Talk:The Vaidyas in Ancient Times

Preface

The profession of the Vaidya, the physician, is as eternal as medicine itself. It is not confined to a civilized state of society alone. Even when man was in the primitive stages of his development, there must have been one person who would have salvaged his mate or offspring or members of the tribe when ill. His remedies might have acquired a definite shape from that of consoling sounds to herbs and incantations or coarse methods of medical and surgical manipulations.

Vaidyas of Rgveda Era

In the ancient Indo-Aryan era, the institution of the physician was found to be well recognized and established ever since the days of the Rgveda. The Aswins were considered in the Rgveda as the physicians of the gods. The divine profession of being a physician has not been assigned to become hereditary but was open to anyone to pursue. We find the specific reference to the physician, the Bhisak, who is credited with the learning and the possession of disease remedies in Rgveda. Physician is the person who has store of herbs at hand, treats the kings and common men.

By that time, medicine had developed into a more structured practice, requiring a certain level of knowledge that was often found among educated members of society. Thus it was the Brahmana, the natural teacher and priest of the society who was generally a physician. The sages held the Soma herb supreme among the plant kingdom and its juice opened their vision to immortal truth.

Wih Soma as their sovereign Lord. The plants hold colloquy and say, O, King, we save from death the man, Whose cure a Brahmin undertakes.

Vaidyas of Atharvaveda Era

The Atharvaveda is necessarily the source of the Ayurveda because we find the preoccupation with the remedies for diseases, evil spirits, and other ailments of a person. During those times the physician was considered as a magician with the qualities of both a priest and a therapist. However, the various branches of medical aid have attained their distinctive ramifications nowadays. There is treatment by herbs, organic body juices, by incantations and we have surgical extractions and the countering of poisons.

There were four different branches or techniques of treatment well defined during the Vedic age. They are:

1. The Atharvani - It corresponds to magical charms.
2. The Angirasi - It corresponds to body juices or organo-therapy.
3. The Daivi - It corresponds to the divine or psycho-therapy.
4. The Manusi - It corresponds to the human or drug therapy.

Vaidyas in Post Vedic Era

The position of the Vaidya was predominant in the golden age of Ayurveda which was the post-vedic period. In the Caraka Samhita, we have a complete picture of the physician, his equipment of learning and therapeutic accessories, his dress and manners, his standard of ethics, and his general position in society as a guide and leader.

Dress

Like the present-day counterpart, the ancient physician of the country was conspicuous by his clean and well-washed clothes, his short-clipped hair and nails, and his general demeanor of smartness and geniality. The medical graduate should enter into the medical profession wearing a white raiment, holding an umbrella and handstick. He should wear shoes and avoid gaudy clothes. He should be imbued with a spirit of helpfulness, brotherhood, and sincerity towards all the creatures . It is noteworthy that even in England for many centuries, the physician held a gold-tipped cane in his hand while visiting his patients.

Manners and Ethics

Code of Conduct in General

The physician was expected to be a paragon of gentlemanly qualities. He should not be a braggart. Even though possessed skills and learning in his science, he should not be loud in proclaiming it to the world. Caraka lays down. Even though being knowledgeable, one should not boast and speak of it much. For though a man be virtuous otherwise, boastfulness makes him hateful to people. His general attitude must be genial, gentle, modest, and sincere. He should not harbor any ill feelings against anyone and should look upon the destitute, the poor, and the helpless as his kith and kin and be ready to offer help to the needy people.

Code of Conduct Towards Females

Vaidya's attitude towards women was particularly aloof and detached. When he enters a patient's house he should keep his head bent and not be curious about the things and persons about him. His mind must be devoted to the welfare of the patient alone. If he had to enter to treat a woman, he should never go unaccompanied and he should neither laugh nor smile nor exchange irrelevant words with her. No gifts offered by her in the absence of the husband should be accepted. Even if he discovers her attachment to him and her amorous overtures, he should not respond, neither should he divulge them to others.

As per Kasyapa Samhita

The Kasyapa Samhita is emphatic on the subject. It also describes the attitude he should have towards another physician who may happen to be interested in the patient. In the household of the patients, he should never engage himself in jokes with women, even with female servants. He should not utter their names without prefixing terms of reverence, he should always speak giving the place of honor. He should not try to have any transaction with or great attachment to them. He should accept nothing from the woman without the knowledge of her husband. He should never enter without informing beforehand. He should neither talk nor sit with a woman in privacy. He should never look at her when she is uncovered or should - not laugh at her. He should be indifferent towards her if she shows her love but should never tell it to anyone.

If any other physician comes in, he should forgive him and win him over with friendly conversations. If he finds fault with him again and again, he should be challenged to debate and should be overpowered, from the very beginning, by the authority of other texts. He should not be allowed to speak. If he begins to speak, one should bawl out. One should not treat him roughly losing control but should overpower him only with words of seeming praise.

As per Vagbhata

Vagbhata sums up admirably the picture of a true Vaidya, his attitude and equipment. Vaidya is the one who visits the patient only on invitation, well dressed and having perceived the good omens, who having entered reposes his mind on nothing else than the patient, who examines the patient and his malady considering the etiological factors, who never divulges or discloses any shameful features of the patient's life and who knows the proper time and stage of treatment and uses it, he indeed is the true physician that achieves success in his treatment.

Professional Ethics

Vaisyas, the Primitive Followers

The medical profession was originally pursued as a means of living by the third caste of the Aryan society i. e. the Vaisyas. The Brāhmaṇas and the Ksatriyas also learned the science, the former for research in the higher spheres of knowledge and for the relief of humanity purely as a mission of compassion, the latter for the advancement of the science and the protection of oneself and his dependents from the disease. Yet all the four castes were entitled to study the science of Ayurveda for general enlightenment in the matter of purity, health, happiness, and longevity. Everyone was supposed to learn the science for the sake of a righteous and pure life.

Remittance

Though the professional Vaidya was making a living out of his profession and often fixed up the fees due to him in any particular undertaking, he yet had a code of ethics to be observed. He treated the poor, the destitute, the maimed, the travelers, and the mendicants free of charge. Even in cases where there was no previous agreement about the fees, it was obligatory on the part of the patient to pay his fees and discharge his debt to the physician. There was a widespread attitude which is prevalent even today that among the debts that are particularly sinful if not paid, the physician's debt comes under that category.

Professional Epitome

The ideal, apart from the exigencies of the physician's profession with regard to the fees, was always to keep in view the principle of compassion and service for fellow men. Besides these accomplishments, the Vaidya was also required to be a good polemic. If he was interrogated by a fellow of the same profession on any point of theory and practice, he must be able to meet him in discussion and if the opponent persists in carping at him, he should deal with him severely and subdue him by reproaches and repulses in satirical terms.

The Vaidya was enjoined to seek the aid of other members of his class in the diagnosis of different cases and in determining prescriptions and their pharmaceutical preparation. He must not quarrel with the fellows of his profession. A general spirit of geniality and kindliness and a supreme ambition to advance the welfare of the people were demanded of him.

Strategy of a Physician

We observe that the one great preoccupation of the ancient physician was to find out whether a particular case that came to him was curable or incurable. A whole science of the signs and symptoms that prognosticated the favorable and the unfavorable trend of disease was laid out to enable physicians to avoid the path to infamy and reproach by handling cases that were incurable by him through any measures. Many factors must have been behind the dread of incurable cases. The fear of unpopularity and consequent fall in patronage was one of the eminent factors. But even more persuasive was perhaps the dread of state punishment or penalty if a physician was found to have been responsible for the death of a patient. A wise physician sometimes undertook the treatment of even incurable cases only after declaring it to be such before the relatives of the patients and tried severe methods and measures with the permission of the relatives and the state officials. The physician would leave no stone unturned in saving the patient's life while absolving himself of the responsibility for his failure.

Prognostic Ethics as per Hippocrates

On this subject of prognostics, there is a striking resemblance in the spirit behind the growth of science between the works of Indian writers like Caraka and the Greek author of Medicine, Hippocrates. Hippocrates says thus in the book of Prognostics:

It appears to me a most excellent thing for the physician to cultivate Prognosis, for by foreseeing and foretelling in the presence of the sick, the present, the past, and the future and explaining the omissions which patients have been guilty of, he will be the more readily believed to be acquainted with the circumstances of the sick; so that men will have confidence to entrust themselves to such a physician.

The physician will manage the cure best to his knowledge. He also would have foreseen what was to happen from the present state of matters. As it is impossible to make all the sick well; it is advisable to foretell what is going to happen. Some patients die even before the physician can visit him and some die immediately after the physician reaches him. Some patients even die after living perhaps only one day or a little longer before the physician can bring him the required medications or herbs for his cure. Hence it becomes necessary to know the nature of such affections, how far they are above the powers of the constitution, and if there are chances of any miracle in the disease. Thus a man will be more esteemed to be a good physician, for he will be able to treat better.

In the Book of Prognostics, the fore-knowledge of the physician recommended by the Hippocrates to physicians denotes three reasons:

1. For the confidence of mankind, which it will conciliate to the physician.
2. It will free the practitioner from all the blame if he has announced beforehand the fatal result of the disease.
3. Being a very great instrument in effecting the cure.

The Hippocratic foreknowledge rests not only on the observation of the signs but also on the understanding of them. He suggests that a physician who wants to excel in this professional field should be able to comprehend and estimate the doctrine of all the signs and compare all the symptoms properly. Then only he will be able to judge properly beforehand who will recover from a disease and who will die. He will also diagnose who will be sick for a long and who will get cured fast.

Prognostic Ethics as per Caraka

One can see from the Section of Prognostics of Caraka that dreams, sights, sounds, complexion, voice, and many other such traits show the upcoming attack of a disease. Certain such symptoms after the onset of the disease can prognosticate sure death or recovery. There is a great element of mystical lore in it. But there is much that may be verifiable by observation and experiments and that is a great aid to the physician who undertakes the treatment.

The physician should follow his curative procedure in a preconceived manner. He should first win the confidence of the patients. Then he should free himself from the blame by announcing the issue of the disorder about which he is consulted to the patient. He should explain the whole treatment procedure to the patient and take his or his relatives' consent before the treatment. He should free himself from the blame of infamy before starting the preparation of drugs.

Significance of Prognostics in Today's Era

Looking to the importance of general Prognostics, the notion is why this branch of Semiology is no longer practiced by the present professionals. It was the best possible technique of first describing the general phenomena of diseased action and then applying them to a particular case. It comprises taking a comprehensive view of the whole subject described before attempting to examine the patients before diagnosing. This reflects the broader, more generalized approach that ancient scholars often took, in contrast to the more specific focus of modern medicine, who confine their attention to particular facts and neglect the observation of general appearances. No one will be offended by the statement that although we have learned to examine particulars of disease with greater accuracy than our forefathers did, the sphere of mental vision is more confined than theirs. Ancient physicians often took a more comprehensive approach to understanding health and disease. Surely, we might gain a useful lesson by endeavoring to combine more primitive comprehensive views with the present practice of more accurate and minute observation.

The Vaidya and Society

The degree of honor accorded to the learned professions represents the degree of the refinement of the civilization of the society and the people forming it. Among the learned professions, the medical profession is accounted to be the most supreme as it deals with the vitality of health, happiness, and survival of the race. From the earliest history of civilization, the physician was under the veil of either the priest, prophet, or physician as it befitted the spirit and degree of refinement of that particular age.

Primitive Therapeutic Practices

In the early dawn of human history, religion and medicine were scarcely distinguishable from each other. Every ill-humor of the body or the mind was attributed to the evil influence of some invisible spirit and exorcism or propitiatory rite was all the therapeusis complied. Naturally, the priest was the therapist or curer of the disease as the healing formed an integral part of the ritual of religious worship.

Medical Practitioners of Vedic Era

In the Rgveda, the earliest available records of civilized human life, the knowledge of healing, as a science comprising both the religions and lay forms of therapeutics, had reached a high degree of progress. Besides the healer and the healing science were already developed as an institution and the healer, the Bhisak, or the physician was held in high honor among the gods as well as among men. The hierarchical order of the gods in the tradition of a race sent the hierarchical order among its men.

The Aswins

The Aswins were twins and experts in medicine. They healed and mended the injuries to the gods when they had fights with the demons. They grew up in human society as the divine healers and the sect called Atharvama after Atharvana, the seer and founder of the Atharvaveda. They were accounted as the healers and exorcists in the Vedic and post-Vedic times. The Aswins though originally minor gods were later raised to the high status of the other gods and regarded worthy of being offered oblation in sacrifices by the virtue of their proven powers in the healing art.

The Aswins, who are the physicians of the gods are celebrated as the resuscitators of sacrifice because they reunited the severed head of sacrifice. It is these two, that successfully treated Pusan when his teeth had loosened, Bhaga when he had lost his eyesight, and Indra when his arm had stiffened. These two, moreover, cured Soma the Moon-god of consumption and restored him to his happiness when his health deteriorated. When Cyavana, the son of Bhrgu, who was a drunkard had become decrepit with loss of voice and body luster as the result of old age, the Aswin-pair brought him back to normal condition.

On account of these and many other miracles of the Aswins, they came to be regarded as the greatest of physicians due to the great personages received by the Indra and others. In Charaka Samhita, Caraka recites their wonderful feats, and even Dhanvantari known as the God of medicine, considered the Aswins as the gift to mankind by the real gods. They were regarded as the originators of the Science of Medicine. The Vedas and a few other pieces of literature of that time have several songs and hymns dedicated to Aswins in their honor, which are the indications of the status, recognized by the Vedic society.

Medical Regimen in Post-Vedic Era

Post Vedic is the period succeeding the Vedic Era, retained its respect for the real healers though by then already the impostors known by the name of Kuvaidyas or Kuhakas from which the modern term Quack is derived had made their appearance in society and were increasing in their number. The Caraka Samhita which belongs to that period between the Vedas and the Smrti and Mababharata devotes a lot of attention to distinguishing the real physician and the pretentious quacks. It accords the greatest homage to the real physicians and condemns elaborately the destroyers of life, whose ways and manners are fully described in impressive words in a whole chapter.

That reflects the true conditions of the society in that era. By then, the profession of the healer must have become an attractive, lucrative, and enviable one of social distinction. Caraka offers sincere and respectful obeisance to the true physician, the bringer of life. Those who are ignorant of this science of healing yet practice this profession should be shunned as they are the messengers of death on this earth. But at the same time, the patient should salute those who are learned in the science skillful, pure, expert in performance, practice of hand, and self-controlled. The society reflects the true conditions obtained by the medical regimen.

Rise of Semiology

A huge stress is laid on the cases whose symptoms and disease were not cured. The reputation of the physician or vaidya treating the cases in which there is a dread of failure is bound to become low. Loss of reputation, loss of monetary emoluments, and worse results such as perhaps the censure and punishment by the State where death was recognized due to wrong methods of treatment, is the biggest terror in the minds of medical practitioners. This gave rise to an elaborate science of diagnosis and investigation in the light of the patient's dreams and premonitory symptoms. It also included the diagnosis of casual circumstances like attending to, the surroundings of the patient, the messenger he sends to fetch the physician, omens on the physician's path, and such other conditions. This is elaborately described in the whole section devoted to it known as prognostics.

Incurable Cases

Throughout the literature of Caraka and even in the preface of the treatise on Caraka Samhita there is an insistence on avoiding the under-taking of cases showing the symptoms of incurability. Such cases are known as Pratyakhyeya those that deserve to be refused. This does not mean that the incurable cases were refused the treatment absolutely but the physician declared the condition of the patient before his relatives to be incurable and with the permission of the state and his relatives, heroic measures were resorted to alleviate the disease.

The physicians would undertake such cases to treat the patient with the view to alleviate the evil, so as perhaps to assuage the pain or prolong the life as long as possible. The patient suffering from cough from birth with all the fully developed symptoms and who is debilitated should be considered incurable but if the cough is of recent origin and the patient is strong the treatment should be undertaken despite declaring it to be of the incurable type. When the abdominal disease due to the gathering of fluid has gone beyond the stage of treatment or if the humoral tri-discordance has not been subdued, the physician should summon the patient's kinsmen, well-wishers, wives, Brahmins, state authorities, the caste, and elders and speak to them about the precarious condition of the patient. If not treated, the patient's death is certain. But if treated by poison therapy he may have a chance to survive. Having spoken thus and being permitted by the patient's well-wishers to proceed, he must administer poison. There is nothing more reasonable perhaps that even the modern counterpart of the old-time Vaidya can do under such circumstances.

References

1. Agniveśa, Caraka, Dṛḍhabala, and Shree Gulabkunverba Ayurvedic Society. The Caraka-Saṃhitā. ed., Shree Gulabkunverba Ayurvedic Society, 1949. 6 vols.