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| Sunday, 20 October 2002 |
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Ancient Sinhalese medical lore by ASIFF HUSSEIN Concern for the sick and ailing is perhaps one of the most important attributes of a civilised society. The care a given society provides to its less fortunate members afflicted with disease and other disabling physical conditions could be taken as a measure of its moral obligations. It is here that one feels the high level of civilisation the ancient Sinhalese had reached in pursuit of that noble objective of providing healthcare to all living beings guided by that wise saying 'Arogya parama labha' (Health is the greatest wealth). The earliest reference to medicine among the Sinhalese is found in the ancient Sinhalese chronicle, the Mahavamsa composed by Mahanama sometime around the 5th century A.C. The chronicle has it that Queen Viharamahadevi, prior to the birth of Prince Dutugemunu, gifted to the Buddhist clergy medicines in order that she may conceive. It also alludes to King Dutugemunu having donated medicine to the sick. The above events relate to a period not later that the 1st century B.C. clearly showing that the Sinhalese had attained a high level of medical knowledge well before the Christian era. Physician kings What is however remarkable is how Sinhalese royalty itself involved themselves in alleviating the sufferings of their subjects. Perhaps the greatest monarch in this regard was King Buddhadasa who lived in the 4th century B.C. and was adept in a variety of medical disciplines including general medicine, surgery, obstetrics and veterinary medicine. The sequel to the Mahavamsa, the Chulavamsa tells us that the King constantly carried along with him his knife and whenever he met the afflicted freed them from their pains. Among his more notable feats may be cited his attendance on an outcaste Chandala woman of Helloligama who suffered from a condition known as mulhagabbhini (the state of the foetus being in an abnormal position). This condition the poor woman suffered as many as seven pregnancies and seven times both mother and child were saved by Buddhadasa. It speaks well of the nobility of the King to have set aside ancient caste prejudices and to have attended on an untouchable woman in distress. The King is also said to have split open the skull of a young man to remove a frog dwelling therein and put together again the parts of the skull, thereby effecting a cure. The King's concern for others was not limited to fellow humans, but also extended to animals, for the Chulavamsa tells us that the King cured a cobra smitten with belly disease by slitting open its belly, taking out the diseased parts and applying a remedy. Besides such astounding surgical feats, the King is said to have established hospitals (Vejja-sala) in the villages, as well as shelters (Sala) for the cripples and the blind. He is also said to have appointed physicians for elephants, horses and soldiers. King Buddhadasa is also credited with the compilation of the Sarartha Sangraha, a comprehensive medical treatise in Sanskrit. The work though similar in arrangement to the Samhita of Shushruta contains much original information as well and deals with such topics as clinical diagnosis, preparation of drugs, surgical instruments and operations, obstetrics, epilepsy, tuberculosis, eye diseases and ear, nose and throat diseases. Hospitals and dispensaries There was also King Aggabodhi VII (8th century) who went to the extent of undertaking fresh research on the efficacy of medicinal herbs. According to the Chulavamsa the King studied the medicinal plants over the whole island of Lanka to find out whether they were wholesome or harmful to the sick. Then there was King Parakramabahu I (12th century) who the Chulavamsa says was well versed in medical lore and showed physicians the proper use of instruments by skilfully treating several people with his own hand. The story is also told of a crow suffering from an ulcer that had formed in her cheek who came moaning piteously to a great hall built for the sick by the King. The physicians who rightly diagnosed her condition cured her at the King's command. The King is also said to have built provender houses in which medicines were collected and provided maintenance to discerning and skilled physicians quick in diagnosing ailments. It would surprise many to learn that the Sinhalese could perhaps boast of the oldest hospital in the world. The Chulavamsa has it that King Sena II (9th century) built a hospital (Vejjasala) on the Chetiya mountain and this very probably refers to the Mihintale hospital now in ruins. Archaeological excavations have revealed that the hospital was quite a complex structure and comprised an outer and inner court, refectory, pharmacy etc. The rooms used for the preparation and storage of medicines were situated in the outer court as suggested by the discovery of stone querns used in the grinding of herbs in this area. The inner court was surrounded by a number of cells where the patients appear to have been treated. This is the oldest archaeological evidence for a hospital we have so far. Heinz Muller-Dietz in his Historia Hospitalium (1975) describes it as being perhaps the oldest hospital in the world. Medical remedies Epigraphic evidence also testifies to the existence of various other hospitals and dispensaries in the island. For instance, the Kiribat Vehera pillar inscription of the 10th century records the grant of certain privileges by King Siri Sangabo (probably Kassapa IV) in respect of a garden named Giri-vatta attached to the dispensary at Tumbarab (Tumbarab behed-ge). The dispensary was such a hallowed institution that it had the privilege of offering sanctuary to offenders, showing that it was held in the esteem that churches were held in medieval Europe and diplomatic missions are held in the present day. A Medirigiriya slab inscription of about the 11th century refers to ved-hal kemiyan (employees of the hospital), ved-hal dasun (serfs of the hospital), ved-sam-daruvan (state physicians) and ved-hal-bad-gam-bim (villages and lands attached to the hospital). All this would suggest that the hospitals of yore were complex institutions provided with state-sponsored physicians, nurses, medicines and lands for their maintenance. Ancient Sinhalese physicians practised a variety of medical treatment and had a considerable pharmacopoeia. Medical treatment using leeches to draw bad blood was evidently known for the Mihintale tablet inscription of Mahinda IV (10th century) alludes to a physician who applies leeches (Puhunda-vedak). The 13th century Saddharma-Ratnavaliya mentions the consumption of medicinal pastes or kalkas, application of oils and administration of medicine through the nose, while the Pujavaliya also of the 13th century refers to oils given to be drunk. The Saddharmaratnavaliya also refers to such traditional remedies as velmi (liquorice) and sun (asafoetida) while the Saddharmalankaraya mentions Siddhinguru (dried ginger) and vagapul (long pepper) as being used in medicines. The Chulavamsa has it that Mahinda IV (10th century) had the alms bowls of bhikkhus filled with garlic, pepper, ginger and the three kinds of myrobalans (tiphala). The three myrobalans referred to are the fruits of aralu (Terminalia chebula), bulu (terminalia belerica) and nelli (Phyllanthus embilica) which are collectively known as triphala in Ayurveda and figure prominently in the treatment of a variety of ailments. Efficacy of Sinhalese medicine We also come across references to the efficacy of Sinhalese medicine in the accounts of foreign writers, notable among them being Joao Ribeiro, the Portuguese soldier-historian who served in Sri Lanka from 1641-1658. Ribeiro has this to say in his reputed work 'Fatalidade Historia De Ceilao': "They are great herbalists, and in case of wounds, tumours, broken arms and legs they effect a cure in a few days with great ease. As for cancer, which is a loathsome and incurable disease among us, they can cure it in eight days, removing all viscosity from the scab without so much as leaving a mark anywhere to show that the disease had been there. " I have seen a large number of soldiers and captains cured during my residence in the country, and the ease with which this was done was marvellous. In truth, the land is full of medicinal herbs and many antidotes to poison, which I have myself tried to learn as a remedy against snakebites". Indeed many Sinhalese medical beliefs and practices have been shown by modern research to have a valid scientific basis. Particularly interesting are the findings of Dr.C.G. Uragoda in his epoch-making 'Traditions of Sri Lanka. A selection with a scientific background' (2000). Dr. Uragoda has shown that the concept of heatiness in foods, smoking of attana (Datura alba) and adatoda (Adhatoda vasica) in the treatment of asthma and the oral administration of venivel (Coscinium fenestratum) as a prophylactic against tetanus do have a sound scientific basis after all. The concept of heatiness in foods he attributes to a high histamine content. For instance, he has shown that such kinds of fish as balaya (skipjack) and kelavalla (tuna) which have been traditionally regarded as heaty, do in fact have a high histamine content, a substance which may cause allergic reactions among some people. Dr. Uragoda has also convincingly shown that the olden day Sinhalese were well aware of the fact that the mosquito was responsible for the transmission of malaria long before Sir Patrick Manson advanced his Mosquito-Malaria theory in 1884. As evidence, he has cited an interesting passage in Sir Emerson Tennent's Ceylon (1859) which alludes to the Sinhalese of his day employing mosquito curtains as a precaution against Malaria. This would indicate that the Sinhalese knew that the mosquito was the vector of the malaria parasite well before Manson advanced his famous theory. |
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