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The
Art & Science of Healing
The History of the prevention and treatment of disease, or in other words,
the science of healing, is a very exciting adventure spanning almost the
entire history of man, much of it unrecorded. It starts from primitive medicine
and folklore, when it was considered more an art than a science, continues
through the remarkable scientific breakthroughs of the nineteenth and twentieth
centuries, to the hitech developments of today.
There is a evidence to show that early Man did not regard death and disease
as natural phenomena. Common maladies, such as colds or constipation, were
accepted as normal and were cured by such herbal remedies as were available.
These were not the only disease. Serious and disabling disease were considered
to be of supernatural origin. They might be the result of a magic spell,
visitation by a malevolent demon, or the work of an offended god who had
either projected a dart, a stone, a worm into the body of the victim or
had abstracted something, usually the soul of the patient. The treatment
then applied was to lure the errant soul back to its proper habitat within
the body or to extract the evil intruder, be it dart or demon, by counterspells,
incantations, potions, suction, or other means.
It is clear that man was a fast learner. Soon he was discovering the science
in Medicine. The becomes very clear when we study the history of Indian
medicine. The earliest concepts of medicine in India are set out in the
sacred writings called the Vedas, especially in the metrical passages of
the Atharva Veda, which may possibly date as far back as the 2nd
millennium BC. The system of medicine called Ayurveda was recorded by Dhanvantari
who was deified as the god of medicine.
The period of Vedic medicine last until about 800 BC. The Vedas are rich
in magical practices for the treatment of diseases and in charms for the
expulsion of the demons traditionally supposed to cause diseases. The chief
conditions mentioned are fever (takman), cough, consumption, diarrhoea,
dropsy, abscesses, seizures, tumours and skin disease (including leprosy).
The herbs recommended for treatment are numerous.
The golden age of Indian medicine, from 800 BC until about AD 1000, was
marked especially by the production of the medical treatises known as the
Caraka-samhita and Sunshruta-samhita, attributed, respectively, to Caraka,
a physician, and Shushruta, a surgeon. Estimates place the caraka-samhita
in its present form as dating from the 1st century AD, although
there were earlier versions. The Sushruta-samhita probably originated in
the last centuries BC and had become fixed in its present form by 7th
century AD. Of somewhat lesser importance are the treatises attributed to
Vagbhata. All later writings on Indian medicine are based on these works.
Not being allowed to cut the dead body, the Hindu's knowledge of anatomy
was limited. But where there is a will there is a way. Some medicine men
would keep the dead body in a basket sunk in a river for seven days. Now
the parts could be easily separated without crude, still it allowed the
development of anatomy. The emphasis in Hindu anatomy was given first to
the bones and then to the muscles, ligaments and joints. The nerves, blood
vessels, and internal organs were very imperfectly known.
The Hindus believed that the body contains three elementary substances,
microcosmic representatives of the three divine universal forces, which
they called spirit (air), phlegm and bile. Health depends on the normal
balance of these three elementary substances. The seven primary constituents
of the body-blood, flesh, fat, bone, marrow, chyle and semen - are produced
by the action of the elementary substances. Semen was thought to be produced
from all parts of the body and not from any individual part or organ.
Both Caraka and Shushruta state the existence of a large number of diseases,
the latter believing there were as many as 1,120. Rough classifications
of diseases are given. In all texts "fever" of which numerous types are
described, is regarded as important. Phthisis (wasting disease, especially
pulmonary tuberculosis) was apparently prevalent, and the Hindu physicians
knew the symptoms of cases likely to terminate fatally. Small pox was common,
and it is probable that smallpox inoculation was practiced.
Hindu physicians employed all five senses in diagnosis. Hearing was used
to distinguish the nature of the breathing, alternation in voice and the
grinding sound produced by the rubbing together of broken ends of bones.
They appear to have had a good clinical sense and their discourses on prognosis
contain acute references to symptoms that have grave import. Magical beliefs
still persisted, however, until late in the classical period, thus, the
prognosis could be affected by such fortuitous factors as the cleanliness
of the messenger sent to fetch the physician, the nature of his conveyance,
or the types of persons the physician met on his journey to the patient.
Dietetic treatment was important and preceded any medicinal treatment. Fats
were much used, internally and externally. The most important methods of
active treatment were referred to as the "five procedures" the administration
of emetics, purgatives, water enemas, oil enemas and sneezing powders. Inhalations
were leeching, cupping and bleeding.
The Indian materia medica was extensive and consisted mainly of vegetable
drugs, all of which were from indigenous plants. Caraka knew 500 medicinal
plants, and Sushruta knew 760. But animal remedies (such as the milk of
various animals, bones, gallstones) and minerals (sulfur, arsenic, lead,
copper sulfate, gold) were also employed. The physicians collected and prepared
their own vegetable drugs. Among those that eventually appeared in Western
pharmacopoeias were cardamon and cinnamom.
As a result of the strict religious beliefs of the Hindus, hygienic measures
were important in treatment. Two meals a day were decreed, with indications
of the nature of the diet, the amount of water to be drunk before and after
the meal, and the use of condiments. Bathing and care of the skin were carefully
prescribed, as were cleansing of the teeth with twigs from named trees,
anointing of the body with oil, and the use of eyewashes.
In surgery, ancient Hindu medicine reached its zenith. Operations performed
by Hindus surgeons included excision of tumours, incision and draining of
abscesses, punctures to release fluid in the abdomen, extraction of foreign
bodies, repair of anal fistulas, splinting of fractures, amputations, caesarean
sections, and stitching of wounds.
A broad array of surgical instrument were used. According to Shushruta,
the surgeon should be equipped with 20 sharp and 101 blunt instruments of
various descriptions. The instruments were largely of steel. Alcohol seems
to have been used as a narcotic during operations, and bleeding was stopped
by hot oils and tar.
In two types of operations especially, the Hindus were outstanding. Stone
in the bladder (vesicle calculus) was common in ancient India, and the surgeons
frequently removed the stones by lateral lithotomy. They also introduced
plastic surgery. Amputation of the nose was one of the prescribed punishments
for adultery, and repair was carried out by cutting from the patient's cheek
or forehead a piece of tissue of the required size and shape and applying
it to the stump of the nose. The results appear to have been tolerably satisfactory,
and the modern operation is certainly derived indirectly from this ancient
source. Hindu surgeons also operated on cataracts by couching, or displacing
the lens to improve vision.
From being leaders in the art and science of healing, Indians now are pale
imitators of the West. Let us hope that like our ancestors we too will blaze
a trail of glory of which our sons and grandsons will be justifiably proud.
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