The Medical Sciences

Every ancient civilisation has its own medical tradition that has come up with its own principles for understanding health and diseases. Similarly, every indigenous society or community that lives today has also been a repository of the localized medicinal knowledge system. What is interestingly and importantly unique about the Indian system is that it has both a very long tradition of a formalized medical system with its own principles of organizing its medical universe and a vast web of varied localized medicinal knowledge systems. They interact with each other constantly with the former absorbing local traditions which helps the latter to survive and flourish.

Leech to Leprosy

The basic model for this interaction of the common principles and local medical knowledge has been set perhaps in the Atharvaveda and may have its roots in Rgveda itself. In Vedic times, the usage of leech was so widespread that it has become the symbolic representation of medical profession itself.  A famous verse in Rg speaks of a bard’s father as a “leech”, meaning he was a physician. At one place where Rudra, instead of the usual twin gods Ashwins, is projected as the god of healing, he is said to have leech in his hands.

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In the Sushruta Samhita, one of the earliest medicinal texts (dated variously from 600 BCE to 2nd century CE), we have a detailed description on the use of leeches in medicine. This makes what later became popular in early to late-medieval European medical profession, as leeching (a form of bloodletting), an Indian contribution. Though mostly discontinued, leeching does seem to be making a comeback. Leeches are classified as “medicinal product” in Europe and as “medical device” by the US Food and Drug Administration.

With medicines come medical ethos. Rgvedic descriptions of Ashwins, the physician deities, also provide an ethical template for all physicians: charming, honest, eager to help the afflicted, hurry to those in need, compassionate and quick to come to succour, etc.

While in many contemporary civilizations, leprosy was considered a punishment from the divine forces and lepers were treated as outcasts, the oldest recorded evidence of attempts to treat leprosy comes from a skeleton 4,000 years old discovered in Rajasthan. The report of the archaeological excavation points out that “the leper’s skeleton was interred within a large stone enclosure that had been filled with vitrified ash from burned cow dung”. The use of cow dung was a common medicinal practice in ancient India. A Rgvedic anecdote tells of how a woman was cured of leprosy by Vedic physician deities and she was reunited with her husband. Clearly, medicinal knowledge had attempted to overcome the social prejudices against leprosy and had started building an ethical framework.

Surgery

It is well known that in surgery, India excelled and innovated. Sushruta divided surgical instruments into six major groups. Then there were subgroups. In forceps alone, there were 24 subclasses; in probing instruments 28; and in tubular ones 20. Most of these instruments were made of iron. There were also the forerunners to consciously design instruments in forms occurring in the natural world: “The mouths of these appliances are usually made to resemble the mouths of some particular animal in shape…” says Sushruta Samhita. Sushruta was also the first to graft upon a torn ear portions of skin taken from another part of the body. This would later develop into a well-established medical practice in India, rhinoplasty—surgical reconstruction of severed noses.

Acupuncture, Marma and Connectivity

Ayurveda can be seen as a matrix of various local medicinal knowledge systems. It has often grown by assimilating local knowledge, but not by replacing them. It also contributed to the development of schools of medicines in other parts of Asia. Acupuncture is one such.

Buddhist scholars Shifu Nagaboshi Tomio and Terence Dukes concede that even if it cannot be said “for certain that the Chinese developed their ideas about acupuncture points directly from India, it does seem an obvious extension of Vajramukti teachings.” It is possible that the Indic concept of marma points was later developed by Buddhist missionaries, and this system interacted with an independent Chinese folk tradition enriching both. Martial usage of marma points appear in the Rgveda where Indra uses them in killing Vrtra. Later Sushruta elaborates on them and even tries to provide a naturalistic explanation.

The way Indian texts catalyzed acupuncture’s development can be seen in the way it became a surgical therapy in eye ailments. Medical historian Paul Ulrich points out that “the idea of treating certain ailments of the eye surgically was introduced to China solely through Indian mediation”. These surgical methods were integrated into acupuncture in Japan centuries later. In the 14th century, Japanese Buddhist priest Seigan specialized in ophthalmology and introduced what is known as the golden needle acupuncture treatment for cataract. According to Japanese medical historian Yoshiaki Omura, this method known as “Sudden Lens Dropping” was rediscovered from an ancient Indian ophthalmology method that reached Japan along with Indian Buddhist texts.

Kerala to Carl Linnaeus

It is not only in the well-known and oft-mentioned field of surgery that the Indian medical system contributed. Local knowledge systems of herbs that flourished in India had developed their own classification that critically contributed to the development of the science of taxonomy in the West. British science historian Richard Grove speaks of “the diffusion of indigenous south Asian methodologies of classification throughout the European world, rather than the reverse”. Here he refers to the Ezhava—a community of traditional physicians in Kerala—who helped Dutch botanist Hendrik van Reede tot Drakenstein compile an important botanical work Hortus Malabaricus (Garden of Malabar) that deals essentially with medicinal flora of the Malabar area of Kerala; it was published in 12 volumes (1678-1693).

Anthropologist Anna Lowenhaupt Tsing explains:

“John Ray, known for his ‘grammar’ of botany, obviously read van Reede… Yet he attributed no importance to the Ezahava dialogue that brought that species to him. The system itself was knowledge, not its components of parts. Carl Linnaeus, known as the father of modern biological classification… unselfconsciously adopted van Reede’s Malabar classifications without noting them as foreign. For him, all correct knowledge could be united through the use of a universal method. There is no understanding here of knowledge as gained in dialogue—and certainly not dialogue between Christians and non-Christians.”

What Can We Give the World?

The most important aspect in studying Indian contribution to medicine is not the glorification of the past, nor even the historically important aspect of correcting the Eurocentric narrative of the development of medicine. It is about creating an interface with the Indian medicinal knowledge system with modern science.

What has India given to the rest of the world? Did we give cellular biology, molecular biology or structural biology? Did we give structural genomics, functional genomics or pharmacogenomics? No, but we can give Ayurvedic biology and Ayugenomics to the world alright. We need to think really seriously about that.

A good opening for such an exploration is provided in the case of the eastern system of healing points like marma and related acupuncture. Even to this day the marma points-based therapy is a flourishing science in the southern parts of India. However, unlike acupuncture, the marma system has never been popularized in a systematic way. But both marma and acupuncture have a commonality that necessitates a perceptional shift in the modern system of medicine.

Dr Helene M Langevin, a clinical endocrinologist, whose interest in chronic pain led her to the study of acupuncture, found that more than 80 per cent of acupuncture points in the arm are located along connective tissue planes. She also points out that the connective tissue is “something of an orphan child in medicine, although it is an integral part of the musculoskeletal system”. They are “basically absent from orthopaedic textbooks, which deal principally with bones, cartilage, and muscles”.

Now this opens up an entire new realm for the therapeutic sciences. The Indic medical systems seem to have tapped into the dynamic nature of connective tissue towards which Western medicine has started taking tentative, baby steps. The human body is more connected at the very physical level than Cartesian medical science has presumed, and the connections are more dynamic than what the conventional medical establishment imagined.

Ayurveda and associated Indic systems of medicine, including the Siddha system in south India, harbour the world’s most elaborately systematized knowledge of herbal plants and remedies. India has provided the world a bio-cultural model that augments sustainable domestic and social health. The neem-turmeric-tulsi veneration that can be seen throughout India with equally exhaustive utilization of these plants in medical formulations is one example. Cattle—particularly cow-based medical formulations used in local medical systems throughout India—along with their ritual usage is another example. Apart from these, India is also home to perhaps the world’s most medicinal local knowledge systems that provide a hunting ground of multinational pharmaceuticals and, hence, have been a victim of bio-piracy.

Science writer Brendan Borrell, who documents recent attempts of scientists in reverse engineering herbal health solutions, points out:

“The scientists make careful observations of patients already using a variety of traditional herbal remedies to identify the most promising one, then conduct a clinical trial of that remedy. Finally, they identify the active compound, which becomes the starting point for drug development. Their approach, called reverse pharmacology, was inspired by the efforts of Indian scientists hunting for new drugs from ancient Ayurvedic medicine. The beauty of it is that even if a manufactured drug never emerges, the researchers can advise traditional healers and the communities they serve about which herbs work and which do not.”

Consciousness Studies

For a long time, the term ‘consciousness’ has been an outcast for western science, though both ‘science’ and ‘consciousness’ share the same etymological root. Consciousness-related studies are not mere philosophical speculations.  They have serious implications for the way we look at many brain ‘disorders’.

In the Indian school of philosophy, Samkhya emphasized the fundamental unity of mind and body—making the mind more a subtle matter than a separate category by itself. This has led to the development of models that looked for the correlates of the modes of consciousness well within the body. The tantra and yoga traditions have taken a view of correlating consciousness and the levels of consciousness-based perceptional changes involving interactions between spinal cord and brain.

Dr Subash Kak, physicist and consciousness researcher, pointed out a possibility of a correlation between Indic and neuroscientific understanding of the inner realm: “Since cognitive abilities are localized, the idea that a contemplative discipline can help a subject further these abilities becomes plausible. The Vedic texts insist that such furtherance has been observed. A modern understanding of this phenomenon is that the subject, by means of the meditative discipline, changes the organization of the cognitive centre. This belief is open to experimental refutation.”

An even more puzzling correlate to the chakras emerge from another researcher. Neuroscientist Candance Pert discovered the cellular binding site for endorphins in the brain. She has recorded an anecdote regarding the yogic chakras along the spinal cord.

Once a yoga practitioner visited her laboratory and showed her the map of the chakras. She narrates what happened:

“I had no idea what he was talking about, but trying to be helpful, I pulled out a diagram that depicted how there were two chains of nerve bundles located on either side of the spinal cord, each rich with many of the information-carrying peptides. He placed his own chakra map over my drawing and together we saw how the two systems overlapped. It was the first time I seriously considered that there might be a connection between my work and the Eastern viewpoint.”

Closely connected to the chakras is the concept of kundalini—the psychic movement symbolized by the serpent. Perhaps this was the greatest psychological-medical discovery made by the ancient Indian system; it has enormous meanings and consequences in areas as different from studying the biological basis of art to alienation.

Psychiatrist and psychotherapist Carl Jung studied kundalini in the therapeutic context but without much success. In a pathbreaking single-handed study of a thousand individuals either disturbed or internally stimulated, Californian psychiatrist Lee Sannella identified the psycho-social effects of what he called “kundalini experience” with relation to both ‘psychosis’ and ‘transcendence’.

Today, “kundalini syndrome” is very much part of trans-personal psychology’s vocabulary. It refers to a personal crisis that a subject may experience associated with kundalini awakening either through deliberate means of yoga practices or through an accidental trauma or ecstasy. Either way, kundalini is redefining the way psychiatry has been looking at the problems of, well, the psyche.

Today, medical science is also studying the religious phenomenon—not as the pathology of the mind any more, but as integrating the bio-psychological process of the human psyche. Works by Andrew Newberg, Michael Persinger and VS Ramachandran define this new field.

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Patanjali Yoga can be considered the first systematization of the brain-based search for religious experiences. Once again, Indic insights have become the basis for cutting-edge medical explorations into unknown realms of the psyche. Indic contributions are a major factor in either seeding or catalyzing a whole range of western mental health systems from studying holotropic experiences to transpersonal psychology to Jungian psychology. We need to move now from Ayurvedic biology to Ayur-psychology and Ayur-psychiatry.

We shall then discover the contributions of the past to invent a formidable future.