The Art is Long

Primary Texts on Medicine and the Humanities

Alexis M. Butzner

• Publisher: Chemeketa Press
• Year: 2021
• ISBN:
  9781943536948
• Topic: Medicine
• Subtopic: Medical Theory, Practice & Reference

The Art Is Long: Primary Texts on Medicine and the Humanities gathers introductory texts in the growing field of medical humanities. This unique volume presents a lens with which to examine the intersection of literature and medicine with diverse selections that span time and the globe. With authors from Sushruta to Hippocrates, Margery Kempe to John Donne, and Susie King Taylor to Sigmund Freud, the volume also highlights the voices of women, people of color, and those who have been overlooked or marginalized by the medical establishment.

The Art Is Long aims to expand the medical humanities canon. In addition to more traditional works, readers will find snippets of literary and narrative encounters with medicine by writers who are neither doctors nor nurses, including professional caretakers and people who might be labelled “quacks” today but whose contributions represent a part of medical history.

This anthology also includes medical reportage and philosophy, fiction and nonfiction, image and poetry. The shifts in genre, style, and perspective provide a wealth of opportunities to reflect on medical history and literary techniques, focusing on narratives that highlight a personal context for medical subjects in a single volume.

Selections

Sushruta’s Compendium
(Sushruta Samhita)^*

SUSHRUTA

(Indian, ca. sixth century BCE)

Sushruta Samhita translates literally as “Sushruta’s Compendium.” It was composed at some point during the sixth century BCE by the Indian physician Sushruta, who was renowned as a physician and is called by some the father of surgery. His compendium is a foundational text of ancient Ayurvedic medicine, one of the oldest systems of health in the world. Ayurveda means “knowledge of life” in Sanskrit and is still widely practiced in its modern form, although Western practitioners have labeled it an alternative medicine. The Ayurvedic system understands health to rely upon a harmonious balance of three Doshas (vata, pitta, and kapha). These Doshas govern the functions, movement, and growth of the body. As you read, consider these excerpts’ descriptions of the various branches of Ayurvedic medicine, its theory of disease, and the practices and oaths required of new students.

[On the Origin and Types of Ayurveda]

The Áyurveda (which forms the subject of our present discourse), originally formed one of the subsections of the Atharva Veda;¹ and even before the creation of mankind, the self-begotten Brahmá² strung it together into a hundred thousand couplets (Shlokas³), divided into a thousand chapters. But then he thought of the small duration of human life on earth, and the failing character of the human memory, and found it prudent to divide the whole of Áyurveda into eight different branches such as, the Salya-Tantram, the Sálákya-Tantram, the Káya-Chikitsá, the Bhuta-Vidyá, the Kaumár-Bhritya, the Agada-Tantram, the Rasáyana-Tantram and the Vájeekarana-Tantram. Now about the characteristic features of each of these branches of the Science of Áyurveda:

The Salya-Tantram⁴—The scope of this branch of the Medical Science is to remove (from an ulcer) any extraneous substance such as, fragments of hay, particles of stone, dust, iron or bone; splinters, nails, hair, clotted blood, or condensed pus (as the case may be), or to draw out of the uterus a dead fetus, or to bring about safe parturitions in cases of false presentation, and to deal with the principle and mode of using and handling surgical instruments in general, and with the application of fire (cautery) and alkaline (caustic) substances, together with the diagnosis and treatment of ulcers. The Shálákya-Tantram⁵—embraces as its object the treatment of those diseases which are restricted to the upward (lit: region above the clavicles) fissures or cavities of the body, such as the ears, the eyes, the cavity of the mouth, the nostrils, etc.

The Káya Chikitsá (General diseases)⁶—treats of diseases, which, instead of being simply restricted to any specific organ, or to any particular part of the body, affect the entire system, as Fever, Dysentery, Hemoptysis,⁷ Insanity, Hysteria, Leprosy, unnatural discharges from the urethra, etc.

The Bhuta-Vidyá (Demoniacal diseases)—lays down incantations and modes of exorcising evil spirits and making offerings to the gods, demons, Gandharvas, Yakshas, Rakshas⁸, etc. for cures of diseases originating from their malignant influences.

The Kaumára-Bhritya (Management of children)—deals with the nursing and healthy bringing up of infants, with purification and bettering of mothers’ milk, found deficient in any of its characteristic traits, and also with cures for diseases peculiar to infant life and due to the use of vitiated mother’s milk or to the influences of malignant stars and spirits.

The Agada-Tantram (Toxicology)—deals with bites from snakes, spiders, and venomous worms, and their characteristic symptoms and antidotes. It has also for its object the elimination of poison whether animal, vegetable, or chemical (resulting from incompatible combinations) from the system of a man, overwhelmed with its effects.

The Rasáyana-Tantram (Science of Rejuvenation)—has for its specific object the prolongation of human life, and the invigoration of memory and the vital organs of man. It deals with recipes which enable a man to retain his manhood or youthful vigor up to a good old age, and which generally serve to make the human system invulnerable to disease and decay.

The Vájeekarana-Tantram (Science of Aphrodisiacs)—treats of measures by which the semen of a man naturally scanty or deficient in quality becomes shorn of its defects; or is purified, if deranged by the vitiated humors of the body (such as wind, etc.); or is invigorated and increased in quantity (if pure and healthy); or acquires its healthy and normal consistence (if thinned and enfeebled by indiscretions of youth). [In short, it deals with things which increase the pleasures of youth and make a man doubly endearing to a woman].

*

Thus the entire science of Áyurveda is classified into the eight preceding branches. Now tell me, which of them is to be taught and to which of you? Said the disciples:—“Instruct us all, O Lord, in the science of surgery (Shalya) and let that be the chief subject of our study.” To which replied the holy Dhanvantari: “Be it so.” Then the disciples again said:— “We are all of one mind in the matter, O Lord, that Sushruta shall be our spokesman and ask you questions conformably to the general trend of our purpose. All of us will attentively hear what you will be pleased to discourse to Sushruta, [and that will save you the trouble of teaching us individually]”. To which replied the venerable sage—“Be it so. Now listen, Sushruta, my dear child. The object or utility of the science which forms the subject of our present discussion, may be grouped under two distinct sub-heads such as (1) the cure of diseased persons, and (2) the preservation of health in those who are not afflicted with any sort of bodily distempers.”

[On the Definition and Nature of Disease]

Disease: Its Definition:—The Purusha (man)⁹ is the receptacle of any particular disease, and that which proves a source of torment or pain to him, is denominated as a disease. There are four different types of disease such as, Traumatic or of extraneous origin (Ágantuka), Bodily (Shárira), Mental (Mánasa) and Natural (Svábhávika). A disease due to an extraneous blow or hurt is called Ágantuka. Diseases due to irregularities in food or drink, or incidental to a deranged state of the blood, or of the bodily humors acting either singly or in concert, are called Shárira. Excessive anger, grief, fear, joy, despondency, envy, misery, pride, greed, lust, desire, malice, etc. are included within the category of mental (Mánasa) distempers; whereas hunger, thirst, decrepitude, imbecility, death, sleep, etc. are called the natural (Svábhávika) derangements of the body. The Mind and the Body are the seats of the abovesaid distempers according as they are restricted to either of them, or affect both of them in unison.

Samshodhanam (Cleansing),¹⁰ and Samshamanam (Pacification of the deranged or agitated bodily humors giving rise to the disease), and the regimen of diet and conduct are the four factors which should be duly employed in order to successfully cope with a disease….

Physicians should look upon these four factors of food, conduct, earth and time, as the accumulators, aggravators and pacifiers of the deranged bodily humors and of the disease resulting therefrom in man. Diseases due to causes which are extraneous to the body may affect the mind or the body. When it would affect the body in the shape of any traumatic disease (such as an inflammation due to a blow or sword cut), it should be treated medicinally like the rest of the physical maladies, while the remedy should consist in the enjoyment of pleasurable sounds, touch, sights, taste or smell where the mind would be found to be the seat of the distemper….

The term Purusha should be interpreted to include within its meaning the combination of its five material components, and all things resulting therefrom, such as the limbs and members of the body, as well as the skin, the flesh, the blood, the veins and the nerves, etc. The term Disease signifies all distempers incidental to the several or combined actions of the three deranged bodily humors and blood. The term Medicine signifies drugs and their virtues, tastes, potency, inherent efficacy (Prabháva) and reactionary properties (Vipáka). Appliances (kriyá) denotes such processes as, surgical operations, injections, emulsive measures, lubrications, etc. The term Time signifies all opportune moments for medical appliances.

[On the Initiation of a Student into Ayurvedic Study]

Now we shall discuss the Chapter which deals with the rites of formal initiation of a pupil into the science of Medicine (Shishyopanayaniya-madhyáyam).

Such an initiation should be imparted to a student, belonging to one of the three twice-born castes such as, the Bráhmana, the Kshatriya, and the Vaishya,¹¹ and who should be of tender years, born of a good family, possessed of, a desire to learn, strength, energy of action, contentment, character, self-control, a good retentive memory, intellect, courage, purity of mind and body, and a simple and clear comprehension, command a clear insight into the things studied, and should be found to have been further graced with the necessary qualifications of thin lips, thin teeth and thin tongue, and possessed of a straight nose, large, honest, intelligent eyes, with a benign contour of the mouth, and a contented frame of mind, being pleasant in his speech and dealings, and usually painstaking in his efforts. A man possessed of contrary attributes should not be admitted into the sacred precincts of medicine….

Then having thrice circumambulated the sacrificial fire, and having invoked the firegod to bear testimony to the fact, the preceptor should address the initiated disciple as follows:—“Thou shalt renounce lust, anger, greed, ignorance, vanity, egotistic feelings, envy, harshness, niggardliness, falsehood, idleness, nay all acts that soil the good name of a man. In proper season thou shalt pair thy nails and clip thy hair and put on the sacred cloth, dyed brownish yellow, and love the life of a truthful, self-controlled anchorite and be obedient and respectful towards thy preceptor. In sleep, in rest, or while moving about—while at meals or in study, and in all acts thou shalt be guided by my directions. Thou shalt do what is pleasant and beneficial to me, otherwise thou shalt incur sin and all thy study and knowledge shall fail to bear their wished for fruit, and thou shalt gain no fame. If I, on the other hand, treat thee unjustly even with thy perfect obedience and in full conformity to the terms agreed upon, may I incur equal sin with thee, and may all my knowledge prove futile, and never have any scope or display. Thou shalt help with thy professional skill and knowledge, and Bráhmanas, thy elders, preceptors and friends, the indigent, the honest, the anchorites, the helpless and those who shall come to thee (from a distance), or those who shall live close by, as well as thy relations and kinsmen [to the best of thy knowledge and ability], and thou shalt give them medicine [without ...

Table of contents

• Cover
• Title Page
• Copyright
• Contents
• Introduction: The Long Art
• Selections
• Themes
• Acknowledgments
• Index