CHARAKA AND SUSRUTA.

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the churned ocean the moon, a marvellous tree, and sacred cow, the Goddesses of Love, Wine, and Beauty, and, finally, the white-robed physician, Dhanwantari, with the cup of the Amrita in his hand. In pity for the ills of mortals, he caused himself to be born on earth as a prince of Benares, and having retired to the woods as a hermit, after the manner of ancient Hindu princes, dictated to Susruta, a son of the famous warrior-sage Visvamitra, his Ayur-Veda.*

In the works of Charaka and Susruta we find a condition of medical and surgical knowledge not unworthy to be compared with that of the Hippocratic writers, of which, however, there is no indication in the earlier Vedic age, and which had left few traces of its existence in the sixteenth century of our era. Only a few particulars can here be given. The most striking feature is the high place assigned to surgery, a fact sufficient in itself to disprove the priestly origin of these works. "Surgery," says Susruta, "is the first and highest division of the healing art, least liable to fallacy, pure in itself, perpetual in its applicability, the worthy produce of heaven, the sure source of fame on earth." At the same time he emphasises the unity of medicine: "He who only knows one branch of his art is like a bird with one wing". Practical and theoretic knowledge must be combined: "He who is versed only in books will be alarmed and confused, like a coward on the battle-field, when in face of active disease; he who rashly engages in practice without previous study of written science is entitled to no respect from mankind, and merits punishment from the king; but he who combines reading with experience proceeds safely and surely like a chariot on two wheels ". He similarly warns his pupils against unintelligent repetitions from books: the student who thus obtains his knowledge" is like an ass with a burden of sandal-wood, for he knoweth the weight but not the value thereof".

As a specimen of the general style of the work, and of Hindu military medicine, we may take chapter xxxiv. of the first book: "When the king goeth with his army against

rebels or enemies to punish their wickedness, he shall take with him a skilful physician, a pious penitent, whose prayers are heard (and an intelligent astrologer). The physician must see to the food, water, wood and places of encampment, and examine them carefully for they may be poisoned by the enemy. If he find poison he must remove it, and so save the army from death and destruction, and he may learn how to do this from the chapter on poisons. The pious penitent must keep off by his prayers evil influences arising from the breath (? incantations) of the powerful, the pains of the oppressed, and the shame of sin (and the astrologer must avert misfortunes indicated by the stars, directing them upon a specially appointed sacrifice). If disease arise in the army the physician must show the greatest diligence, and especially guard the king's person, for he involves the whole people, as saith the proverb: 'Were there no king the people would devour one another'. His tent shall be near the king's tent, and he shall have his books and drugs always at hand. There shall be a flag over his tent that the sick, poisoned, and wounded may find him quickly." Here the writer suddenly changes the subject: "The physician, the patient, the medicine, and the nurse are the four feet of medicine upon which the cure depends. When three of these are as they should be (gunavat), then by their aid the exertions of the fourth, the physician, are of effect, and he can cure a sore disease in a short time. But without the physician the other three are useless even when they are as they should be, just as the Brahmans who recite the Rig- and Sama-Vedas are useless at a sacrifice without the Brahman who recites the Yagur-Veda. But a good physician can cure a patient alone, just as a pilot can steer a boat to land without sailors. The physician who has penetrated into the hidden sense of the medical books, who has seen and taken part in operations, who has a ready hand, an honest mind, and a bold heart, who has his instruments and books always by him, who possesses presence of mind, judgment, resolution and experience, and who sets the truth

above all things, such a physician may be called a true foot (pada) of medicine. The patient deserves this name when he has vital force, and nerve (to resist pain), no incurable disease, no great poverty, self-restraint (to avoid harmful pleasures), faith in the physician, and obedience to his directions. The drug to be called a 'pada' must grow on a good soil, and be gathered on a favourable day, be given in proper doses at a right time, and be fresh. Finally the nurse is a 'pada' when he is kind-hearted, without false shame, strong, trustworthy and mindful of the physician's orders.”

The most famous achievement of Hindu surgery is the manufacture of new noses by flaps taken from the cheeks or forehead, an operation specially demanded in a land where despotic rulers and jealous husbands were singularly addicted to mutilating their victims. But Susruta also mentions the division of the supra-orbital nerve for neuralgia, and laparotomy and suture of the intestine for obstruction or injury-operations lately re-introduced into medicine. He describes more than one hundred instruments, the first and best of which is the hand, and carefully distinguishes twelve species of leeches, a section of his work afterwards highly valued by the Arabs, who in the eighth century A.D. translated portions of the works of both the great Hindu physicians.5

And this brings us to the important question: When did this remarkable development of Hindu medicine, which arose and vanished so mysteriously, actually take place? The lower limit is fixed by the above-mentioned translations at about 750 A.D., but it is very difficult to find a higher one. Older writers, relying on the fact that both Susruta and Charaka are mentioned in the great epic, Mahabharata, considered that the works attributed to them must be at least as old as the Homeric poems. But the Mahabharata underwent revisions and additions to a very late date, and recent Sanscrit scholars assert that the language of the medical books indicates an age certainly not long anterior to Alexander's invasion, B.C. 327, and

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possibly even later than this. Now these dates, B.C. 327A.D. 750, nearly correspond to the period of the predominance of Buddhism in India, and it seems highly probable that this Buddhist millennium was also the golden age of Hindu medicine. The brotherly love and sympathetic pity inculcated by the "enlightened" was more likely to favour the progress of the holiest of arts than the caste prejudices and endless formalities of Brahmanism; nor are we without definite indication of the high honour in which Buddhists held the physician. Thus one of the chief evils of poverty is that the poor man cannot get a physician or medicine, and travellers are warned against settling in a land where there are not five things—a king, a river, rich men, teachers and-physicians. When King Asoka, the Constantine of Buddhism, made that faith the religion of his empire, B.C. 250, he issued a series of edicts, two of which have reference to our present subject. In the first, "the man of loving spirit, beloved of the gods," declares that no animal is to be put to death, and we may, perhaps, connect this with the extraordinary passage in Susruta which forbids medical aid to hunters and to all who kill or trap animals. In the second, Asoka says that he has established two "cures," one for men and another for animals, not only throughout his own dominions, but in those of neighbouring monarchs, and has arranged for the collection and planting of medicinal herbs in those places where they do not exist.

There can be little doubt that these "cures" included hospitals, and possibly even medical schools. Buddhist pilgrims from China in the fifth and seventh centuries tell us of houses of mercy for the sick which they found in various parts of India, and the famous hospital for animals at Surat may conceivably have owed its origin to Asoka.

The Mahavansa, or Cingalese chronicle, gives us still clearer evidence on the subject. When King Duttha Gamani was on his death-bed, B.C. 161, he ordered the record of his deeds to be read to him, in which it was said: “I have daily main

tained at eighteen different places, hospitals provided with suitable diet, and medicines prepared by medical practitioners for the infirm ". King Buddhadasa (A.D. 341) was a mine of virtue and an ocean of riches, who patronised the righteous, discountenanced the wicked, and comforted the sick by providing medical relief. The stories of his own cures are mostly mythical. "A priest hurriedly drank some water which had frog's spawn in it, and an egg entering the nostril ascended into the head, and being hatched became a frog. In rainy weather it croaked and gnawed the head of the priest. The Rajah, splitting open the head and extracting the frog, and re-uniting the severed parts, quickly cured the wound." There seems no reason, however, to doubt the essential truth of the following: "Out of benevolence entertained towards the inhabitants of the island, the sovereign provided hospitals, and appointed medical practitioners thereto for all villages. Having composed a work containing the substance of all medical science, he circulated it among the physicians of the island for their future guidance. He ordained that there should be a physician for every ten villages. He set aside twenty royal villages for the maintenance of these physicians, and appointed medical practitioners to attend on elephants, on horses, and on the army. On the main roads he built asylums in various parts for the reception of the lame and blind. This man of great compassion was wont to carry his case of surgical instruments in the folds of his loin cloth, and to afford relief to every afflicted person he met."

But the most important of the Cingalese hospitals was that founded by Parakkama the Great (1164-1189). "And this ruler of men built further a large hall that could contain many hundreds of sick persons, and provided it with all things needful as stated underneath. To every sick person he allowed a male and female servant, that they might minister to him by day and night and furnish him with the physic that was necessary and with divers kinds of food. And many storehouses also did he build therein filled with grain, and with all things useful for medicine. And he also made provision for the maintenance of wise and learned