The physician (vaidya)

The editor reports the author's explanation of the word vaidya (chapter 1, verse 18): vidyā is omniscience (kevalajñāna), which reveals the characteristics of the soul (jīva) and all other things; because this work arose from that vidyā it is called vaidya, and the scholars who study and reflect on it are also called vaidyas. The editor calls this a beautiful meaning that no one could dispute.

Note: The verse reference (अ.1, शलो. 18) is printed at the top of p.26.

The verse says grammarians call the noble science arising from vidyā (here the eye of omniscience) 'vaidya', and that those who study it with reflection are also called vaidyas.

The physician is described as one who knows the meaning of the medical texts, is intelligent, versed in the views of other teachers, skilled in treatment suited to the disease and in combining medicines, steady, religious, of good conduct and taught by many teachers; such a physician is said to be respected even by learned great men.

The verse ends by calling a physician who is devoted to dharma, of good conduct and purified by study under many teachers fit to be honoured by the wise and the great.

One who knows well the whole course of the doshas, which cause suffering to all beings, through accumulation, aggravation, the fifteen kinds of spread, lodging, manifestation and differentiation, is called the best physician (uttama bhiṣak).

A fit physician is described as truthful, steady, forgiving and light-handed, accomplished and himself healthy, one who has seen great treatments and has learned the meaning of the whole Ayurvedic science from a teacher's mouth, and free of carelessness; only one adorned with these qualities is called a proper physician.

Having studied the science of Ayurveda through a teacher's instruction, one should see and experience the whole of treatment along with the compounding of medicines; only one who knows the texts and has experience of treatment is a fit physician, and one who knows only the texts or only the practice cannot be.

A physician who is expert in both practice and theory, intelligent, and has knowledge of all medicinal preparations, the science of instruments, surgical instruments and the texts is said to be fit, with the king's permission, to treat all the people.

Only one who treats by the strength of knowledge, freeing people from disease, is called a vaidya; those who do other work by learning are not.

It says physicians are of two kinds: the śāstra-vaidya, who has only studied the medical texts, and the kriyā-vaidya, who is skilled only in practice; mastery of both marks the best physician, for just as a man with one leg tied cannot walk, a physician skilled in only one cannot treat properly. Ignorant physicians sometimes succeed by chance, like a blind man catching a quail, but they cannot tell how to use a medicine, which preparation suits which disease, what caused it or what relieved it, and through them patients sometimes die before their time. Quoting chapter 7, verse 49, it says an ignorant physician who treats out of greed or delusion kills his patients and should be restrained by kings, and that even a nectar-like medicine in ignorant hands is like poison or a weapon; so the physician should study the texts under a teacher and gain experience beside great physicians before treating on his own.

Note: The printed sentence also calls the physician who has only studied the texts क्रियावैद्य; from the context it is the शास्त्र वैद्य.

Of the four components of treatment, the wise physician is called the chief, because without him the others are useless.

The physician should never treat out of desire or delusion, greed for money, attachment to friends, anger at enemies, regard for kin or other mental impulses, nor for the sake of honour or his own fame; a learned physician treats only out of compassion for the sick, for the sake of the next world and for the destruction of karma.

The physician should treat the patient as his own son, as a father lovingly protects his son, since the patient has placed his trust in him and deserves compassion; a good physician should always, in every way and without carelessness, protect the patient for the sake of dharma.

At the very start of medical science, the translation says, the root-text authors, great sages who could tell the fit from the unfit, laid down that this treatment is to be given only to the fit: brahmins, holy men and friends who are like relatives are to be treated with one's own medicines as one's own kin, which is praiseworthy, while Bhils, hunters, the fallen and other doers of sinful deeds are not to be helped, that is not treated, because they use the help for sinful deeds; thus this science prospers and friends, fame, dharma, artha and kama are gained.

According to the editor, the author (chapter 1, verse 21) says that one who belongs to one of the three higher classes, brāhmaṇa, kṣatriya or vaiśya, is of blameless conduct, skilful, naturally humble and intelligent, and who with a keen desire to study medicine approaches the teacher in the morning and asks, is entitled to study this science.

The editor says the author directs the teacher to learn the student's caste, family and qualities and examine him thoroughly, then give him several vows in the presence of the Lord Arhat, and only then begin his studies; he adds that this shows how students were trained in ancient times and why they became scholars of high rank.

The editor says the author teaches, in chapter 7, that the physician should treat without self-interest: treatment destroys sins, increases dharma and gives happiness in this world and the next, and there is no austerity greater than treatment. Treatment should therefore not be undertaken out of desire, delusion or greed, nor from affection for a friend or anger at an enemy, nor from kinship or for the sake of honour; the physician should keep his mind free of all such disturbance and treat out of compassion for the sick and for the wearing away of his own karma. Treatment given thus is never in vain and brings success, as a farmer's diligent farming bears fruit.

The editor reports the author's description of the physician (chapter 7, verse 38): truthful, steady, forgiving, deft of hand, able to prepare medicines himself, one who has seen great treatments carried out, who knows the meaning of all the śāstras and is never careless. He should treat patients as his own sons; and, as chapter 1 says, a physician who knows the text, is intelligent, has studied the views of other Ayurvedic authors, is skilled in major procedures and has gained experience from many teachers is respected even by the learned.

A person born in a kṣatriya, brāhmaṇa or vaiśya family who is intelligent, of pure conduct, skilled and humble is said to be entitled to study this science, approaching the teacher in the morning to ask for instruction.

The teacher is told to examine the disciple's qualities, nature and family first and, if he is fit, to have him take the vows of non-violence, truth, non-stealing and the rest before the Jina, and only then to teach him this science, and not others.

The outer means of learning are named as the teacher, books and similar aids, fellow students, lodging and food; the inner means as health, intelligence, humility, effort and love of learning.

Treatment done with these aims is said to bring the physician every reward by itself, wealth and fame without his asking, just as well-done farming yields its harvest through effort and fortune; treatment done with a pure heart gives every happiness in this world and the next.

From treatment the physician is said to gain sometimes merit (dharma), sometimes wealth, sometimes happiness, sometimes friendship, sometimes fame and sometimes greater practice in treatment.

There is no land without people, no person who does not eat and no one who eats who stays free of disease; therefore, the text says, a learned physician always gains wealth.

A virtuous physician practised in the principles of the scriptures, with the help of the other chief limbs (medicine, attendant and patient), is said to bring quick relief even to a gravely ill patient, as a teacher benefits his disciples through right faith, knowledge and conduct.

The patient is said to view mother, father, sons, friends, relatives, wife and all others with suspicion in the matter of medicine, but to trust the physician who wishes his good in every way.

Even if a physician who knows only the texts and one who knows only the practice come together, the two are said to be unable to treat, just as two one-legged Devadattas tied together cannot walk.

Even when an ignorant physician's treatment succeeds, it is said not to be praised by the learned, just as letters that happen to be carved by a wood-boring insect or an ignorant person are not read by scholars as writing, nor taken as a means of knowledge.

A physician who out of ignorance cuts open an unripe swelling (boil) thinking it fully ripe, or neglects a fully ripe one thinking it unripe, is called ignorant and a great sinner; a wise patient should leave such physicians and not be treated by them. Only he who knows the unripe, burning and ripe stages of swelling well is the master, the best among physicians.

The physician who undertakes the binding of mercury is to know its texts and to have chief attendants, all the needed equipment, wealth and devotion to the guru, always worshipping the Jina.

In a badly garbled passage the physician is described as of good mind and auspicious conduct, a friend to living beings, devoted to truth and dharma, joyful and compassionate, forbearing, wise and learned, treating according to the particular person; the text then quotes the four attitudes: kindness to all beings, gladness towards those who keep vows, compassion for the suffering and indifference towards the cruel and the deceitful.

At the very start of medical science, the text says, the earlier great sages who wrote the root texts and could tell the fit from the unfit laid down that brahmins, holy men, relatives and those who come for help are to be treated with one's own medicines like one's own kin, which is good and through which knowledge shines and friends, fame, wealth, dharma and kama follow, while hunters, bird-catchers, outcastes and sinners are not to be treated.

Holy men are to be treated with pure, fresh, nourishing and fragrant medicines of many tastes, potencies and vipakas, well freed of life (prasuka), such as perfumers describe in their shops and that come from distant islands; when these cannot be had, a holy man should choose sinless medicines with care, by the distinctions of cut or split, whole, living or lifeless, and single- or common-bodied plants, and himself treat holy men, as the Kalpa-vyavahara also says.

The physician of holy men should himself be a holy man; failing one, a Jain layman (shravaka); failing that, even one of wrong faith; and failing that, even a wicked physician of wrong faith, won over with honour, gifts, great trust, mantras, medicines and knowledge, is to be engaged to treat the holy men, who must be protected in every way and whose comfort alone is to be thought of, for the destruction of karma.

Charaka is quoted from his chapter on disease and physician: one who wants success in his work and wealth, fame and heaven after death should seek the welfare of all living beings in every way, beginning with cows and brahmins.

The physician's dharma is said to be to have a gentle mind, act for the good of others, behave as a brother to all and help living beings, and, wishing the welfare of all, to be devoted to truth and dharma and endowed with friendliness, joy, compassion, equanimity, forbearance, insight, knowledge and learning, treating according to scripture with regard to the particular person; for the scripture says the dharma of good people is kindness to all beings, contentment towards those who keep vows, compassion for the poor and suffering and indifference or neutrality towards the wicked.

To show the opponents' self-contradiction, the translation quotes their own saying that a physician should first eat meat himself and then explain its qualities and faults to others, and that before stating the qualities and faults of grains, meat, fruits, tubers, vegetables and the like the physician should taste them himself; it uses these sayings to reject the claim that the meat sections were not meant for eating meat.

In the section on the treatment of holy men, the translation says, holy men are to be treated with medicines such as the special fragrant substances sold in perfumers' shops, produced in various distant islands, chiefly of many kinds of taste, potency and vipaka, well freed of life (suprasuka), well formed, tasty, fragrant, with all qualities, fresh, clean and nourishing (santarpana); if such medicines are not found, all suitable medicines grown in कृष्ण regions, turned up with the ploughshare and not too dry, are to be collected in every season as they can be had; and if even these are not had, holy men are to treat holy men with pure, life-free (prasuka) medicines whose living state has been removed, chosen after considering the body divisions, such as single-bodied (pratyeka) and common-bodied (sadharana), according to karma, as the Kalpa-vyavahara says.

Only holy men devoted to yoga, the translation says, can properly treat holy men with life-free, pure substances; if a physician who is a holy man is not found, a lay follower (shravaka) is to treat them, and if he too is not found, a physician of wrong faith (mithyadrishti) is to be satisfied with honour, gifts, great respect, mantras, medicines, knowledge and the like and made to treat them, for holy men are to be protected in every way and their comfort, that is the removal of their diseases, always cared for, since they are intent on destroying karma.

Charaka too is cited from his chapter on disease and physician: a man who, being a physician, looks for success in treatment (karmasiddhi), gain of wealth (arthasiddhi), fame in this world and heaven in the next should strive to follow his teacher's instruction, keep in mind that the health of all beings, beginning with cows and brahmins, rests on the physician alone, and always give them assurance of health.

Deluded physicians of wrong faith, lacking the knowledge of which substance belongs to the class to be eaten and which to the class of eaters at the time of eating, are said to have become eaters of everything, edible and inedible.

Even when this is explained at length by reasoning and scriptural proof, present-day physicians, intoxicated with the pride of ill-learning grasped from a wicked viewpoint, are said not to be ready to accept it, which the translation finds no wonder: a quoted saying holds that a fool who understands nothing is not hard to correct and a learned, intelligent man is still easy to persuade, but not even Brahma can make a proud pandit understand who has gained a little knowledge and is very conceited, let alone ordinary people.