DISSECTING ROOM
which in essence have not changed,
A landmark in the history of Ayurveda
A history of Indian medical literature, vols 1A and 1B
G Jan Meulenbeld. Groningen: Egbert Forsten, 1999. Pp 1473. 17500.
ISBN 9069801248. Vols 2A, 2B, and 3 published later this year.
or various reasons the history of
F
Ayurveda, the Indian classical
system of medicine, has often
been misinterpreted and, outside India,
undervalued. Ayurvedic texts, vast in
number and covering a period of at
least 2000 years, are of course com-
posed in Sanskrit, a language few know
well. Good Sanskrit scholars find more
than sufficient material for research in
the areas of philosophy, literature, and
comparative philology, whose study
has dominated this branch of Indology
in its fairly short history of little more
than 200 years. Medical works have
never been considered of general inter-
est and have not as a rule
been included in univer-
sity curricula. For those
few scholars attracted by
the subject difficulties
abound, the foremost
being the effort required
to obtain manuscripts of
the texts, traditionally
passed from generation to
generation within families
of hereditary physicians.
Even in the 19th century,
the heyday of manuscript
collection, Thomas Wise
reported in the Review of Melanie Anne
the History of Medicine
(1867):
Among such families the ancient
works are so highly valued that
the influence of station, rank and
money will often be ineffectually
asserted in procuring these
manuscripts. In some cases it is
even difficult to obtain permission
to copy such works at the owners
house, from a belief that all the
good to be derived from their
possession which God had
bestowed upon the individual and
his family would vanish on the
work being sold or even the
precepts communicated to
unauthorized individuals.
Despite this, a few stalwarts persisted
until they acquired the material they
desired and from the end of the 19th
century there has been a steady, if
small, output of research by scholars of
note.
Ayurvedic practitioners often claim
that Ayurveda has a history of many
millennia. No doubt this is in part true,
for references to forms of medical prac-
tice are found in the oldest literature of
THE LANCET Vol 356 September 23, 2000
For personal use only. Not to be reproduced without permission of The Lancet.
both dealt with diseases imported from
India, the Vedas. However, when
Indologists speak of Ayurvedic texts
they are referring to the corpus of liter- extensive use, of pharmaceutical prepa-
ature dedicated solely to medicine, of
which the earliest that have come down
to us are the compendia of Caraka,
Susruta, and Vagbhata, the Great
Three fathers of Indian medicine.
Precise dating of these texts is simply
impossible. Hardly anything is known
about their authors and the texts have
been continually edited and supple-
mented since at least the 7th or 8th
centuries CE. Scholars continue to
debate, but nowadays the generally
accepted date for the emergence of
Penwith Moors
medical compendia as such is roughly
the first two centuries CE.
Traditionally Ayurveda has eight
branches: internal medicine; diseases of
the head and neck; surgery; toxicology;
possession by spirits, etc; paediatrics;
rejuvenation therapy; and aphrodisiacs.
The compendium of Caraka, possibly
the oldest, is in the main a text on
internal medicine although all of the
other branches are mentioned as well.
It also contains much material of inter-
est to the philosopher. The com-
pendium of Susruta is primarily a text
on surgery. There are two texts
ascribed to Vagbhata, The Heart of
Medicine and The Summary of Medicine.
They seem to date from the 6th cen-
tury CE, but nobody knows whether
Vagbhata composed both texts or
whether there were two authors named
Vagbhata. The Heart of Medicine, a
highly erudite synthesis of the ancient
tradition, has always been at the centre
of Ayurvedic medical education, espe-
cially in South India.
Although these works firmly estab-
lished the principles of Ayurveda,
later texts show that the system was by
no means static. The Indian subconti-
nent, subject to continual invasion,
other parts of the world and absorbed
techniques from other systems of medi-
cine. The later Middle Ages, for
instance, saw the introduction, then the
rations from metals, especially of mer-
cury, recommended particularly for
fever, jaundice, diarrhoea, and lung
disease. Calcination of mercury and the
preparations thus obtained probably
originated with the Arabs. In the 1st
half of the 15th century Bhavamisra, in
his important work Bhavaprakasa,
dealt with syphilis, introduced by the
Portuguese. The inventiveness of
physicians is clear from the commen-
taries on the chief text; to this day prac-
titioners of Ayurveda pride themselves
on inventing new reme-
dies for their patients.
Caraka, Susruta,
Vagbhata and their works
are the subject of volume
1A of A history of Indian
medical literature; volume
1B contains the annota-
tions to the first volume.
The next two volumes,
due for publication next
year, will deal with
remaining authors and
texts; the final volume will
be an index. As G Jan
Meulenbeld points out,
this is neither a continu-
ous history of Indian
medical literature nor a critical history
of Indian medicine, but a systematic
review of sourcesthe precursor, one
hopes, of a general history.
Meulenbeld, whose erudition is well
known to Indologists, is that exceed-
ingly rare combination of doctor, psy-
chiatrist, psychotherapist, and Sanskrit
scholar who is best able to advance
knowledge in this area. His work, the
result of many years of meticulous
research, is a landmark in the study of
the history of medicine and deserves a
place in every good reference library.
In the past Indian medicine spread
across the Eastern world to Tibet,
Central Asia, Indo-China, Indonesia
and Japan, filling the same role in Asia
as Greek medicine in the West. At pre-
sent there is increasing interest in
Ayurveda in the West. It is high time
for its venerable history to become bet-
ter known.
Anne Glazier
Department of South Asia, School of
Oriental and African Studies, London
WC1H OXG, UK
1119