Mandala Of Indic Traditions
Does Ayurveda Begin With Dhanvantari, The Ancient Physician
By D.P. Agrawal
In the history of Indian medicine, Dhanvantari, though very famous, is an
elusive name, shrouded in the mist of antiquity. According to some authorities,
he was the giver of Ayurveda or the science of life to the world. In this
essay we will try to trace his identity, as researched by Dwarkanath. We will
also quote the legends associated with Dhanvatari.
Dwarkanath in his interesting essay admits that though names such as Asvins
(the celestial physicians), Kasiraja Divodasa and terms like Bhisak and Bhesaja
occur frequently in the Vedas, the name of Dhanvantri does not occur in them.
As we shall see, Dhanvantri is considered to be a divinity and the god of
medical science. Another Dhanvantri was the king of Kasi and the preceptor
of Susruta. Dwarkanath explains that a study of the puranas, the Harivasma
and some later works shows that there were, in addition to the divine Dhanavantri,
three other Dhanvantars who belonged to different periods of time. They were:
(i) Sri Dhanvantari who, according to Brahmavaivarta, was one of the
16 disciples of Bhaskara, the sun-god, under whom he is stated to have studied
Ayurveda; (ii) Kasiraja Divodasa, surnamed Dhanvantari, an incarnation of
the divine Dhanvantari who, it is said, was no other than Lord Visnu, the
preserver and protector of the universe; and (iii) Sri Dhanvantari who was
one of the 'nine jewels' that adorned the court of Samrat Vikramaditya. Some
authorities think that the last-mentioned Dhanvantari was the author of the
well-known lexicon on drugs, the Dhanvantarinighantu.
Outstanding authorities on Ayurveda, were also honoured in ancient and medieval
India with the honorific Dhanvantari. Thus Dhanvantari refers not only to
the progenitor of Ayurveda but is also associated with a rich medical tradition
and a hierarchy in the history of medicine in India.
Little is known about the lives of the several Dhanvantaris except for a
few references available in the Ayurveda-samhitas and the Puranas.
These sources have referred to Adi-Dhanvantari, Kasiraja Divodasa Dhanvantari
and Dhanvantariyas, i.e., the school of surgeons. According to the Srimad
Bhagavata Purana, it was Bhagavan Dhanvantari, who revealed Ayurveda to
the world. This Dhanvantari, who is said to be the original or the first,
has been known as Adi-Dhanvantari. He is worshipped even today as the presiding
deity of medical science.
According to the tradition given in Brahmavaivartapurana, the creator
of the universe, while studying the four Vedas, separated Ayurveda from them.
He is then stated to have imparted the knowledge of this science to Bhaskara
(sun-god). Surya, thereafter, wrote his own samhita on Ayurveda and taught
the same to 16 disciples of whom Dhanvantari was the foremost. Each one of
these 16 disciples, in his turn, wrote a separate treatise of his own.
That Kasiraja Divodasa Dhanvantari was a prehistoric figure derives support
from the internal evidence provided, among others, by the Susrutasmhita,
the Agnivesasamhita, the Carakasamhita, the Visnupurana
and the Harivamsa. The Visnupurana and the Harivamsa
have, between them, furnished credible and consistent genealogical accounts
of the dynasty to which Kasiraja Divodasa belonged.
(According to Visnupurana)
The genealogical accounts, referred to above, show that Kasiraja Divodasa
belonged to the royal line founded by Pururavas of the lunar dynasty. According
to the Harivamsa, Kasiraja Divodasa belonged to the line of Anena who
was himself a descendant of Pururavas. Kasya, referred to in the Visnupurana
genealogy, represents the fifteenth generation from Anena; Dhanvantari the
third from Kasya and Divodasa the third form Dhanvantari. Dhanvantari is stated
to have divided the entire range of Ayurveda into eight divisions (the Astangas),
each division representing a speciality. These specialities are:
(i) Kayacikitsa (Internal Medicine)
(ii) Kaumarabhrtya or Balacikitsa (Paediatrics)
(iii) Bhutavidya or Grahacikitsa (Psychiatry)
(iv) Salakyatantra (Otto-Rhino-Laryngology & Opthalmology)
(v) Salyatantra (Surgery)
(vi) Visatantra (Toxicology)
(vii) Rasayanatantra (Geriatrics)
(viii) Vajikaranatantra (The therapy for male sterility, impotency and the
promotion of virility)
This Dhanvantari, whom we may refer to as the Senior, was the great grandfather
of Kasiraja Divodasa Dhanvantari.
It is not known if Kasiraja Divodasa Dhanvantari himself wrote any treatise
on Ayurveda, specially on salyasalakyatantras. Probabaly the author
of Cikitsatattvavijnana and Cikitsadarsana was Dhanvantari Divodasa
and that of Cikitsakaumudi, Kasiraja. The only available work which
fully reflects the contribution made by Kasiraja Devodasa Dhanvantari is the
Susrutasamhita. It is seen from the opening passages of this work that
Susruta, who was foremost among the disciples of the Kasipati, compiled the
teachings of his preceptor.
Acarya Susruta has quoted Kasiraja Divodasa Dhanvantari as telling his pupils
that "Ayurveda originally formed one of the sub-sections of Atharvaveda".
During the times of Kasiraja Divodasa Dhanvantari medical science adopted
a well-developed scientific methodology (pramanas), comprising observation
(pratyaksa) and inductive, deductive and analogical reasoning (anumana
and upamana), in addition to the authoritative knowledge (aptopadesa).
These developments eventually led to the theory and practice of medicine into
two broad-based but interrelated branches, viz., (i) preservative, promotive
and preventive medicine, and (ii) curative medicine. Kasiraja Divodasa Dhanvantari
was also responsible for the division of the two main branches of surgery,
viz., Salyatantra and Salakyatantra.
Dwarkanath dates Kasiraja Devodasa Dhanvantari to about 3000 BC, which is
difficult to sustain.
With the rapid growth of knowledge and the increasing tendency among the
practitioners to specialise in one or the other of the eight branches of Ayurveda,
particularly surgery, a stage seems to have reached when the demand for making
provision for imparting proper training in the specialities and the production
of specialities in them became imperative and pressing. This inference is
based on the dialogue that is stated to have taken place between Kasiraja
Devodasa Dhanvantari on one hand and on the other Acarya Susruta, Aupadhenava
and others, who had approached the former at his hermitage in the Himalayas
with the request that they may be taught surgery. Kasiraja is seen to have
initially enquired of them as to which of the eight specialities of Ayurveda
they desire to learn from him. Said the disciples, "Instruct us all,
O Lord, in the science of surgery (Salya) and let that be the chief
subject of our study." Replied the holy Dhanvantari, "Be it so."
Then, the disciples said, "We are all of one mind in the matter, O Lord,
that Susruta shall be our spokesman and ask you questions conforming to the
general trend of our purpose. All of us will attentively hear what you will
be pleased to discourse to Susruta (and that will save you the trouble of
teaching us individually)." To which replied the venerable sage, "Be
it so. Hear me discourse on the science of surgery (Salyatantra) which
is the oldest of all the branches of Ayurveda
All hold this tantra to
be the most important of all the branches of Ayurveda inasmuch as instantaneous
effects can be produced with the help of such measures as surgical operations,
external application of Ksaras (alkalies/caustics), cauterisation, etc., and
inasmuch as it contains all that can be found in other branches of Ayurveda
as well. Hence it is eternal, is a source of infinite piety, imparts fame
and opens the gates of heaven to its votaries, increases the duration of human
existence on earth and helps men in successfully fulfilling their mission
and earning a decent competence in life."
There is adequate evidence in the Agnivesasamhita, a contemporary
medical work, to show that specialisation had reached a stage when general
practitioners and medical specialists preferred to refer all cases that may
need surgical treatment to specialists in surgery. This ancient medical classic
is not only encycolopaedic in its sweep, but is also held in great esteem
as a highly authoritative treatise on Kayacikitsa. It may be incidentally
stated that Kayacikitsa, like its modern counterpart, internal Medicine, is
a department of medicine which deals with diseases that involve metabolic
disturbances to a lesser or greater extent and cannot be treated surgically.
The reference it has made in several contexts to Dhanvantariyas and Dhanvantari
support the view (a) that Kasiraja Divodasa Dhanvantari was not only a contemporary
of Bhagavan Punarvasu Atreya but was also recognised by the latter as a great
authority on surgery; (b) that the school of surgeons was already well established;
(c) that this school comprised surgical specialists, specialists in the surgery
of the mouth, throat, nose, ear, eye and head, as well as experts in cauterisation
(agni or dahakarma), the application of ksara (alkalies/caustics)
and other special procedures employed in the practice of surgery; and (d)
that, as in modern times, the internists confined themselves to the practice
of medicine only and, by a convention and tacit understanding, they either
sought the help of surgical specialists in cases which needed surgical intervention
or referred such cases to surgeons.
Obstertrical surgery too seems to have been highly developed. This is evidenced
not only by references that occur in the Agnivesasamhita but also by
the description of the procedures for (i) the induction of abortion in cases
where the pregnancy may either endanger the health or the life of the mother,
(ii) curetting in cases of incomplete abortion, (iii) the induction of labour
in cases of delayed delivery or uterine inertia, (iv) versions of different
kinds, in cases of mal-positions and mal-presentations, (v) the removal of
the foetus in cases of difficult labour or defects in the maternal passage,
by an abdominal section, reminiscent generally of the modern Caesarian section,
(vi) evacuation of a dead foetus by craniotomy, and (vii) the delivery of
retained placenta by manual manipulation, specially massage which is reminiscent
of the Credas method.
The reference to the views of Dhanvantari (Kasiraja Divodasa) on the formation
and development of the human embryo in thr Agnivesasamhita bears out
the vivid description furnished by Acarya Susruta in his samhita. Commenting
on this description, Prof. Keswani observes:
"The various development stages of the human embryo from the time of
its fertilisation until full term have been so well described that one is
amazed at the acuity of their observations. The only interference one can
therefore draw is that they must have had some sort of aid of optical instruments
to be able to describe even the microscopic appearance of the early zygote
(fertilized ovum) and must have studied embryology in experimental animals;
or, that it was their routine practice to examine and even to dissect the
abortus and the still born. (Quoted by Dwarkanath)"
Even though the Kasiraja had preferred the Samkhya system of natural
philosophy, he is yet seen to have accepted the logical methods and concepts
of the Nyaya system of natural philosophy as a matter of course. These
concepts refer to dravya (substance), guna (attribute), karma
(action/motion), samanya (generality), visesa (particularity)
and samavaya (inherence) as well as paka (reaction/transformation),
samyoga (combination/synthesis) and vibhaga (separation/analysis).
It may be noted that the Nyaya methodology and concepts were taught
earlier by the sage Bharadvaja and Bhagavan Punarvasu Atreya who discoursed
on them as well as on the principles of the Samkhya system. Kasiraja
Divodasa Dhanvantari, on the other hand, did not expatiate on them. He confined
himself to the teaching of the Samkhya system.
A matter of considerable significance, worthy of mention here, is the fact
that Kasiraja Divodasa Dhanvantari and his followers had a complete theory
of drug-composition, molecular structure, physico-chemical properties, therapeutical
actions of articles of food and drugs and pharmacological actions, viz.,
rasa, guna, virya, vipaka, and prabhava. These concepts were based
on the Nyaya doctrines of paramanus (atoms) and anus
He is seen to have had no patience with the dialecticians of his time who
stoutly held that attributes or qualities, rather than the substance to which
they relate, are of primary importance. After adverting to various theories
advanced by contemporary schools of thought, the Kasiraja observed:
"Dravya (substance) is the most important factor
with which medical science is concerned. Dravya is necessarily actions
and attributes which are inseparable and of which it (the dravya) is
the primary cause or, to put it more precisely, the attributes have an inseparable
inherence samavaya with the substance by way of cause
In this view, the strucructural composition of the dravya (substance),
or better still, its anus (molecules), the kind and number of paramanus
(atoms) that compose the latter, and their spatial relationships are factors
that uniquely determine the attributes or qualities of the substance. Dwarkanath
thinks that these and similar other ideas that punctuate the discourses of
Kasiraja Divodasa Dhanvantari show that his approach, besides being rational,
was that of a molecular biologist.
The Kasiraja has wholly adopted the Samkhya system of natural philosophy
as the main basis of the Ayurvedic concept of man, his body, senses, mind
and soul, comprehended in the term sarira, on the one hand, and his
physical and biological environment, on the other. He has accorded to this
system the status of a fundamental or pure science. In fact, he has prefaced
his discourses on sarira with the Samkhya theory of cosmogenesis
and evolution of matter, mind and senses.
Kasiraja Divodasa Dhanvantari has not derived some of the fundamental physical
and biological (including the psychological) concepts, or the psychosomatic
concept of man, which forms the essential basis of Ayurveda, from the Samkhya
school of natural philosophy but also adopted the three-fold Samkhya classification
of dukhas or miseries, viz., adhyatmika, adhibhautika
and adhidaivika. He has, besides, enlarged the Samkhya classification,
referred to above, on the basis of the nature of stressors abhighatas
that cause one or the other kind of diseases.
Thus, diseases belonging to the adhyatmika class are stated to be
of constitutional and/or idiopathic types. They include saririka or
somatic and manasika or psychic disturbances. Of the three-fold functional
factors of the body, viz., vata, pitta and kapha (slesma),
and the latter the upheavals of rajas and tamas. The saririka
or somatic diseases are of three kinds. They are: (a) the adibalapravrtta
or genetically determined diseases either father-derived (pitrja)
or mother-derived (matrja), (b) janmabalapravrtta or congenital
diseases that are determined by the vicissitudes of the mother when pregnant,
and (c) dosabalapravrtta or diseases engendered by errors in diet,
actions, and faulty observance or non-observance of health regimen.
The adhibhautika type of diseases is said to be caused by environmental
stressors, both physical and biological (including invisible living things).
Known as the sanghata-balapravrtta or the traumapatic, it involves
external or internal injuries abhighatas caused by blows,
sharp instruments, overstrain, bites of wild animals, poisonous reptiles,
The third kind, the adhidaivika, comprises three sub-groups. Of these,
the first group, the kalabalapravrtta, includes diseases engendered
by meteorological disturbances, such as variations in atmospheric temperature,
hot or cold, humidity or dryness, rain and wind, seasonal or otherwise. The
second group, the daivabalapravrtta, comprises diseases that are caused
by forces beyond human control or due to providential dispensation. Examples
of these are injuries caused by lighting, heat-stroke, pandemics and the like.
The third group, the svabhavabalapravrtta, includes natural, organic
and functional changes that occur in the human body due to the passage of
time, as in aging.
The profound influence the Samkhya concept of evolution had on Kasiraja Divodasa
Dhanvantari is seen reflected in his discourse on dosakriyakala
a concept which refers to the pathogenesis of diseases in general, and reactions
of the body that lead to vrana or inflammation leading to ulcers, in
The concept of kriyakala taught by the Kasiraja should assume importance
today in the fields of medicine and surgery in view of the developing trends
relating to the concept of pathogenesis, especially in the field of rheumatoid
diseases. These developments envisage what is termed as 'anticipatory guidance'
which is expected to make it possible 'to look at the natural history of any
disease as a process that can be averted, interrupted or delayed at various
points in its evolution'.
The versatile nature of Kasiraja Divodasa Dhanvantari's teachings, both fundamental
and applied, embracing all the astangas or eight specialities of Ayurveda,
his discourses on surgery and subjects basic to the study of this speciality,
have been acknowledged by some of the well-known authorities as outstanding,
pioneering and the earliest in the world. Dwarkanath mentions that the latest
to make an objective assessment of the compilation of the teachings of the
Kasipati by Acarya Susruta is Jurgeon Thorwald of Germany, the author of The
Triumph of Surgery, The Triumph of Surgeon and The Dismissal,
published by Thames & Hudson, London. In his latest work, entitled Science
and Secrets of Early Medicine Egypt, Mesopotamia, India, China, Mexico
and Peru, (translated and published in 1962 by Thames & Hudson) ,
he has, referring to the teachings of the Kasiraja (which he has described
as Susruta's collection), observed: "They reflected an unusual degree
of rational medical experience. In particular, it revealed a creative strain
Referring to the discipline of anatomy, which is basic to the study and practice
of surgery, says Thorwald: "Beyond all that, the Susrutasamhita
contained a lecture dealing with the study of anatomy." After discussing
the method of preparing the human cadaver and the procedure for dissection
described in this lecture, he says: "Certainly this was the oldest lesson
in dissection known to history."
The importance attached by the Kasiraja to anatomical knowledge as an essential
pre-requisite for the study and practice of surgery is seen from the following
observations he had made:
"Therefore, a surgeon desiring knowledge free of all doubt must investigate
well the dead body and study the human anatomy. In short, direct observation
and theoretical knowledge together contribute to the enhancement of the surgeon's
store of knowledge as a whole.
"It is for this reason that the body of a man who has not died of poison
or of a long-standing disease and who has not lived to be 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., and 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
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, for 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."
Another pre-requisite for training in surgery was the insistence on the practice
of operative surgery. Emphasising its importance, the Kasipati observes:
"The preceptor should see that his disciple attends to the practice
of surgery even if he has already thoroughly mastered the several branches
of the science of medicine, or has perused it in its entirety. In all acts
connected with surgical operations of incision, etc., and injection of oil,
etc., the pupil should be fully instructed as regards the channels along or
into which the operations or applications are to be made (karmapatha).
A pupil, otherwise well read, but uninitiated into the practice of medicine
or surgery, is not competent to take in hand the medical or surgical treatment
of a disease. The art of making specific forms of incision should be taught
by making cuts in the body of a puspaphala (a kind of gourd), alabu,
watermelon, cucumber or urvaruka. The art of making cuts either in
the upward or downward direction should be similarly taught. The art of making
excisions should be practically demonstrated by making openings in the body
of a full water-bag or in the bladder of a dead animal or in the side of a
leather pouch full of slime or water. The art of scraping should be introduced
on a piece of skin on which the hair has been allowed to remain. The art of
venesection (vedhya) should be taught on the vein of a dead animal
or with the help of a lotus-stem. The art of probing and stuffing should be
taught on worm (ghuna) eaten wood or on the reed of a bamboo
or on the mouth of a dried alabu (gourd). The art of extraction should
be taught by withdrawing seeds from the kernel of a bimbi, bilva
or jack fruit, as well as by extracting teeth from the jaws of a dead animal.
The act of secreting or evacuating should be taught on the surface of a shalmali
plank covered over with a coat of bee's wax and suturing on pieces of cloth,
skin or hide. Similarly the art of bandaging or ligaturing should be practically
learned by tying bandages round the specific limbs and members of a karnasandhi
(severed ear-lobe) should be practically demonstrated on a soft severed muscle
or on flesh, or with the stem of a lotus lily. The art of cauterising or applying
alkaline preparations (caustics) should be demonstrated on a piece of soft
flesh; and lastly, the art of inserting syringes and injecting enemas into
the region of the bladder or into an ulcerated channel should be taught by
asking the pupil to insert a tube into a lateral fissure of a pitcher full
of water, or into the mouth of a gourd (alabu).
"An intelligent physician who has tried his prentice hand in surgery
(on such articles of experiment as gourds, etc.) or has learnt the art with
the help of things as stated above or has been instructed in the art of cauterisation
or blistering (application of alkali) by experimenting on things which are
most akin or similar to the parts or members of the human body they are usually
applied to, will never lose his presence of mind in his professional practice."
The extracts above, from the discourses of Kasiraja Divodasa Dhanvantari
as compiled by Susruta, are meant to highlight the insistence on rigid and
high standard of training expected of a student who has opted for surgery.
Thorwald's comments on the different kinds of surgical instruments, mentioned
by the Kasipati in his lectures on the subject, are significant. He observes:
"The vast variety of Indian surgical instruments
which have come down to us from the first millennium A.D. suggests that surgery
had developed to an extraordinary extent in early India. Many of these
instruments evidently come from times almost inconceivably remote. Their forms
testify to extreme practical good sense. That is apparent from a comparison
of the early Indian instruments (a) with Roman, (b) and modern (c) tools intended
for the same purposes. Whole epochs of world history lie between the Indian
and modern bone forceps in group 1, or the pincers, trocars, and cauteries
in 2, 3 and 4." "But the modern forms are already anticipated by
those of the ancient instruments. Twenty sharp and 101 blunt instruments are
described in the Susrutasamhita. In addition, special types of tables
are mentioned, to be used in 'major operations'."
The field of surgery covered by Kasiraja Divodasa Dhanvantari in his lectures
is extensive. It includes, among others, such details as purvakarma
(pre-operative measures), pradhanakarma (main operative techniques
and procedures) and pascatkarma (post-operative measures including
care); the employment of different kinds of sutures and needles; measures
for the prevention of sepsis (raksoghna); different kinds of bandages
and the art of bandaging; the use of alcoholic drinks for producing insensitiveness
to pain during and after operations; amputations; the setting up of dislocations
and fractures and the use of different kinds of splints.
Among the various surgical measures taught by the Kasipati which became world-famous,
mention has to be made of rhinoplasty or skin-grafting and lithotomy. The
former has since formed the basis for the development of plastic surgery in
modern times. Commenting on the Kasiraja's discourse on this subject, Thorwald
"Restoration of a mutilated nose by plastic surgery
might well have been a chapter-heading in the Susrutasamhita. The following
directions were given: 'When a man's nose has been cut off (as a punishment)
or destroyed (by disease), the physician takes the leaf of a plant which is
of the size of the destroyed parts. He places it on the patient's cheek and
cuts out of his cheek a piece of skin of the same size (but in such a manner
that the skin at one end remains attached to the cheek). Then he freshens
with his scalpel the edges of the stump of nose and wraps the piece of skin
from the cheek carefully all around it and sews it at the edges. Then he places
two thin pipes in the nostrils to facilitate breathing and to prevent the
sewn skin from collapsing. Thereafter he strews powder of span wood, licorice-root
and barberry on it with cotton. As soon as the skin has grown together with
the nose, he cuts through the connection with the cheek."
After referring to the practice of nose-repair in Europe in the latter half
of the sixteenth century and to the illustrated description of it furnished
by Gasparo Tagliacozzi, Professor of Surgery at Bologna, in his book De
Curtorum Chirugia per Insitonem as well as to the work of Bishop Ranzano
of Lucure, written earlier in 1492, in which this operation was described,
"There is scarcely any doubt that this method of operation,
which seemed to emerge out of nothing, out of obscurity of medieval medicine,
had its roots in early India. It was there that the basic idea of the attached
flap had been born. The point was that the flap remained connected to the
part of the body to which it belonged until it had grown into the site of
the transplant. Nowhere else in the whole world of antiquity do we find any
precedent for that conception."
Tracing the history of the development of rhinoplasty in modern medicine,
Thorwald proceeds to note:
"In 1814 a newspaper account from India promoted a
pioneer of modern plastic surgery, Joseph Constantine Carpue, to attempt Europe's
first restoration of a lost nose. Branca and Tagliacozzi had been forgotten,
but Carpue was greatly interested to read of a method for restoring noses
practised successfully by itinerant surgeons in the villages of colonial India
exactly as described in the Susrutasamhita thousands of years
before. Among other things, the nineteenth century newspaper story is testimony
to the vast spans of time over which medical practices should survive in India.
That is good reason for assuming that the oldest tangible evidence of Indians
medicine were based upon still older traditions."
As regards lithotomic operations, Kasiraja Divodasa Dhanvantari has given
a detailed description of it in connection with the surgical removal of stones
from the bladder and urethra by perineal incision.
Known as mutresmari (cystic calculus), this condition has been a common
complaint in India, as in other tropical countries, due to high evaporation
of body-fluids and the concentration of urine when not removed, the patient
is subjected to prolonged agony and dies of uraemia or the rupture of the
The development of the operation for the removal of cystic stones, known
as 'cutting for the stone' in Europe was for a long time traced to Rome and
Greece. The Hippocratic oath includes a promise by the physician that he should
leave the lithotomy operation 'to those who are experienced in it'. But for
this solitary reference, there does not appear to be any mention of the treatment
of the stone bladder in early European medicine. Celsus in the first century
A.D. is seen to have referred to the removal of the stone in the bladder 'with
However, lithotomy came to be known in Europe from the fourteenth century.
It is seen that "itinerant lithotomists went from country to country
practising the art". According to the medical historians of Europe, Giovanni
de Romanis and Marios Santos, of the late fifteenth and early sixteenth centuries,
were the founders of the 'modern art of lithotomy'. Now Thorwald has raised
the question as to "where these men learned the method and where the
method had been invented." He has himself sought to answer these questions
"Now that the texts of the "Susrutamamhita,
of at least two thousand years before the times of these Italians, were available,
it was found that they contained an exact description of bladder surgery.
The surgeon was to rub the second and third fingers of his left hand thoroughly
with fat, and make sure that his nails were clipped close. Then he introduced
these fingers into the patient's anus. He must thrust them vigorously, high
enough until he could feel the stone in the bladder, for it would probably
be pushed backward and down by pressure on the abdominal wall. Then he had
to press the stone down against the rectum, and with the knife wielded by
his right hand cut through the perineum towards the stone. A forceps was then
introduced through the incision, the stone grasped and drawn out."
He then proceeds to observe:
"Bold and incredible as this operation sounds, the
findings of medical history have left no doubt that it was performed in the
manner described and that it could have been performed successfully. From
the days of Atreya and his predecessors, a direct line leads through Greece
and Rome to the middle ages, and on still further to the surgeons of the nineteenth
century who, until the development of bloodless fragmentation of the stone
in the bladder and the discovery of antisepsis, took the same measures to
save sufferers from bladder stone. They too could point to quite a few cases
in which the operation succeeded, although they did not even stitch up the
wound, but waited for natural healing."
Thus Dwarkanath gives a brief discussion of the more important contributions
made by Ksiraja Divodasa Dhanvantari. The areas covered by him, otherwise,
have been vast and they embraced such fields as sarira (physiology
and anatomy), different aspects of dravyadi-vijnana (pharmacology
and material medica) and cikitsa (therapeutics, relating to internal
medicine). However, the more widely acknowledged contribution made by him
relates to sarira and salyasalakya-tantras. So much so,
some scholars, who belonged to a much later period, had described his pupil
Susruta who complied the teachings of the Kasiraja in his now well-known samhita
the Susrutasamhita as an authority on sarira:
sarire Susrutah proktah.
As an example of some very significant contribution, made by the Kasiraja
in the field of sarira (physiology, in particular) may be cited the
discovery of the haemopoietic or blood-forming principle or factor in the
yakrt (liver) known as the ranjakapitta and the role of both
liver and spleen in the formation of the blood.
The functions attributed by the Kasipati to this pitta are seen to
be nearly the same as those ascribed to the liver extract in modern times.
Chronologically speaking, it was Kasiraja Divodasa Dhanvantari who was not
only the first in the world of medicine to locate and describe the functions
of the principle or factor directly concerned with the formation of the blood,
but also to prescribe the raw liver of goats in the treatment of anaemia that
follows in the wake of certain forms of (idiopathic) haemorrhage, known in
Ayurveda, as the raktapitta.
He also suggested the administration of preparations containing goat's liver
in the treatment of naktandhya or night blindness.
It will be of interest to mention that Acarya Vagbhata, one of the trinities
of Ayurveda, who belonged to about the fifth century A.D., located and described
a similar principle or factor with identical functions, in the stomach.
There are also references in the early Ayurvedic literature to the use of
the stomach and intestines of animals in the treatment of anaemia due to the
loss of blood.
Dwarkanath says that the importance of these discoveries are highlighted
by the fact that, after an interval of more than two thousand years, Minot
and Murphy showed in 1926 that the liver was the most effective ingredient
in the treatment of anaemia, specially the pernicious type. Ricks and his
co-workers in 1948 and Smith, a few years later, described an amorphous red-principle
from proteolised liver and showed it to be effective in pernicious anaemia
in very small doses, around half a milligram. This substance has since been
shown to be the Vitamin B12. Likewise, Castle in 1920, showed the presence,
in the stomach tissue, of a factor (the Castle's Intrinsic Factor)
necessary in the formation of the haemopoietic principle. He showed that this
principle was effective in the treatment of pernicious anaemia.
The few examples of the discoveries made by Kasiraja Divodasa Dhanvantari
and his followers should be sufficient to emphasise the fact that his contribution,
both in the fundamental and applied aspects of the science and art of medicine,
made so far back in time, were perhaps revolutionary. Several thousand years
later, 'modern medicine' has been rediscovering many of the findings of the
Kasipati and other early pioneers of Ayurveda.
C. Dwarakanath. 1990. Dhanvantari. In Raghvan, V. (Ed.) Scientists: Cultural
Leaders of India. New Delhi: Ministry of Information and Broadcasting.
Bag, A.K. 1997. History of Technology in India. Delhi: Indian National
Academy of Science.
Mukhopadhyay, G. N. 1983. On the medical authorities. In History of Science
in India ( Ed. Debiprasad Chattopadyaya). New Delhi: Editorial Enterprises.
Sharma, P.V. 1992. History of Medicine in India. Delhi: Indian National
Academy of Science.
Commenting on Agrawal's article on Dhanvanatari, Paul Wilson says, I'm surprised
that Agrawal failed to mention the passages at the beginning
of Charak that deal with the origins of Ayur-Ved. Wilson quotes the following
In Charaksamhita, Charak says, With the idea of a remedy in view, the assembly
of sages went into meditation. (I:15-17)
The sages duly visualized (the categories) by force of their intuitive
He, the sage of great wisdom and dedication, grasped instantly the whole
science of span of life consisting of three branches (etiology, symptomatology,
and therapeutics) but of immeasurable extent; thereby the sage Bharadvaja
enjoyed an infinitely long and healthy life and conveyed all this to the
other sages. (I:25-26).