Indian medicine has a long history. Its earliest concepts are set out in the sacred writings called the Vedas, especially
in the metrical passages of the Atharvaveda, which may possibly date as far back as the 2nd millennium BC. According to a
later writer, the system of medicine called Āyurveda was received by a certain Dhanvantari from Brahma, and Dhanvantari
was deified as the god of medicine. In later times his status was gradually reduced, until he was credited with having been
an earthly king who died of snakebite.
The period of Vedic medicine lasted 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, diarrhea, dropsy, abscesses, seizures, tumours, and skin diseases (including leprosy).
The herbs recommended for treatment are numerous.
The golden age of Indian medicine, from 800 BC until about AD1000, was marked especially by the production
of the medical treatises known as the Caraka-saṃhitā and Suśruta-saṃhitā, attributed, respectively, to Caraka, a physician, and Suśruta, a surgeon. Estimates
place the Caraka-saṃhitā
in its present form as dating from the 1st century AD, although there were earlier versions. The Suśruta-saṃhitā probably originated in
the last centuries BC and had become fixed in its present form by the 7th century AD. Of somewhat lesser importance are the
treatises attributed to Vagbhata. All later writings on Indian medicine were based on these works.
Because Hindus were prohibited by their religion from cutting the dead body, their knowledge of anatomy
was limited. The Suśruta-saṃhitā recommends that a body be placed in a basket and sunk in a river for seven days. On its removal the parts
could be easily separated without cutting. As a result of these crude methods, 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 (comparable to the humours of the Greeks). 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 Suśruta state the existence of a large number of diseases (Suśruta says 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. Smallpox 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,
alteration 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 administrationof
emetics, purgatives, water enemas, oil enemas, and sneezing powders. Inhalations were frequently administered, as were leeching,
cupping, and bleeding.
The Indian materia medica was extensive and consisted mainly of vegetable drugs, all of which were from indigenousplants.
Caraka knew 500 medicinal plants, and Suśruta 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 cardamom and cinnamon.
As a result of the strict religious beliefs of the Hindus, hygienic measures were important in treatment. Two meals
aday 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 werecarefully 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 Hindu 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, cesarean sections, and stitching of wounds.
A broad array of surgical instruments were used. According to Suśruta the surgeon should be equipped with 20 sharp
and101 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 (vesical 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.