History India South Asia · History of Medicine · Recommended movies, books etc. · Uncategorized

Notes on the history of Ayurveda – 3: Ideas of infection and contagion in the past

[In this series I attempt to inform readers of the wonderful scholarship that exists on the history of Ayurveda, which is one among several of the premodern medical traditions of South Asia. See here and here for the previous articles.]

The book ‘Contagion: Perspectives from Pre-modern Societies‘ (2000) is a great introduction to how people in the past thought about diseases which spread from one person to another, or rapidly within a community. It is difficult indeed to get into the shoes of people from around the turn of the millennium and imagine a world where the concept of germs in the air, water and surfaces was, unlike for us today, not a given. Historians have done a great job of detailing such past societies, and here we will take the help of two such scholars who have worked extensively on the history of pre-modern South Asia: Rahul Peter Das and Kenneth Zysk.

The editors of the book, Lawrence I Conrad and Dominik Wujastyk, provide a helpful overview in their introduction:

That certain diseases are readily transmitted from an ill person to a healthy one is something that one might expect that all pre-modern societies would have noticed and explained in some way. As several papers in this volume show, the phenomenon of contagion was recognised by society at large, and was especially clear to pastoralists and those charged with the care of animals who did not need great epidemics to observe the spread of disease among their herds.. Both Chinese and Indian doctors posed the question of why many people should all fall prey to a single disease at a single time and place.

In the previous post we looked at the chapter written by Rahul Peter Das in this book. Here we will look at Kenneth Zysk’s chapter (Zysk currently is affiliated with the University of Copenhagen).

With respect to how disease was understood in the Vedic period (1200 BCE to 800 BCE), Zysk and Das come to similar conclusions. ‘Magico-religious’ explanations were the dominant ones:

Except for physical injuries such as broken bones or wounds, diseases were ordinarily considered to have been the result of demonic forces. Indeed, a disease was synonymous with a demon in Vedic India… In the minds of the Vedic Indian, disease was either sent by the gods or transmitted by humans via witchcraft or magic.

Zysk provides some excellent examples of this kind of thinking:

Ascites or dropsy, known in the Vedic literature as Varuna’s seizure (varunagrhita), is the disease thought to be sent by a rul­ing god because of a transgression against the cosmic and moral order (rta). Clear reference to the disease first occurs in the Sunahsepa legend of the Aitareya Brahmana, where Varuna seized the descendant of Iksvaku and his belly swelled up; then with the recitation of the auspicious verses, the bounds around his belly were loosened, his stomach began to shrink, and with the loosing of the last bound, he was released from the seizing-disease.

While such explanations remained dominant for several centuries, there occurred major changes in the South Asian concepts of disease around the turn of the millennium with the rise of organized medicine in Buddhist monasteries and its later metamorphosis into what is known as classical Ayurveda (see here for detailed overview of the origins of Ayurveda). The Charakasamhita and the Sushrutasamhita are the best known treatises of classical Ayurveda. In these we see more empirical and ‘rational’ ways of thinking about disease, though the previous Vedic-era magico-religious ontology does not go away completely. Zysk mentions that

Caraka devotes an entire chapter to epidemics (janapadoddhvamsaniya). He discusses the four (environmental) causes of epidemics: wind (vata), water (jala) land or place (desa), and time or seasons (kala)… In the classical phase of Indian medicine there emerged, in part at least from em­pirical observation, an understanding of a relationship between human beings and their environment. In this connection, certain environmental factors ac­ted upon individual or people, causing diseases and epidemics… Moreover, some maladies were known to be transferable from individual to individual by physical contact, providing the basis for an Indian theory of disease transmis­sion by touch. This early Indian idea of “contagion”, however, seems to have played an insignificant role in the overall systems of Indian nosology. Finally, as a carryover from the earlier Vedic medical tradition, different supernatural powers acted as causes of disease.

In summary, the classical Ayurvedic treatises contain several references to what can be called an understanding of contagion: it was well-recognized that several diseases spread from one person to another, or arose together in many persons in quick succession. Why and how this happened, was explained by the existing frameworks of disease causation: supernatural and environmental influences. This blend of supernatural-environmental explanation of disease, and especially epidemics, lasted and dominated for almost two millennia, until the early 1900s when the germ theory of disease became the dominant explanation in India (beginning with English-educated urban-based communities). One of the best documented examples of the continuation of supernatural explanations is the attribution of smallpox in many parts of India, well into the twentieth century, to the goddess Sitala.

In the next installment of this series we will look at the contents of the Ayurvedic classical texts in more detail.

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