Talk:Method of theoretical and practical studies

Medical Arts

The medical man was expected to know the following arts viz:

1. Distillation
2. Operative skill
3. Cooking
4. Horticulture
5. Metallurgy
6. Sugar manufacture
7. Pharmacy
8. Analysis and separation of metabolic compounds
9. Compounding of metals
10. Preparation of Alkalis as they were indispensable in the preparation
11. Application of his curative measures in clinical undertakings.

Supportive Medical Procedures

Moreover an analysis and experiment with the animal, vegetables, mineral poisons require a certain amount of knowledge and skill in these allied arts and crafts. These arts gradually developed and specialized to such an extent that each became a regular independent science viz, botany, zoology, chemistry, pharmacy etc. These sciences have developed as hand-maids of medicine and hence expertise of these subjects was must for a person who intends to pursue medical field. Hence a person linked with Medical field should master the following processes:

1. The art of preparing flower juices and other intoxicating liquors.
2. Taking out the parts of arrows, spears etc from the patients body
3. Incision of open wounds and blood vessels.
4. Cooking various dishes with the various exudations like asafoetida combined in different proportions.
5. Grafting, planting and culture of plants.
6. Melting and reducing stones and minerals to ashes.
7. Knowledge of the preparation of all things that can be prepared from the juice of sugar-cane.
8. Knowledge of the combination of minerals and herbs.
9. Combining and isolating minerals.
10. The science of producing new compounds of minerals.
11. The art of extracting the alkalis out of minerals.

The importance of all-round or comprehensive knowledge and the inadequacy and even danger of partial knowledge was expressed by Atreya in a very significant words. A full conception of the science will never be attained by the knowledge of only a part of it. Vagbhata also says:

If a man be well read in Caraka but ignorant of even the names of diseases described in Susruta and other works or if he be not wanting in practical methods but wholly ignorant of Caraka, what can such a poorly equipped man do to relieve the ailments of patients?

Thus the dangers of incomplete knowledge by a general back-ground of comprehensive knowledge were avoided. The student was advised to pay special attention to have full and clear understanding of the technical terms without which he would not be able to grasp the correct interpretation of the medical science. A physician who is not conversant with the canons of exposition though he may be a student of many treatises will fail to grasp the meaning of these treatises.

To qualify a medical person, only knowledge of medical sciences and arts were not sufficient, in addition he had to study other sciences relating to life. It is not possible to include all the knowledge of science in a single treatise. One who studies exclusively one science cannot arrive at a correct determination of things, therefore a physician should be versed in the various sciences to have a full grasp of things.

To acquire this kind of knowledge, he was advised to learn from the experts in that particular branch. The truths expounded in other sciences but referred in medicine for our purpose, are to be understood in their full context from the experts in those sciences. For knowledge, the ancients never hesitated to approach even an unfriendly person. Thou should listen and act according to the words of instruction of even an unfriendly person. Equal importance was given to theoretical and practical training. The person devoid of or deficient in one, is ill-entitled to the practice of medicine.

He who is learned only in the theory of the science but not skilled in practice gets confounded at the approach of a patient. He who is skilled in practice but is audacious and ignorant of the theory of the science, does not receive approval of good men and receives capital punishment from the king. In both these cases, the physicians lack in dexterity and are inept in their duties, for they know only half the science and are like birds with only one wing .

In the medical arts, specially in surgery, dominant importance was attached to the practical work and training. Lot of theoretical knowledge is of no avail , if one does not possess practical knowledge. Thus it is clear that the knowledge of the medical aspirant of those days was very comprehensive and was not easy to attain in many respects beyond the actual conditions obtaining even today among the general profession.

Means And Methods Of Study

The methods the ancients adopted for disseminating this standard of knowledge and enabling such a comprehensive and thorough proficiency in the science were study, teaching and discussion with those versed in the same subject. The first mode is called as Adhyayana or learning from the teacher, the text and other things pertaining to the science. This word though in its limited sense meant only the learning, yet in a larger sense comprised the whole course of instruction, theoretical as well as practical.

Means of Study

According to Caraka, there are three modes of ascertaining the nature of disease. They are:

1. Authoritative instruction
2. Direct observation
3. Inference

Out of this group, of the three sources of knowledge, the knowledge derived from authoritative instruction comes first. Thereafter investigation proceeds by means of observation and inference.

Methods of Study

There are the three channels of acquiring knowledge:

1. The first and the most important is the theoretical knowledge.
2. Second comes the practical experience or application of theoretical knowledge.
3. Third in the line is the inferential method.

Inferential method comprises of logical elaboration as well as the further supplementation by the intelligent teacher or student based on speculative or imaginative corollaries drawn from the main data of the theoretical text as well as the practical experience acquired in the past.

Theoretical

The first step in theoretical study was the mastering of the texts thoroughly. The texts of the science which were the treatises on medicine and surgery at that time, such as Caraka and Susruta Samhitas, were written mostly in a very concise style known as Sutra style. The books were in combined form of both prose and verse. The prose was in a concise style while the verse was mostly in its simplest form that is Anustup. They were meant to be easy for cramming by the pupils and comprehended in their scope of exposition as an encyclopedic range of the subjects. Their main characteristics were the logical exposition of the theories and methodical classification into various categories.

Composition of Books

The exposition of the subjects begins with a general outline of the subject in brief followed often by a detailed description of its various aspects. At the end, there is a recapitulation of the whole matter, mentioning in brief all the subjects covered in the chapter. One of the chapters is devoted entirely to the enumeration of the subjects in the form of index. This system of exposition of a treatise was intended to preserve the text intact and to prevent interpolations.

The chapters represent various methods of expositions namely:

1. Simple description
2. Catechism
3. Debates
4. Discussions

Detailing by Teachers

The teachers of Ayurveda attempted to arrive at full and precise definitions of the terms and concepts, on which they used to build the frame-work of the science. They attempted to show the original derivations of words in order to enable the student to understand the original as well as the current connotation of the terms used in the treatises. They made an extensive usage of similes culled from nature and daily life, in order to illustrate and clarify the meaning of their words to all the three grades of intelligence of the student's that comprised the class.

There was a remarkable catholicity of outlook in their teaching and they stimulated further achievements in the field of knowledge by giving constant impetus to the pupils for progress. This theoretical knowledge was imparted by an oral system of education. This was the practice adopted for the acquisition of Vedic knowledge as well as the knowledge of any other branch of science in ancient India.

Theoretical Training as Per Susruta

The method adopted in actual training as described in Susruta is very unique.

• The preceptor should impart instruction to the best of his ability, to the disciple who has approached him in a state of cleanliness wearing his upper garment and with an attentive mind at the appointed hour of instruction.
• One should learn to recite word by word or verse by verse.
• They should be linked together properly as words, phrases and verses.
• Having thus formulated them, they should be repeatedly recited.
• One should recite neither too fast nor in a hesitant manner nor in a nasal twang but should recite bringing out each syllable distinctly without over-stressing the accents and without making any distortions of the eye-brows, lips and hands.
• One must recite systematically and in a voice not too high-pitched nor too low.
• No one should intrude when they are studying.

Theoretical Training as per Caraka

Caraka describes how the teacher imparts the knowledge to students and the method of study of the students in the ancient times as follows:

• The student should sit at ease on even and clean ground.
• He should concentrate his mind, go over the aphorisms in order, repeating them over and over again all the while understanding their import fully and correct his own faults of reading and recognize the measure of those in the reading of others.
• In this manner a sincere student should take to studies at noon, in the afternoon and in the night.

Oral Training

This is the one aspect which fundamentally differs from the modern system of education. The ancient days learning depended much on their power of memory while the modern day learning is more dependent on the books. One significant reason for this difference is the achievement and progress of the printing art that has made possible the availability of the required number of books. This is the reason why there is comprehensive encyclopedic books written in Sutra or most concise style to minimize the burden on the brain. The ancients paid special attention for cultivating the power of memory. The power of verbal memory was developed to a degree which is almost incredible in present time.

They memorized the whole Caraka and Susruta and later on when memory power began to wane, Vagbhatta epitomized the texts of these two books in one volume and 1/3 size. The diction of this literature was in the form of verse in order to facilitate memorizing. This may look like a stupendous task to us unaccustomed to such memory feats, but there are some scholars even in modern days who can remember the references from many books. Caraka and Susruta have different application techniques. Due to this reason the methods and systems under which it was to be imparted was different.

Preliminary Stage

Hence we find that the preliminary stage of learning was memorizing the sacred texts through indefinite repetition and rehearsal by both the teacher and the student. This means that the cultivation of memory was accorded a most important place in the ancient education system. The powers of verbal memory were accordingly developed to a degree almost incredible in modern times.

Secondary Stage

Even at the present day when manuscripts are neither scarce nor expensive, the young Brahmans, who learn the songs of the Veda, the Brahmanas and the Sutras, invariably learn them from oral traditions and know them by heart. They spend year after year under the guidance of their teacher, learning a little every day, repeating what they have learnt as part of their daily devotion until they master their subject and are able to become teachers.

Vedic Curriculum

The Rgveda consists of 1017 poems, 10580 verses and about 153826 words. But besides the Rgveda, the Sutra works mention a number of other subjects to be learnt by the student. An Indian scholar informed Max Muller that even so late as the early Seventies, the Vedic curriculum comprised of the following:

1. The Samhita or hymns
2. The Brahmana
3. The Aranyaka
4. The Grhya Sutras
5. The six Vedangas

As per Max Mulller

Max Muller arranged to collect various readings for his edition of the Rgveda, not from manuscripts, but from the oral tradition of Vaidik Srotriyas , described by the Indian Scholar, Mr Shanker Pandurang, who was entrusted with the work. Muller collected a few of our Rgveda verses as basis. Again as Max Muller well puts it that We can form no opinion of the power of memory in a state of society so different from ours as the Indian Parisads are from our Universities. Features of memories such as we hear of now, show that our notions of the limits of that faculty are quite arbitrary. Our own memory has been systematically undermined for many generations. He has further stated in some of his writings about the dependence on verbal memory for the transmission of sacred literature has continued to this day in a sense.

Max Muller calculates that these ten books contain nearly 30,00 hues with each line reckoned as thirty-two syllables. According to his information, this course was to be finished in eight years. Now a pupil studies everyday during the eight years except on the holidays. There being 360 days in a lunar year, these eight years would give him 2880 days. From this 384 holiday have to be deducted, leaving him 2496 workdays during the eight years. On this computation, a student of the Rgveda has to learn about twelve slokas a day. A single sloka was consisted of thirty two syllables.

Personal Touch

Adhyapana

The instructions, being personal, consisted of a great deal of elaboration of the succinctly worded texts and even supplementation from a line of traditional instruction carried down through a successive line of teacher and pupil. In his teaching, the teacher always took into view the three grades of the intelligence of the pupils. They may be highly intelligent, moderately intelligent and below average intelligent students. Without this supplementary part, the texts perhaps would yield very meagre fruit of knowledge. One has to therefore remember while assessing the value of this difficult and concise texts that they were only the skeleton required in the filling up of much vital stuff from a parallel tradition of supplementary lore. They were mere precis, bare outlines of the subject prescribing only the highlights of the principles and theories to be explained and expounded by the learned teacher. This method of directly imparting the knowledge was known as Adhyapan which was prevalent in ancient times. It was maintained by the personal and direct conveyance from the teacher to the pupil.

Vyākhyāna

It included the imparting of the text of the treatise as well as exposition in elaborate terms of the implications of the texts. This method was known as Vyakhyana or Vivaraṇa. This elaboration of the implications in the texts of a treatise was known as Tantra-yukti. Caraka describes these Tantra-yuktis to be similar with the texts. It awakens the mind and illuminates it so as to make the sense of the treatise exhaustively clear.

Significance of Direct Study

One who has acquired a good grasp of even one branch of this science will be able to acquire an understanding of the other branches due to his fundamental strength in understanding general principles. That the mastering of a branch of science enables a pupil to acquire proficiency in other branches with ease, is a statement in Caraka which bears out the fact that not only mastery in any one or more branches of Ayurveda but a good acquaintance though not mastery in all branches was the ideal aimed at. A sound and thorough understanding of the knowledge and not any haphazard learning was the ideal enforced in the ancient times. Thoroughness was relentlessly aimed at, both by the master and the pupil, is fully borne out. This signifies the importance of the teacher, and Susruta emphasizes the necessity of study under a Guru in very vehement terms. He who learns his science directly from the preceptor and repeatedly studies and practices it, is indeed the real physician while all others are mere pilferers.

Medical Conferences

Time-old Tradition

The idea of holding national and international conferences of scholars and scientists in any branch of knowledge is not confined to modern times only. This was an old custom of ancient times and we have an ample evidence in the Caraka Samhita supporting that they met either periodically or whenever there arose doubt and differences of the opinion on important questions affecting the theory and practice of science.

There took place large or small conferences and discussions to resolve the doubts and establish an authoritative doctrine on the subject. These discussions were different in their character from clinical meetings and debates. These were national gatherings where scholars and thinkers from various parts of the country and even scholars from neighboring countries, assembled in the interests of the advancement of medical science as a whole. The promotion of exchange of doctrines and their international dissemination was promoted in such meetings. 

Various Conferences

• There is a conference on a smaller scale of sages depicted in Caraka Samhita, wherein the nature of Vata and other body-forces are discussed.
• There is another conference devoted to the discussion of the theory of Taste and of the elemental composition of its varieties.
• There is a conference of sages for discussing the origin of disease and the formation of body elements.
• On the question of eugenics, of marriage inheritance and constitutional traits and peculiarities, there are discussions among sages and their leader sage Atreya gives out two authoritative conclusions on each subject after the debate.
• Other such discussions are on the subjects like timely and premature death and relative merits of various purgative drugs and other such topics.

As per Caraka Samhita

The Caraka Samhita opens with the description of one of the greatest such conferences of sages, when the people as a whole were confronted with the phenomenon of acute disease and premature death and selected and deputed one of them. Bharadwaja learnt the science of life from Indra.

Summary

Thus as a sincere and serious method of advancing the cause of the science and the well-being of mankind, the conferences and debates and discussions were held in Caraka's times even as they are done today. This bespeaks the high degree of enlightenment and the love towards progressive knowledge among the learned and their sincere desire for human welfare in those early times of history.

Practical

Foreword

The common charge against the ancient genius in general and medicine in particular is that its nature is more speculative and theoretical than practical and useful. It suffered in the estimation of the world more through world's ignorance of her achievements than through the absence or insignificance of such achievements. The two fields in which the country excelled in the past were philosophy and medicine.

The ancient philosophers were realists and practical men. They tested the validity of their conclusion by resorting to the practice of yoga and religious devotion. Yoga and practical religion were closely allied to philosophy and was not merely intellectual or imaginative pastime and adventure.

Ancient Perspective

The people in the ancient times have been practical people and have never allowed their theories to run away without yielding actual results affecting daily life. This was the opinion of the great western scholars who have studied original books with a scientific spirit. This is even more true of the realm of medicine. Medical theories have to be justified and tested in everyday life. Medicine and surgery could not have survived if they had not stood this test of day to day verification and fulfillment.

They did this due to the fact that the system of medical education laid great emphasis on the study of anatomy and physiology, on dissection of dead bodies and on practical demonstrations, on models as well as on the clinical study of patients in order to enable the students to have a thorough grasp of the secrets of the structure and functions and behavior of each and every part of the human mechanism in health and disease.

Both the treatises, Caraka and Susruta repeatedly emphasize the necessity and importance of practical work. Susruta, the treatise on surgery tries to give even greater importance to practical study. Now listen as I describe its foremost branch which is not in conflict with direct experience, authoritative text, inference and example. He gives priority to practicals in the enumeration of methods of study. In ancient works, the order of words or phrases is kept meticulously according to their importance.

As Indian Medical science paid much attention to the study of practical work as it did to theoretical side, we shall review in detail some of the various references pertaining to practical work found in the classics of medicine. To get recognition by the king, the physician should not only study but also do the practical work. After studying, he should take practical training.

Botany

The goat-herds, shepherds and cow-herds and other foresters are acquainted with the names and forms of plants. No one can claim to have a perfect knowledge of the use of medicinal herbs by just the acquaintance with the names or forms of them. If one who knows the uses and actions of herbs, though not acquainted with their forms, can be called as knower of science, then what need to be said of the physician who has a knowledge of herbs in all their aspects.

He is the best of the physicians who knows the science of the administration of drugs with due reference to clime and season and who applies it only after examining each and every patient individually. This is examined by speculating the below mentioned parameters:

• Nature
• Efficacy
• Origin country or region
• Season
• Preservation
• Dose of medication
• Administration over particular disease

Preparation of Drugs

Preparation of the drugs is the process performed to modify the natural properties of a substances. It radically modifies the properties of the substances. By skillfully carrying out synthetic and analytic procedures on drugs by time-factors and pharmaceutical processes even a small dose of a drug may be made to produce powerful action and a big dose of medication is made to produce a very mild result.

As per Caraka

Caraka describes the importance of practical knowledge in the preparation of drugs and in prescribing them. The best physician knows the art of combination as well as the systematic administration of these preparations both internally and externally. The art of prescription depends on the knowledge of dosage and time. The success of a physician depends on this art. Hence the skillful physician stands superior to those possessing merely a theoretical knowledge of drugs. The drug whose name, form and properties are not known or the drug which though known, is not properly administered, will cause a disaster.

Anatomy

A surgeon desiring knowledge free of all doubt must investigate well the dead body and study the human anatomy. The direct observation and theoretical knowledge together conduce to the enhancement of the surgeon. It is the store of knowledge as a whole. Due to this reason the body of a man who has not died of poison or of a long-standing disease and who has not lived till too old and whose bowels and excrements have been removed should be fitted in a case and wrapped in sacred grass or bark cloth or reeds etc. Then it should be placed in a running current of water at a spot not exposed to public view. When it is soaked well for seven days, it should be taken out and scrubbed slowly with a brush made of either cuscus grass, hair, bamboo or balwaja grass and all the body-parts such as skin etc. Then the details of the external and internal body limbs as have been described in the text should be observed keenly with the eyes.

It is not possible to see with the physical eyes the subtle principle of the spirit in the body as it is visible to the eye of wisdom or meditation. The wise physician therefore should know the truth both by studying the body as well as the text of the science and resort to practice having cleared all his doubts by the help of both observation and authoritative texts.

Surgery

After the disciple is fully versed in the texts of the science, he should be given practical training by the means of dummies and substitutes for the human limbs. He should be taught the practical line of procedure as regards to the oleation therapy.

The art of making excision or amputation should be demonstrated on the following vegetables:

1. Puspaphala - It is a kind of gourd.
2. Alabu - It is a Bottle- gourd.
3. Kalindaka - It is water-melon.
4. Trapusa - It is cucumber.
5. Brvdruka - It is Phut cucumber.

Practice of Surgery

• The art of cutting either in the upward or downward direction should be also taught.
• The art of making incisions should be demonstrated by making cuts in the water bag or in the bladder or in the leather pouch full of slime or water.
• The art of scraping should be instructed on a piece of stretched skin with hair on it.
• The art of perforation or venesection should be taught on the vein of a dead animal or on a lotus.
• The art of probing or sounding should be taught on worm eaten wood or on the reed of a bamboo or on the mouth of a dried bottle gourd.
• The art of extracting should be taught by with-drawing seeds from the kernel of a Scarlet-fruited gourd, Bael or Jack-fruit, as well as by extracting teeth from the jaws of a dead animal.
• The act of draining or evacuating should be taught on the surface of a small plank covered over with a coat of bees wax.
• The art of suturing should be demonstrated on pieces of thin and thick pieces of cloth, skin or hide.
• The art of bandaging or ligaturing should be practically learned by tying bandages round the individual limbs and members of a full-sized dummy.
• The art of plastic surgery of the ear should be practically demonstrated on a soft muscle or flesh or on the stem of a lotus lily.
• The art of cauterizing or applying strong alkaline preparations should be demonstrated on a piece of soft flesh
• The art of inserting tubes and catheters into the region of the bladder or into an ulcerated channel, should be taught by inserting a tube into a lateral orifice of a pitcher full of water or into the mouth of a bottle gourd.

References From Sources

The references found from the available source denote that:

One who practices experiment on things above-mentioned in a systematic manner does not err in carrying out operative measures. Therefore the wise physician desiring dexterity in operative and cauterization procedures should practice on suitable objects these operative experiments.

Practice of other operative measures

One desirous of saving his life should avoid even from a distance the physician who often makes improper and unskillful use of alkali, operative instruments, thermal cauterization and drugs, even like a virulently poisonous serpent.

Practice in Venesection

No one can be said to be fully skilled in venesection. For these veins and arteries are naturally always vibrant with motion. Like fish they are ever moving. Therefore the physician should venesect with great care.

Clinical Examination

Significance

The greatest importance to practical training is given in the clinical examination of the patient. Seeking to know the nature of a disease by direct observation, the physician should explore by means of his sense- organs, with the exception of the tongue. The entire field of sensible data is presented by the patients body. Having considered all the factors and from all points of view, the learned physician should formulate his opinion first as regards to the nature of the disease and the line of treatment.

The physicians after examining everything in every possible aspect and diagnosing after full investigation will never be mistaken and will be able to achieve the desired result. Thus are declared the signs and symptoms of fatal prognosis in the subject of complexion and voice. The practitioner would not get confused in the art of prognosis if he has a sound knowledge on this subject. The physician who by palpation ascertains these various palpable signs, will never be confounded in the matter of prognostic knowledge of the life-span of a patient.

Diagnosis by a Physician

The physician who perceives these foreboding symptoms of the sense faculties in their right nature knows the death or survival of a patient. Thus we have propounded the subject under consideration correctly. The student of the medical science should pay constant heed to it. This way he can become a successful practitioner securing fame and riches for himself. The physician who keeps on observing repeatedly the development of diseases and the condition of the patient will not differ in treatment. Hence those alone that act after investigation are considered wise.

The wise physician should carefully investigate even the minutest changes in the hypertrophy, normality and the atrophy of the morbid element as well as the strength of the body, gastric fire, vitality and mind. The circumspect physician, constantly observing the variations in the stages of the disease should prescribe such treatment helpful for the therapeusis.

The physician desirous of ascertaining by the method of palpation, the measure of life left to the patient, should palpate the latter entire body with his hand which must be in a normal condition. If it is not so, he should get the palpation done by someone else. One who investigates very minutely all these in the determination of the morbid condition as well as in deciding the line of treatment and then starts the actual treatment can never fail in his task.

Prognosis as per Caraka

Caraka is even so particular as to prescribe that the clinician must possess the normal and healthy condition of the mind and hands which are used to examine the patient. Therefore the physician who is of sound mind and understanding should know accurately the diseases from the view-points of etiology and symptomatology etc.

Prognosis as per Vagbhatta

To illustrate the importance of constant practice, Vagbhatta compares the medical training to other practical art. Practice bestows on a man true insight which leads to success in treatment even as the skill to distinguish between the good and the bad among precious stones is not derived from a mere acquaintance with the theoretical knowledge of gems.

Jivaka's Story

It must be noted that the Guru was accompanied by his students when going for clinical examination of the patient. The following Jivaka's story bears ample evidence of this fact. With Atreya as his teacher, Jivaka mastered everything excellently at the instruction from his Guru. Atreya wanted a young brahman when he visited his patients along with him.

One day he took Jivaka also with him, gave him directions to administer certain remedies and then went away. Jivaka thought, in the present case the master has made a mistake. If the patient takes this medicine, he will die this very day. As the remedy which the master has prescribed is not good, I shall contrive an expedient. So he left the house along with Atreya and said when he came back again, "The doctor has told me not to give the medicine which he had prescribed, but a certain other remedy". When the patient was treated in this way he became better.

The next time Atreya visited the patient, after asking how he was getting on, he gave directions that the same medicine should be given to him on the following day. Being asked whether he meant the medicine which he had prescribed first or that which he had afterwards ordered, he said, "What did I prescribe first and what afterwards?" He was told, "You prescribed the one when you were present here, about the other you gave orders to Jivaka." He said to himself, "I made a mistake. Jivaka is endowed with great insight. Then he said that the medicine which Jivaka had prescribed was to be given.

Atreya became well pleased with Jivaka and took him along with him wherever he went. The Brahmans sons, said, "O teacher, you are well pleased with him because he is a king's son and you bestow instruction upon him, but none upon us". He replied, "That is not the case. Jivaka possesses great intelligence and he is able to comprehend intuitively whatever I indicate to him".

They said, "O teacher, how do you know this?" He said to the Brahman's sons, "Go and ask the prices of various commodities, you ask of such a one and you ask of such another. And having so spoken he sent them off to the market. He also gave orders to jivaka to ask the price of a certain article. The Brahman's sons did as they were bidden. Jivaka did likewise.

But then he said to himself, "Suppose the master asks the prices of other wares, what shall I reply? I shall make myself acquainted with the prices of other commodities as well." When they had all returned to their teacher, they rendered an account of those things which they had been ordered to do. Then Atreya began to ask the prices of articles which he had not mentioned, paying to each of them, "O Brahmana's son, what does this commodity cost?" He whom he questioned, replied that he did not know. In like manner did the others make reply when he questioned them. But Jivaka, when he was asked told him the price of every kind of goods.

"O Brahmans sons", said Atreya, "have you heard?" "Yes, we have heard". "Behold, this is the reason why I said that Jivaka, as he is possessed of remarkable insight, intuitively comprehends any matter, intimation being given to him" replied the teacher.

Adhyapana or Instruction

Method of Instruction

Adhyapana or exposition before others formed an eminent part of studies. This method was regarded to be important in making the subject clear to the person himself and enabling him to acquire a knack for imparting it to others. The teacher when teaches the worthy disciples, he will grasp all the aspects of teaching described. He will also imbibe all the aspects that the teacher did not describe but implied.

Significance of this Method

The method of teaching was exposition which consisted of expounding the subject before the students. Senior students and post-graduates acted as junior teachers and it formed a part of their own training. This method helped to produce efficient teachers of the science. A sound and thorough mastery and not any haphazard learning was the ideal enforced. It is clear that thoroughness was relentlessly aimed at, both by the master and the pupil.

Clinical Discussions And Conferences

Significances

The third method of the acquisition of knowledge was the discussion with the men of his own line of learning after he has fully acquired his scholarship and skill in exposition, that gives the final touch to the student's proficiency and enlarges field of vision by highlighting on many obscure points. This process sharpens his wits and methods of cogent argument. He then becomes an adept in the full sense. This process co-relates with the clinical meetings of the colleges and conferences of the present day.

Logic, an Eminent Aspect

Logic was one of the subjects in secondary school education which was the foundation for the scientific medicine. And if the medicine is to be maintained on scientific level, every medical student should be taught the basic principles of logic. Otherwise the doctor devoid of logic will convert the scientific medicine into dogmatic practice.

Discussion Ordeals

A physician should discuss with another physician. Discussion with a person of the same branch of science increases the knowledge and happiness. It contributes towards the clarity of understanding, increases dialectical skill, broadcasts reputation, dispels doubts regarding things heard by repeated healing and confirms the ideas of those that have no doubts. It enables one to hear a few new things in the course of discussion. Sometimes, secret meanings, which the teacher imparts to the ministering disciple in a propitious moment gradually, the excited disputant, desirous of victory reveals in the process of discussions. Hence it is that discussion with men of the same branch of science, is applauded by the wise.

That the medical conferences were held for the advancement of the science and for the acquisition and spread of knowledge, has already been described in the course of this chapter.

Scientific Concept

All these methods, rules and regulations and the meticulous study of logical postulates aimed to making the medicine a scientific structure of practical utility. These facts clearly denote that the ancients had developed and maintained a high standard of theoretical science and practical art of the medical profession. However, this knowledge is not an illumination to those who are devoid of understanding.

Factors Affecting Success in Medical Profession

One comes to the conclusion that a vital essence of success or failure of the medical profession depends upon one factor that is whether the medical knowledge is purely scientific or otherwise. If it is scientific, it would lead to happiness and success; if it is unscientific it will bring misery and unhappiness. Added to this when we read the following aphorisms showing the importance of the study of the whole as against the part, our heads bow down with veneration to these Maharsis. A full conception of the science will never be attained by the knowledge of only a part of it. The physician therefore was required to be fully equipped for such clinical tests, to be sound with the judgement of the disease and to be keen in his sense - perceptions.

Skills of a Physician

One skilled in both science and art deserves recognition by the king. Therefore the intelligent man who desires health and long life, should not take any medicine prescribed by a physician who is a stranger. While describing the qualities of a Vaidya, Caraka gives equal importance to practical work as to theoretical study. Clear grasp of theoretical knowledge, wide practical experience, skill and purity of body and mind these are to be known as the tetrad of desiderata in a physician.

Hence the physician who possesses the fourfold accomplishment consisting of theoretical knowledge, clear interpretation, right application and practical experience, is to be regarded as the re-claimer of life. But salutations are constantly proffered to others who are learned in the science, skillful, pure, expert in performance, practiced of hand and self-controlled.

The man who is acquainted with the characteristics of all the diseases and is versed in all the therapeutic measures is a worthy physician. He should be the one who is thoroughly versed both in theory and practice, who is skillful, upright, pure, deft of hand well equipped, possessed of all his faculties, who is conversant with human nature and line of treatment, who possesses special insight into the science, who is free from self-conceit, free from envy, free from irascibility, endowed with fortitude, who is affectionate towards his pupils, proficient in reading and skillful in exposition.

Summary

It is no wonder that with such meticulous elaboration of the methods of examination, the physicians were far-famed in the past for their skill in diagnosis and healing. This medical glory was at its zenith during the time beginning with the period just preceding Buddha until the 8th century A. D., when the physicians of the country were invited to Jundishapur and Baghdad for consultation and were put in charge of the hospitals. Its highest achievement was during the period of Asoka when the culture was carried across the oceans to the south and the mighty mountains and the table-lands to the north.

During that time, Tibet, parts of Java, Sumatra in the east, Bactria, Persia. Places almost to the shores of Greece in the west was a part of the country. It was established not by military conquest, not by invasions and commercial exploitation but by the devout and humanitarian priests and missionaries who carried the sacred words of knowledge and the means of healing along with them. They possessed the means of healing, both spiritual and physical. That is an ideal which was pursued in the ancient times without laying open to the charge of imperialism and exploitation in the wrong sense. Spirit of knowledge knew no bounds, not even of time and space and transcended the distinctions of race, color and religion.

References

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