A Short History of Aryan Medical Science/Chapter 9
QUALITIES OF A PHYSICIAN AND HIS PROGNOSIS.
IF it is interesting to know the ideas of the early Indian writers on the theory and practice of medicine, and on other matters appertaining thereto, it will not be less interesting to describe their notions of what a good physician should be like. They have enumerated the qualities requisite in one desirous of practising as a doctor, and explained how he should behave both in private and public life in following his noble profession.
A physician is required to be always clean and tidy. For it is said that a physician who is dirtily and shabbily clad, conceited, foul-tongued, vulgar, and goes to a patient unasked, is not respected even though he be as clever as Dhanvantari. He should have his nails pared and his hair dressed, should have clean clothes, and carry a stick or an umbrella in his hand, wear shoes,* and have a gentlemanly bearing. He must be pure-minded, guileless, pious, friendly to all, and devoted to truth and duty. His chief duty is to treat his patient honestly, and without desire of any gain. To treat a patient conscientiously is supposed to bring "merit" (Punya) to the physician, who should not therefore sell his "Virtue" by treating a poor patient for the love of lucre. For the sake of his livelihood he will be justified in expecting an adequate fee from well-to-do people. He who is in a position to pay his doctor's fee but does not, though under his medical treatment, is styled " wicked," and is said to transfer all his "merit" to the physician. A religious sentiment appears to have been attached to the question of payment. For the Hindoos are enjoined not to approach or interview a king, a preceptor, and a physician " empty-handed," that is, without a gift or offering. It is therefore aptly said that a country is not without men, and men are not without diseases ; so a physician's livelihood is always ensured. A practitioner knowing one hundred remedies for any one disease is called a Vaidya, one with a knowledge of two hundred remedies for any one disease is called a Bhishak, and to one who is acquainted with no less than three hundred remedies for each and every affection is applied the term Dhanvantari. The knowledge of diseases and the knowledge of the drugs are of equal importance to a physician. One without the other is like a vessel without a helmsman.
In the opinion of Sushruta, he who has merely learnt the principles of medicine, and received no practical instruction, loses his presence of mind when he sees a patient, just as a coward gets confused in a battle. On the other hand, he who through mere empiricism has obtained facility in practical work, but knows not the principles of medicine as taught in the books, deserves, not commendation from the learned, but punishment from the king. Both these are unaccomplished and unfit to become practitioners, just as a bird with a single wing is unable to fly.
Hindoo physicians go out to procure medicinal drugs on Sundays, Wednesdays, Thursdays, and Fridays of the light fortnight, and commence the preparation of mineral medicines on Wednesdays, Thursdays, and Fridays. It is customary with some Vaidyas not to prescribe on Mondays, Wednesdays, and Saturdays — the first being particularly objectionable. Patients, on the other hand, avoid commencing treatment on Mondays, Tuesdays, and Saturdays, if they conveniently can. For purgatives or emetics Tuesdays, Thursdays, and Sundays, and for bloodletting Tuesdays and Sundays, are generally preferred.
After making the diagnosis, the physician forms an opinion as to the prognosis. Diseases are divided into three classes, namely, Sadhya (curable), Asadhya (incurable), and Yapya (controllable by remedies only). A patient suffering from a disease belonging to the last class remains well as long as he continues the use of medicine, but relapses as soon as the treatment is stopped, just as a tottering house collapses on the removal of the props. The physician is advised to refrain from treating a disease which is quite incurable.* The other two classes of diseases should be treated with all possible care and skill. In order to acquire success in his profession, the physician is expected to know both the theoretical and the practical sides of the science of medicine. Omens are carefully watched by the Hindoo physicians before attending their patients. Favourable omens are such as the following : kettle-drum, tabour, conch, umbrella, cow with calf, virgin, woman with baby, two Brahmans, fish, horse, skylark, peacock, deer, mongoose, elephant, fruit, milk, flowers, dancing-girl, smokeless fire, flesh, spirituous liquor, sword, shield, dagger, washerman with dry-washed clothes, curds, cereals, banner, full water-pot, etc. The unlucky omens are fuel, hide, grass, smoky fire, snake, chaff, raw cotton, barren woman, oil, molasses, enemy, quarrelling people, one besmeared with ointment, scavenger, eunuch, butter-milk, mud, wet clothes, mendicant, ascetic, beggar, lunatic, one-eyed person, corpse, crow, jackal, empty water-pot, etc. These omens are observed with a view to enable the physician to prognosticate the favourable or unfavourable result of his attendance. They must be met with accidentally by the physician while on his way to the patient. But if the messenger who is sent to call the doctor sees on his way any of the omens enumerated above as good, it is bad for the patient ; if he sees any of the bad ones it bodes good for the patient. The messenger should preferably be of the same sex and caste as the patient, should be of good breeding, without any bodily deformity, clever, clean, well dressed, driving a horse or a bullock carriage, and holding fruits and white flowers in his hand. A widow or a mendicant is not considered a suitable messenger. When a physician is himself a qualified practitioner, well knowing the virtues and properties of drugs, his work becomes much easier if the messenger who comes for him is exact in his description of the disease, if the person attending the patient is careful in giving medicine at stated times, and if the patient is reasonable enough to follow the directions of the physician, and never to question the efficacy of the medicines prescribed.
Next to omens, the Hindoo physician seeks to derive some assistance from his knowledge of dream phenomena and astrology, to ascertain the probable result of his treatment. Everybody may be said to have experienced a dream, but few can say how the body in that state affects the mind, and how this affection produces the phenomena of dreams. Classical writers like Artemidorus, Macrobus, and Thomas Aquinas have in their works tried to solve the problem, and to estab- lish the relation supposed to exist between the dreams and the events which they predict. The Indian writers, too, have endeavoured to throw some light on the question. This, however, is not the place to discuss their theory. Suffice it to say that the Indians have recognised dreams as the result of a state of life distinct both from the waking and the sleeping states, having at the same time a subtle connection with both. Assuming this to be the case, the Hindoo practitioners believe they can derive useful indications from the dreams of their patients. Dreams are, according to them, sometimes caused by fear, debility, and abnormal secretion of urine, wind, or bile. These are distinguished from those which are supposed to be prophetic and symbolic in their character. To ride a camel or a buffalo, to embrace a corpse or a mendicant, to see one's dead relatives, or find oneself besmeared with oil, to eat cooked food, or drink milk or oil, to see raw cotton, ashes, or bones, to discern a bare-headed black person riding a donkey and going in a southern direction, to find oneself decked with red flowers, — all such dreams are considered bad. A healthy man dreaming of these things will get ill, while a sick person will get worse. On the other hand, if one dreams of seeing a living king, friend, or a Brahman, sacred places, muddy water, mountains, rivers, elephants, horses, bees, leeches, or cows, or finds himself covered over with filth, blood, or flesh, or sees his own end approaching, he may hope to be prosperous if healthy, and to recover from sickness if ill. It is an unfavourable dream if a man suffering from fever associates with a dog ; if a consumptive man sees an ape, a lunatic, or a demon ; one suffering either from gonorrhoea, diarrhoea or dropsy sees water; or one subject to epileptic fits sees a dead body. If a leper drinks oil in a dream, or one with abdominal tumour dreams of eating vegetables, or one suffering from cold of eating buns, if one subject to asthma travels in dream, or an anaemic person dreams of eating yellow food, the results are equally unfavourable. The Indians believe in a deity called "Svapneshvari," or Goddess of Dreams, who is supposed to reveal certain events to her votaries in dreams. Remedies are prescribed for averting, as far as possible, the evil effects of dreams.
Astrology is considered to be a helpmeet to the medical science. The Aryans have from prehistoric times pinned their faith on the in- fluence exercised on mankind by the nine planets, namely, the Sun,* Moon, Mars, Mercury, Jupiter, Venus, Saturn, Rahu (the Moon's ascending node), and Ketu (the Moon's descending node). They believe, in common with many other races, that these heavenly bodies rule the destinies of men and nations ; and alleging that they possess a knowledge of their relative influence on the actions of each individual, they profess to be able to penetrate into his present, past, and future. Mr Proctor, in his well-known work, "Our Place among the Infinities," says "that of all the errors into which men have fallen in their desire to penetrate into futurity, Astrology is the most respectable, we may even say the most reasonable." It is also admitted that modern Astronomy owes a good deal of its early progress to Astrology. Kepler, in his preface to the Rudophine Tables, calls Astrology "a foolish daughter of a wise mother, to whose support and life the foolish daughter was indispensable." The admirers of the "daughter" have their own reasons to urge in her favour. It is beside our purpose to undertake to decide whether astrology is based on a scientific truth or is a relic of old superstition. Our present object is simply to record the fact that the Indian physicians are in the habit of consulting their patients' horoscopes when ordinary remedies fail to effect a cure. The malignant planets are appeased by various means. Mars, for instance, when he enters the house of the Moon, subjects the patient to blood-diseases. His evil influence is averted by reciting a certain sacred verse, by the gift of a red bullock to a learned Brahman,* and by an oblation of clarified butter in fire. Certain baths and wearing coral ornaments are also recommended under the circumstance. Different positions of the planets in the patient's horoscope are believed to have different effects, and the remedies vary accordingly. Predictions as regards the duration of a disease, or the possibility of its being cured or not, are now and then hazarded by certain Vaidyas from a consideration of the day of the fortnight or of the week on which the disease manifested itself. There are two opinions on the point, as indicated in the following tables. The Eoman numerals show the 1st, 2nd, 3rd, etc., days of the Hindoo fortnight, and the Arabic numerals, one below the other, show the number of days the disease will last (according to the two different authorities) if contracted on the day noted. The indicates a fatal result.
I. II. III. IV. V. VI. VII. VIII. 15 30 3
5 5 30 3 10 30 3
5 10 30
IX. X. XI. XII. XIII. XIV. Full Moon. New Moon.
5 5 30 3
Sun. Mon. Tues. Wed. Thur. Fri. Sat. 30 45
8 5 7 30
8 6 7
Thus a disease beginning on the first day of the fortnight will last for fifteen days according to one writer, and ten days according to the other. If contracted on a Sunday it may last for thirty days or end fatally. According to Sushruta, human life is either long, medium, or short. A long life may last for a hundred and twenty years, a medium life for seventy, and a short one for twenty-five years. One whose hands, feet, sides, back, nipples, teeth, shoulders, mouth, and forehead are large ; whose arms, fingers, breath, and eyesight are long, brows and chest are broad ; legs, genital organ, and neck short, voice and navel are deep ; whose vigour is great, whose head protrudes backward, whose joints, veins, and arteries are buried in flesh, whose limbs are strongly built ; who is cool and collected, free from disease, and has hair growing on the ears ; whose body, intellect, and experience grow gradually, — such a man is expected to enjoy long life.
One expected to reach the medium age is said to have two or three wrinkles below his eyes ; his legs and ears are fleshy and his nose is turned up.
Short fingers, a long sexual organ, a narrow back, conspicuous gums, and bewildered look, betoken a short life.
Sushruta also devotes a chapter to the description of what should go to make a symmetrical body. Just as the outward form and bearing are supposed to enable the Indian physicians to say how long a person may be expected to live, there are certain signs and indications which it is believed enable them to conjecture when inevitable death will overtake him. Thus, if the breath flow through a man's right nostril continuously for one whole day, he will be no more after three years ; if for two days, he will die in a year ; and if it continuously flows from the same nostril for three days, he will not live beyond three months. If he breathes through the left nostril rapidly during the day and not at all during the night, he will die within four days. Again, he who breathes through the two nostrils simultaneously for ten days together will continue in life for three days only. If the right pulse is intermittent and the left nostril ceases to work, the patient is at the point of death. If his nose becomes bent, and if he is obliged to breathe through the mouth instead of through the nose, he will draw breath for thirty hours only. If one naturally dark suddenly becomes yellow he will die within two months. He whose teeth, lips, and tongue become dry, and eyes and nails black, and to whom yellow, green, and red appear black, will live for other six months only. He who sneezes at the time of the sexual orgasm and passes urine with the emission of semen, has only one year more of life. If faeces are voided simultaneously with urine, the patient will live for one year. If one's hands, feet, and chest dry immediately after coming out of the bath, death will take place in three months. A lean man suddenly becoming fat, or a fat man suddenly becoming lean, will die in six months. One unable to see the tip of his tongue will depart this life within twenty-four hours. If a miser becomes suddenly extravagant or charitable, it shows that he has only six months of life left. If half the body of a person remains warm and the other half cold, and if he has lost the power of hearing, death will overtake him in a week.
The duration of life is also ascertained by looking at the sun's reflection in a plate filled with water. If the patient finds the reflection entire and unbroken, he may be expected to recover soon ; in case he finds it broken towards the south he will die in six months, if towards the west he will die after two months. If he finds it broken on the northern side his end will come in three months, if on the eastern side he will breathe his last in a month. If he sees a hole in the centre of the reflection he will expire before ten days are over, and the day he sees it surrounded by smoke will be his last.
- * This recommendation will perhaps he thought superfluous by the European reader, to whom shoes are a necessary item of dress. In India, however, owing to climatic and other reasons, the covering for feet is not an indispensable article.
- * Fortunately for the patient all are not of that opinion.
- * According to the Hindoo belief the sun revolves round the earth, and not the earth round the sun. Hence it is that the sun is enumerated among the planets or the Grahas as they are called. The moon's ascending and descending nodes are considered obscure planets causing the eclipses of the sun and the moon.
- * Gifts are always made to Brahmans !