activity can only be secured by the services of an able and trustworthy physician. Moreover, the king lived in perpetual fear of being poisoned and his luxurious lifestyle endangered his health. He had therefore great need to entrust his everyday life to the regulation and supervision of the physician. The two aspects of medicine, namely the maintenance of health and long life as well as the combating of disease, found complete application, in a physician's supervision of a king's life. The post of Royal physician needed trustworthiness equally with the ability and hence the system of hereditary appointment might be prevalent in the appointment of ministers.

As per Susruta

"He who studies this science which is expounded by the self-existent Brahma and which is eternal and which is laid open by the Lord of Kasi, is, being of the merit of holy deeds, worshiped by the kings on earth and goes to heaven after death."

As per Caraka

The selection of the Royal physician was based on such a high standard that only the best, wisest, and ablest could hope to be chosen by the king.

As per Vagbhatta

Vagbhatt denotes the place where a royal physician should stay.

A king should make the physician reside near the royal palace, so that he may be ever vigilant everywhere. He shall protect the food and drink of the king, especially from poison. Acquisition and preservation to which are fettered religious merit etc., are dependent on him.

The Royal physician's responsibility was very great In Vagbhatta's words:

The attendance on a king is as dangerous as a sport with weapons, snakes, and fire. It can only be discharged by modest persons through very great dexterity. Having acquired unattainable sway and great honor from the king, one should remain vigilant so as to retain and enjoy them for a long time.

Conduct of Royal Physician

Vagbhatta describes how the physician should conduct himself before his royal master.

• The physician's speech should be consistent with the ends of righteousness and the king's welfare on all occasions.
• Physician should not proffer counsel unless solicited, for such gratuitous advice might easily be deemed a great presumption.
• He should never act in a way that is prejudicial to the king's benefit because that implies destroying his support.
• The physician should see that what he says is palatable as well as wholesome.
• If the physician wishes to advise the king against an evil course, he should do so in strict privacy and in words that are noble and dignified. He should do this only when indifference on his part would be blameworthy.
• If any advice is met with a rebuff, the physician should hold his peace.
• Conversation that is distasteful to the king should not be persisted in.
• Any measure if required should be done only after the approval of the king.
• As regards the treasury and the royal harem, the physician's visits to the places should never go without asking for him. Even if the visit happens, it should be as brief as possible.
• He must show satisfaction with whatever he receives from the king as remuneration.
• While at court, he should avoid confidential conversations with any other than the king himself.
• He should also eschew gossip-mongering, hostile disputation, imitating the king either in his sartorial habits or in his pleasures and recreations.
• The physician should only smile even if the occasion is for loud laughter.
• When a secret relating to someone else is being narrated, the physician should seem as though he were dumb while when a secret concerning himself is being divulged, he should put on the quadruple armor of deafness, fortitude, sweetness, and perfect ease of manner.
• He should not take excessive pains with the object of putting himself in a too highly exalted position.
• Although close to the king, the physician should never take advantage of that relationship for personal gain.

To be a royal physician, a person needs to have complete wisdom, caution, ability, and modesty. Only this kind of person is worthy of being selected as royal physician.

Duties of a Royal Physician

A young physician named Rasayana, a descendant of Punarvasu, held an inherited position within the royal family. The royal physician was required to live within the palace grounds, constantly attending to the king’s daily needs. In addition to caring for the king, he was also responsible for the health of the queen and the prince, granting him access to the harem. The physician had the freedom to enter even the private chambers where the royal virgins lived.

This is supported by a verse from the Naisadhiya-carita, which mentions that only two people could enter the royal virgins' apartments without consequence: the prime minister and a physician learned in the teachings of Caraka and Susruta. The physician was expected to ensure the queen's well-being from the beginning of her pregnancy and throughout the development of the fetus. The king was also advised to follow midwifery guidelines during pregnancy and childbirth. A trustworthy physician, skilled in infant care, would oversee the prince’s health and remain with him.

Another physician was specifically appointed to supervise the kitchen. This physician was required to have the qualities described in Susruta, including being of noble birth, religious, affectionate, well-paid, honest, and devoted. The physician had to be calm, compassionate, intelligent, tireless, and always prepared with medicines. A superintendent, possessing many of the physician’s qualities, was also appointed to oversee kitchen operations. Additionally, the physician was skilled in interpreting emotions based on external gestures.

Daily Personal Treatments to King

The physician who wishes to administer the procedure of emesis or purgation to the king or a person of kingly circumstances or a wealthy man must be ready before beginning his treatment. Only those who are kings or of kingly circumstance or men of abundant wealth can be given the purgation procedure, in this manner. His time of daily visit to the king was very early in the morning. During the eighth part of the night, the king was visited by his physician, chief cook, and astrologer. The physician was given preference in interviews.

Besides emergencies and other important tasks, the physician had to be in constant vigilance for the purity of the food, drink, and medicine served to the king. For this, the physician had to supervise both in the kitchen and at the service in the dining hall. The physician was supposed to taste the food himself first before it was served to the king. The same rule applied to the liquor and other beverages. He had to supervise not only his food and drink and medicine but he had to supervise his bed-chambers too. Protecting the king's bed-stead by incantations was also a part of the duty. The king's bedstead was well protected all around by muttering incantations for protection. Thus the royal physician was expected to look after the king in every detail of his life to maintain perfect health and longevity.

The physician had to manage the luxurious methods of treatment of disease befitting the royal personage. He was assigned the task of taking special care of the queen during pregnancy and delivery. The duties also include the responsibility for the health of the prince and other needs of the king and his family. Thus he was expected to be an expert in all the branches of medical science.

This emphasizes the importance of the medical man and his profession even in ancient times. Such a royal physician was acknowledged and a respected leader in the realm. It was therefore the ambition of those who took up the study and practice of medicine to be one day the king's physician or honored by the royal personage.

Royal Dispensary

The physician has to keep the dispensary as well as the emergency requirement (first-aid) in the palace compound. On one side in the rear of the harem, there should be compartments provided not only with all the kinds of medicines useful in midwifery and diseases but also with well-known herbs and a water reservoir.

In every building in the Royal Court, emergency medical aid was kept. All these buildings should be provided with halls, pits, water wells, bathrooms, and remedies against fire and poison. It should also have cats, mongooses, and necessary means to worship the guardian gods appropriate to each. When the physician had to perform any procedure of Pancakarma or operative work he had to get his hospital fully equipped beforehand for the treatment as well as for any emergency which is likely to arise. The king received an aristocratic method of treatment.

References

• The Caraka Samhita published by Shree Gulabkunverba Ayurvedic Society, Jamnagar, India