Talk:Royal Physician and Hospital

Introduction

Ancient society was ruled by the monarchical system of government. This monarchical government was ruled by the king and his patronages which included the poet, the artist, the scholar, the astrologer, the priest, the physician and the statesman. They formed the king's personnel for his pleasures and pursuits. They enhanced his mental and physical element while in turn received his admiration and encouragement and lavish patronage.

Significance of the Royal Physician

Nizami-i-Arudi, a court poet of Samarkand in his persian book Chahar Maqala, has well said that the four clashes of experts are indispensable in a properly constituted court, to wit secretaries of State, poet, astrologer and physician. While the poet and the others might be dispensed with, the physician and the statesman were indispensable for obvious reasons; that is maintaining order in the constitution of king's body and the constitution of the Government respectively.

Out of these two, the physician was of the greater importance to the king as the health is the basis of all happiness and activity can only be secured by the services of an able and trustworthy physician. Moreover, the king lived in perpetual fear of being poisoned and his luxurious lifestyle endangered his health. He had therefore great need to entrust his everyday life to the regulation and supervision of the physician. The two aspects of medicine, namely the maintenance of health and long life as well as the combating of disease, found complete application, in the supervision of a king's life by a physician. The post of Royal physician needed trustworthiness equally with the ability and hence the system of hereditary appointment might be prevalent in the appointment of ministers.

As per Susruta

"He who studies this science which is expounded by the self-existent Brahma and which is eternal and which is laid open by the Lord of Kasi, is, being of the merit of holy deeds, worshiped by the kings on earth and goes to heaven after death."

As per Caraka

The selection of the Royal physician was based on such a high standard that only the best, wisest and ablest could hope to be chosen by the king.

As per Vagbhatta

Vagbhatt denotes the place where a royal physician should stay.

A king should make the physician reside near the royal palace, so that he may be ever vigilant everywhere. He shall protect the food and drink of the king, specially from poison. Acquisition and preservation to which are fettered religious merit etc., are dependent on him.

The Royal physician's responsibility was very great In Vagbhatta's words:

The attendance on a king is as dangerous as a sport with weapons, snakes and fire. It can only be discharged by modest persons through very great dexterity. Having acquired unattainable sway and great honor from the king, one should remain vigilant so as to retain and enjoy them for a long time.

Conduct of Royal Physician

Vagbhatta describes the way in which the physician should conduct himself before his royal master.

• The physicians speech should be consistent with the ends of righteousness and the king's welfare on all the occasions.
• Physician should not proffer counsel unless solicited, for such gratuitous advice might easily be deemed a great presumption.
• He should never act in a way that is prejudicial to the king's benefit because that implies destroying his own support.
• The physician should see that what he says it palatable as well as wholesome.
• If the physician wishes to advise the king against an evil course, he should do so in strict privacy and in words that are noble and dignified. He should do this only

  when indifference on his part would be blameworthy.

• If any advice is met with a rebuff, the physician should hold his peace.
• Conversation that is distasteful to the king should not be persisted in.
• Any measure if required should be done only after the approval of the king.
• As regards to the treasury and the royal harem, the physicians visits to the places should never go without asked for him. Even if the visit happens, it should be

  as brief as possible.

• He must show satisfaction with whatever he receives from the king as remuneration.
• While at court, he should avoid confidential conversations with any other than the king himself.
• He should also eschew gossip- mongering, hostile disputation, imitating the king either in his sartorial habits or in his pleasures and recreations.
• The physician should only smile even if the occasion is for loud laughter.
• When a secret relating to some one else is being narrated, the physician should seem as though he were dumb while when a secret concerning himself is

  being divulged, he should put on the quadruple armor of deafness, fortitude, sweetness and perfect ease of manner.

• He should not take excessive pains with the object of putting himself in a too highly exalted position.
• Though closely associated with the royal person, the physician should not strain that intimacy in any way nor press it to selfish advantage.

For being a royal physician, a person needs to have complete wisdom, caution, ability and modesty. Only this kind of person is worthy of being selected as royal physician.

Duties of a Royal Physician

Amongst those physicians, a boy physician named Rasayana, the descendant of Punarvasu, held his hereditary office in that royal family. The royal physician had to reside in the palace compound and be ever vigilant as he had to supervise every detail of the king's daily life. In addition to the personal attendance on the king, he was responsible for the health of the queen and the prince. So he had free entrance to the harem. The physician had freedom of access even to the woman's apartments where the virgins of the royal household lived.

The proof to this is in the verse in the Naisadhiya-carita where it is said that there are only two that can enter with impunity the virgins apartments namely the prime minister and the physician who possesses all the learning of both Caraka and Susruta. The physician was expected to take extra care of the queen from the first day of the conception to see that the pregnancy period and intra-uterine growth of the fetus progressed satisfactorily. When she has conceived, the king shall observe the instruction of midwifery with regard to gestation and delivery. Now, in due season, the development of the fetus having been effected by trustworthy physicians well-versed in the treatment of infants, etc. A special physician was appointed to be in charge of the prince's health, who had to stay with the prince.

A special physician was appointed to superintend the kitchen; he was expected to possess special qualification as described in Susruta. The king should appoint a physician to supervise kitchen, who is of noble birth, religious-minded, affectionate, well-paid, of hereditary line, not greedy not a rogue, devoted, grateful, of pleasing appearance, devoid of anger, roughness, envy and deceit, possessed of sense control, fortitude, cleanliness, character, compassion, intelligence, tirelessness and love, who is a well wisher, is clever, bold, skillful and devoid of lethargy. He should possess the above mentioned qualities and should have medicines always at hand.

There he should appoint a superintendent who is for the most part possessed of qualities of a physician. The physician was skilled in the interpretation of internal sentiments by external gestures. Thus he was skilled in the interpretations of gestures too.

Daily Personal Treatments to King

The physician who wishes to administer the procedure of emesis or purgation to a king or a person of kingly circumstances or a wealthy man must be ready before beginning his treatment. Only those who are kings or of kingly circumstance or men of abundant wealth can be given the purgation procedure, in this manner. His time of daily visit to the king was very early in the morning. During the eighth part of the the night, the king was visited by his physician, chief cook and astrologer. The physician was given preference in interviews.

Besides emergencies and other important tasks, the physician had to be in constant vigilance for the purity of the food, drink and medicine served to the king. For this the physician had to supervise both in the kitchen and at the service in the dining hall. The physician was supposed to taste the food himself first before it is served to the king. The same rule was applicable to the liquor and other beverages. He had to supervise not only his food and drink and medicine but he had to supervise his bed-chambers too. Protecting the king's bed-stead by incantations was also a part of the duty. The king's bed stead was well protected all round by muttering incantations for protection. Thus the royal physician was expected to look after the king in every detail of his life so as to maintain perfect health and longevity.

The physician had to manage the luxurious methods of treatment in disease befitting the royal personage. He was assigned the task of taking special care of the queen during pregnancy and delivery. The duties also include the responsibility for the health of the prince and such other needs of the king and his family. Thus he was expected to be an expert in all the branches of medical science.

This emphasizes the importance of the medical man and his profession even in the ancient times. Such a royal physician was acknowledged and a respected leader in the realm. It was therefore the ambition of those that took up the study and practice of medicine to be one day the king's physician or honored by the royal personage.

Royal Dispensary

The physician has to keep the dispensary as well as the emergency requirement (first-aid) in the palace compound. On one side in the rear of the harem, there should be compartments provided not only with all the kinds of medicines useful in midwifery and diseases, but also with well-known herbs and a water reservoir.

In every building in the Royal court, emergency medical aid was kept. All these buildings should be provided with halls, pits, water well, bath-rooms, remedies against fire and poison. It should also have cats, mongooses and necessary means to worship the guardian gods appropriate to each. When the physician had to perform any procedure of Pancakarma or operative work he had to get his hospital fully equipped before-hand for the treatment as well as for any emergency which is likely to arise. The king received an aristocratic method of treatment.

References

• The Caraka Samhita published by Shree Gulabkunverba Ayurvedic Society, Jamnagar, India