Pursuing Virtue: The Physician’s Calling in Ancient India
The medicine of ancient India, also called the Ayurveda, combined mystical experience with scientific inquiry to construct a commentary on life and tradition. The term Ayurveda itself combines the Sanskrit words Ayur, or life, and veda, or science and knowledge. However, the “life science” of ancient India, rather than being limited to biology, also incorporated history and religion.
Foundational texts of Ayurvedic tradition describe concepts like health, well-being, and mind and body. Such texts reveal the religious basis for health and medicine in ancient India, in which the physician, the patient, and the gods are all actors in a person’s health. They are also contributors to the vitality of mind and body. In the complex interplay between these actors, the goal of achieving dharma, or one’s “highest virtue,” is the common theme. Health and dharma were inextricably linked: one needed health to successfully strive for dharma, and curing a person of ill health was the ultimate fulfillment of a physician’s dharma.
As in many civilizations, medicine in ancient India appeared out of necessity. According to University of Vienna Indologist Dagmar Wujastyk, Ancient Indians believed that the spontaneous introduction of disease shattered their ancestors’ paradise. There is no explanation as to why disease suddenly arose, but the need for medicine quickly became evident, because disease was suddenly jeopardizing humanity’s achievement of dharma – and this is where the most supreme of the gods intervened by creating, and revealing, medicine to humankind.
The ancient surgeon Susruta authored the Susruta Samhita (ca. 600 BCE). An exhaustive book on anatomy, surgery, and history, the Susruta Samhita is one of the foundational texts of the Ayurveda. According to this text, medicine was “created by the Being who exists by Himself… In view of the inability of humans to learn it in [its divine] form, [he]…recomposed it”1 in a human language and passed it on to his human protégés. Previously inaccessible in its divinity, medicine became something shared between the gods and mankind, thanks to the generosity of the gods.
The Medical Student
The Caraka Samhita, another foundational text of the Ayurveda, describes four pillars of medicine that maintain good health: the doctor, the patient, the attendant (often a medical student), and the medicine itself.2 Such descriptions designate specific roles for each player, and blur the distinction between expert and sage, student and disciple. Aspiring physicians were advised early on of the importance of scholarly dedication, and undertook preparations resembling those of a monk in training. After examining themselves and their suitability for a lifetime of study, medical students took an initiation oath outlined in the Caraka Samhita.3 Their mentor would say:
Day and night, thou shalt endeavour for the relief of patients with all thy heart and soul. Thou shalt not desert or injure thy patient for the sake of thy life or thy living… Thou shouldst speak words that are gentle, pure and righteous, pleasing, worthy, true, wholesome, and moderate. Thy behaviour must be in consideration of time and place and heedful of past experience.
Though possessed of knowledge one should not boast very much of one’s knowledge. There is no limit at all to the Science of Life, Medicine. Thou shouldst apply thyself to it with diligence.
The ideal physician-in-training, then, was reflective, modest, and in constant pursuit of dharma. Humbled by his place in the vast world of Medicine, the medical student was mindful of, and respected, time, place, and memory.
The Physician and Patient
The physician in ancient India came from the upper castes, not least because physicians were expected to have the resources to provide charitable care (the Ayurvedic text Ashtānga sangraha says that “the physician should use his own resources to treat the poor”).4 The Caraka Samhita describes who ideally practiced medicine, and why:
“And [the Ayurveda] should be studied by brahmins [priests, and the highest class], by those of the governing classes, and those of the trade classes: As a favor by brahmins, in order to protect by those of the governing classes, and for a livelihood by those of the trade classes, and generally by all of them to attain virtue…
It is one’s highest virtue [dharma] to become one who strives to cure the illnesses of those who practice virtue or of those who expound on virtue, and of one’s parents, brothers and sisters.”5
Regardless of the social status of the physician or the patient, Ayurvedic tradition mandated that the physician should strive to heal his patients so that together, the physician and patient could pursue virtue. A patient’s health was not only proof of his physician’s skill but also of the latter’s commitment to virtue.
With such expectations for the physician, according to the Susruta Samhita, the patient-doctor relationship may be considered one of full trust, one in which a patient may trust his doctor more than his own parents. Conversely, “the physician ought to protect that patient like a son.”6
The ancient texts describe a wealth of topics, including the role of the physician as an advisor to kings in epidemics, and for specific medical concerns such as those in women’s health or mental health. All of these topics share a deep basis in the Ayurvedic tradition of knowledge-seeking and spiritual reverence. The practice of medicine today may not be as explicitly linked to religion, but physicians undoubtedly continue to treat their profession as a higher calling. Doctors and medical students might be glad to know that theirs is an ancient tradition with an enduring legacy. Physicians might be drawn to knowing about their history, in India and elsewhere, because their lifelong dual roles as students and caregivers transcend time and place.
- J. Filliozat, The Classical Doctrine of Indian Medicine: Its Origins and its Greek Parallels, English translation (Paris, Delhi: Navchetan Press, 1964), 2.
- Dagmar Wujastyk, Well-Mannered Medicine: Medical Ethics and Etiquette in Classical Ayurveda (Oxford, UK: Oxford University Press, 2012), 104.
- From I.A. Menon and H.F. Haberman, “The Medical Students’ Oath of Ancient India,” Medical History: An International Journal for the History Of Medicine and Related Sciences 14, no. 3 (July 1970): 295–99, https://doi.org/10.1017/S0025727300015593.
- Dagmar Wujastyk, Well-Mannered Medicine: Medical Ethics and Etiquette in Classical Ayurveda, 118.
- Dagmar Wujastyk, Well-Mannered Medicine: Medical Ethics and Etiquette in Classical Ayurveda, 125.