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Medicine in South India
             An investigation of the subject of ‘History of Medicine in South India’ provides a very interesting study and an earnest attempt is made in this regard through this work to bring out the history of medicine in South India with special reference to Tamil Nadu, supported by available sources of evidences – literary, archeological and inscriptional.
 
Contents
CHAPTER I - PRIMITIVE MEDICINE
CHAPTER II - MEDICINE IN THE WORLD – HISTORICAL DEVELOPMENT (Excluding South India)
      Section - I Progress of Medicine in the world other than India
      Section - 2 Indian Classical Medicine
      Section - 3 Renaissance Medicine
CHAPTER III - MEDICINE IN SOUTH INDIA (Excluding Tamil Nadu)
      Section - 1 Early development of Medicine in South India
      Section - 2 Hospitals in Ancient South India
      Section - 3 Physicians of Ancient South India
      Section - 4 Institutions and Medical Development
      Section - 5 Medical Education
CHAPTER IV - MEDICINE IN TAMIL NADU
      Section - 1 The Tamil Medicine ((Early Medicine)
      Section - 2 Nutrition and Health care
      Section - 3 Diseases
      Section - 4 Medicine
      Section - 5 Medical Treatment
      Section - 6 Surgery
      Section - 7 Hospitals in Ancient Tamil Nadu
      Section - 8 Medical Education in Ancient Tamil Nadu
      Section - 9 Status of Medical Men
      Section - 10 Temple and Medical Science

CHAPTER I
PRIMITIVE MEDICINE
             A study of the ‘Primitive Medicine’ deals with the diseases and healing methods followed by the undeveloped, simple and unsophisticated people of the pre-historic period having no recorded evidence. The aim of the first chapter is to bring out a rough sketch of the primitive stage of the medical knowledge of the uncivilized and uncultured people of the world in the very ancient period. The primitive people must have gained their basic knowledge of medicine through observations on behavior of the diseased animals and must have developed that knowledge little by little by the method of ‘trial and error’.

             The first part of this chapter deals with the concept of the primitive people of the western countries on disease, their belief on the supernatural powers in causing disease, the practice of trephination to drive away the spirit out of the body as a method of treatment and the practice of trephination by the Indian medical men on the basis of a medical concept.

             The views of Aletha Tavers, Kennedy, Marshall and Mackay on the Mohenjodaro massacre theory are discussed in relation to Harappan civilization.

             The principle of untouchability towards smallpox patients and their possessions, the practice of inoculation against smallpox by the Hindus, Persians and Chinese and the concept of reciting hymns and prayers for curing diseases as given in the Vedas are all expounded at the end of the first section of this chapter.

             The second part of the chapter deals with the primitive medicine in South India. The medical knowledge gained by the primitive people was kept as a guarded secret and passes on through generations after generations by oral tradition and is still retained by the present tribal people spreading through out South India. The resemblances found in the habits and practices followed by the present tribal sects and by the Sangam people lead to conclude that the medicinal knowledge of the present tribes must have been the reflection of the medical knowledge of the primitive people of South India. Hence the second part deals with the study of the habits, behavior and medical practices of the various tribal sects spread throughout South India, and attributing them to the primitive people of the region.

CHAPTER II
MEDICINE IN THE WORLD – HISTORICAL DEVELOPMENT
(Excluding South India)
             The second chapter deals with country – wise development of medicine in the world based on archeological and epigraphical sources and published works. The gradual improvement of the art of healing in different countries of the world, the role of magic and religion in the medical art, the notable medical scholars who served for the growth of medical science, the establishment of centres of healing and learning and the status of medical men of those days in different countries are discussed to bring out the development of medical science in the world.

             The first section brings out a note on the physicians of the Sumerian Empire (3000 B.C), Imhotep of Egypt (2980 B.C – 2900 B.C) and the Chinese Emperor Fu-Hsi (about 2900 B.C) who had been the originators of the ancient medicine. The superstitious belief of the Babylonians and the code of Hammurabi (2250 B.C) and the practice of ‘Temple Sleep' in Greece and Mesopotamia are hinted out to show the domination of magic and religion over medicine.

             The existence of a rational system in India before the dawn of Buddhism is attested by the evolution of the Ayurvedic system of medicine in India during the 8 th century B.C., the compilation of the medical samhitas of Agnivesa and Susruta and the existence of the Atreyan School of Physicians in kampilya, the Dhanwantari School of Surgeons in varanasi and the university of Taxila . The surgical talents of Susruta and Jivaka especially in cataract operation, lithotomy, leparotomy and craniotomy operations, the surgical instruments as described by susruta and the surgical tools excavated in various parts of India, the establishment of dispensaries during the periods of Maurya and Sunka-Kushana and the redaction of the two Ayurvedic Samhitas are discusses to exhibit the excellence of the ancient Indian medical men.

             The services rendered by Hippocrates (460 B.C – 370 B.C) to medicine, the establishment of the school of Alexandria with its great Library in 300 B.C, the development of Roman medicine and the surgical tools excavated in the Roman country are briefly dealt with. The set-back suffered by the Roman medicine following the burning down of the library at Alexandria in 391 A.D. and the disintegration of the Roman Empire during the 4th /5th centuries A.D. immersed the Western medicine into darkness leaving way to the development of the Arab medicine.

             The prevalence of country-wide hospital system, (320 A.D – 646 A.D), the functioning of the Nalanda University in offering medical education, Vagbhata's medical works the development of alchemy and iatra – chemistry are notable features of Gupta period.

             Following the entry of the Arabs into India during 711 A.D. the Arab medicine was much influenced by the Indian medicine and took a different form known as the ‘Unani Medicine', and more unani hakeems spread through India between the 8th and 9th c. A.D. It gained its popularity during the period of Allaudin khilji (1296 A.D – 1321 A.D). During the Mohammedan rule, more unani hospitals were established with Arab physicians.

             In the west, during the Renaissance period, eminent medical scholars like Leonardo do Vinci(1452 – 1519 A.D), Paracelsus (1490 – 1540A.D), Vesalius (1514 – 1564 A.D) and Ambrose Pare (1510 – 1590 A.D) emerged out and with the establishment of a number of universities with provision for medical education, the European medicine was revived into a modern form.

             The existence of hospitals and the conditions of medical education are discussed in the next section. Though a number of hospitals were established throughout the world, the excavations conducted in Sri Lanka gives a detailed information regarding the structure of the hospital at Mihintale (9th c A.D) and its functioning. The notable educational centres at Taxila, Alexandria, Salerno, Nalanda and Bologna and their mode of functioning exhibiting their distinctive features are discussed. For example, in Alexandria, human bodies were dissected for teaching purpose and in Bologna, the institution was ruled by its students guild.

             Medical practice was controlled by severe restrictions in certain countries. For example, in Babylonia , medical man's hands were cut off for defaulting treatment. The medical profession was pitiable in some countries. For example, the Hellenistic Physicians were sold to Roman Nobles as slave physicians; in Rome , medical men had to canvas the public to get patients. But in India , the medical profession had always been highly honoured.

CHAPTER III
MEDICINE IN SOUTH INDIA
(Excluding Tamil Nadu)
             For the study of the History of Medicine in South India, other than Tamil Nadu, inscriptional evidences are available only after the 10th century A.D. and hence the subject matter up to that period is brought out on the basis of archeological evidence and published works.

             Following the emergence of the Buddhists and Jains in about the 3 rd century B.C. the Ayurvedic system of medicine was introduced in these regions and Vagbhata's Ashtanga Hrdya became very popular among the medical practitioners. The establishment of monasteries and pallis and their functions as learning and healing centres besides religious activities are detailed out in the first section of this chapter. The establishments of Agraharas, Ghatikas, Brahmapurisb and Mathas in Andhra and Karnataka states and the Pyal Schools, Pallis, Village Schools and salais in Kerala are briefed out depicting their functions.

             The existence of eminent medical men like Nagarjuna and Aggalayya of Andhra Desa, Ugradityacharya of Karnataka and Pambummekkatty Nambudripad of Kerala and their medical skill are exposed in detail. The encouragement given to medical men in the form of grants and gifts by the kings and the honors bestowed upon talented physicians are also clearly mentioned on the basis of inscriptional evidences. The grant of land and oil mills by the Queen of King Jayasimha II of Karnataka in 1029 A.D. towards medical aid to students. The honor bestowed upon a medical officer with the title ‘Raja vaidya' and by placing him in charge of the Gutti Fort in 1121 A.D. by the chalukyas of Kalyana and the establishment of a choultry, a maternity home, a general hospital and a school in Andhra desa in 1261 A.D. are examples of encouragement rendered by the rulers towards medical development.

             The history of the Ashtavaidya families of the Nambudiri community in Kerala and the existence of the Parahita families of physicians of the Reddi Kingdom (14th – 15th c A.D) in Andhra desa and their medical services are explained in detail to show that the medical profession had been followed as a hereditary possession.

             The privilege enjoyed by the Ashtavaidyas of the Brahmanical class as being absorbed as kerala court physicians, the recognition of the physicians of other castes of lower status and the unsatisfactory payment of the native vaidyas have been pointed out to bring out the disparity shown between the physicians of different classes. Similarly, in Karnataka, only the kings, courtiers and the learned in society had the advantage of being treated by personal physicians while the common people had to depend on quack-physicians, hereditary and barbers.

             The specialities of kerala medical treatment such as ‘Visha-Chikitsa' (Treatment for poison), ‘Marma-Chikitsa' and ‘Uzhichil' (massage) and the distinctive feature of treatment for rheumatism are brought out exhibiting the growth of medical skill in kerala in a specialized direction.

             During the reign of Ala-ul-Din Ahamad II a large number of hospitals were established in Karnataka and both the Hindu and Muslim physicians were employed in those hospitals. With the decline of the Bahmani Kingdom the Adil shahi dynasty of Bijapur was founded by Yusuh Adil Shah in 1489 and the surgeons attached to the Bijapur court were referred to by Keswani as encyclopedic scholars of medical science who were skilled in plastic surgery also and they were the most famous surgeons during India's medieval period.

             In Andhra, the Agraharas were flourishing at the beginning of the 14 th century A.D., when the Telugu country was under the Hindu rule and their activities suffered a serious set back during the Muslim invasion.

             In Kerala, the Portuguese built the Santa Cruz hospital in cochin in 1506 A.D. for the welfare of the Portuguese fleet and thereby paved the way for the introduction of the European medicine throughout India.

CHAPTER IV
MEDICINE IN TAMIL NADU
             “Medicine in Tamil Nadu” is dealt with in a separate chapter to throw a broader outlook on the subject. The references that helped to bring out this subject are from Sangam literature for the Sangam period, and for the rest of the periods of the Pallavas, Cholas, Pandyas, Vijayanagara and the Nayak Rulers, Tamil Literatures and the inscriptions of those periods are the supporting sources, and some of the sculptural representations for the cholas and later times and a few painting evidences are also helpful to build-up the subject matter into thesis.

             The chapter is divided into 10 sections and in each section, one aspect of the main subject is dealt with from the Sangam to the Vijayanagara and Nayak periods with available references.

1. INTRODUCTION

             Introducing the ‘Siddha System of Medicine' as the ‘Tamil Medicine', the first section deals with an elaborate discussion on the identity and period of Agathiyar as the ‘Founder of the Siddha Medicine'.

2. FOOD AND FOOD HABITS

             The necessity of a balanced diet with good food habits for good health is discussed in the second section and the food items included in the diet-schedule of the Sangam people as revealed from the Sangam works are all brought out and analyzed for their nutritive contents and from the results so obtained inferences are drawn regarding the types of diseases that might have afflicted them.

3. DISEASE

             ‘Disease' is distinguished as ‘noy' (mental distress) and ‘Pini' (bodily sufferings). References of a number of diseases including some peculiar diseases such as ‘Yanait tee noy' (elephant hunger) and ‘Muyalagan' (epilepsy in unconscious state) are brought out and discussed. The abnormal behavior of a mad man (pittan) is illustrated as given in Manimekalai. The deformities such as blindness, deafness, dumbness etc. that are found today were common in the Sangam period also, and Purananuru points out eight such deformities as ‘eight misfortunes' (enperachcham) for mankind.

4. MEDICINE

             The section ‘Disease' is followed by ‘Medicine'. The similar concepts of Tiruvalluvar and Susruta in defining ‘medicine' as having four component factors – the patient, physician, drug and nurse – are discussed in detail. During the Pallava period, taxes were levied on the cultivation and sale of certain herbs like ‘kuvalai' (blue nelumbo) and ‘chenkodi' (plumbago rosco). The life-saving herbs mentioned in Silappadikaram and Kambaramayanam and their strange properties are described in detail. The medicines stored-up in the hospital at tirumukkudal in the 11 th century A.D. are analyzed and the diseases that could be cured by those medicines are tabulated to exhibit the medical knowledge of the physicians of the chola period.

5. MEDICAL TREATMENT

             The characteristics of a good physician are brought out based on literary references. The profound knowledge of the ancient Tamil poets on gynaecology, embryology, and obstetrics is evidenced from Tamil literary works. The skill of a barber lady of Kongunadu in midwifery is projected by her successful performance of the delivery of a king's daughter by means of caesarian operation in the 9 th century A.D.

             The sculptural evidence found in the Dharasuram temple indicates that the process of parturition in Tamil Nadu during the 12 th century A.D. had been performed in the standing position of the pregnant lady.

6. SURGERY

             Literary sources reveal that the ancient Tamil surgeons were proficient in some surgical activities like cauterization, stitching and bandaging of wounds. The application of a specially prepared ghee on the wounds for easy cure, the use of magnet to remove the intruded weapon particles from the wounds and the uses of some medicated oil to preserve the dead bodies project the medical knowledge of the medical men of those days.

7. HOSPITALS

             The existence of healing centre (chakkaravala kottam) and a public resting house (aravi) is found from ‘Manimekalai'. The healing service rendered by the Jains in their monasteries laid the basis for the hospital system in Tamil Nadu. Several inscriptions reveal the establishment of hospitals during the medieval period; for example, the hospitals at Tirumukkudal, Tiruppugalur, Tanjavur and Srirangam. The Tirumukkudal inscription (dt 1069 A.D) and the Srirangam inscription (dt 1257 A.D and 1439 A.D) give detailed reports regarding the functioning of the hospitals at these places and the remunerations paid to the hospitals staff in terms of paddy and kasu, have been converted into the present rupee value and tabulated to bring out a clear understanding of the status of the physicians of those days.

8. MEDICAL EDUCATION

             The attitude of the ancient people towards education and the educational systems followed are discussed. In the medieval period, temples became the centres of learning and healing. Inscriptional source attest the teaching of Charaka Samhita and Ashtangahrdya in the school attached with temple of Tiruvaduturai.

9. MEDICAL MEN

             Library and inscriptional evidences reveal that the medical men of Tamil Nadu had been duly honored and respected right from the Sangam age. Maruttuvan Dhamodaranar was honored by being absorbed as a member of the third Tamil Sangam. Inscriptions show that medical men of outstanding merits were bestowed upon with honorary titles such as ‘Sigamani', ‘Vaidya Sigamani', ‘Vaidya Purantaran' etc. Eminent medical scholars like kalakkudi Vaidyan were appointed as ministers in king's courts. Grants and gifts of land were paid to promote medical science and for the welfare of the medical men in the form of Vaidya Virutti, Salliya Virutti, Visha Virutti etc. during the chola and pandya periods. Jatavarman Sundara Pandya deva granted shares of land to a vaidyan, barber and midwife during the 13 th century.

10. TEMPLE AND MEDICINE

             The effect of temple worship in the matter of healing is discussed in the last section. The structures of the Garpagraham, the various metals and herbs used in the installation of the idol, the medicinal values of the abhisheha waters are all discussed. The medical significance of the performance of velvi (agnihotra) is brought out by pointing out the lives saved by doing agnihotra at the time of the recent Bhopal disaster. The practice of performing velvi in the sangam age, the existence of pyramid in Tindivanam as revealed from excavations and the healing property of pyramids are also discussed.

             The practice of ‘Alaku Kuttutal' is discussed in relation to the Chinese acupuncture. The faith in making offerings and prayers to god is discussed on inscriptional basis. For instance, the inscription of the chola king Rajaraja III dt 1237 A.D. informs that the Assembly of Chaturvedimangalam had made offerings to the Shrine at Tirukkamakottam for the health of the king. Such faiths, though found to be non-sensible, may be taken as ‘agents of refereshing the nervous systems' which helps the process of healing in the body.
 
 
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