History of sickness and medical art 23: India 3

＜　1.  Caraka was a famous ancient doctor　＞

I look at the activity of doctors and the medical groups.

医者や医学派の活躍を見ます。

＜　2.  Two red points show Taxila and Varanasi ＞

Appearance of the doctor

Ayurveda includes two major medical books of Caraka samhita and Susruta samhita.

This title originates in each doctor's name.

Caraka was a court physician of Kanishka King of the 2nd century B.C.

Susruta was a surgeon of several centuries B.C.

These medical books came into existence after the 3rd century A.D., but the schools of medical thought that brought about those had been born around the 6th century B.C.

The school of medical thought of Caraca was active in Taxila of Pakistan(Gandhara),　and it of Susruta was active in Varanasi(a holy place of Hinduism and Buddhism).

The former adopted the medical treatment and the latter had also adopted surgery treatment.

医者の出現

アーユル・ベーダに二大医書のチャラカ・サンヒターとスシュルタ・サンヒターがある。

この書名は医者の名に由来し、チャラカは2世紀のカニシカ王の侍医、スシュルタは紀元数世紀の外科医です。

これら医学書が成立したのは紀元後３世紀以降ですが、それらを生みだした医学派は紀元前６世紀頃から存在しており、その知見が集成されたものです。

チャラカの学派はパキスタンのタキシラ（ガンダーラ）、スシュルタの学派は東インドのベナレス（ヒンドゥー教・仏教の聖地）を中心に活躍した。

前者は内科療法、後者は多くの外科療法も採用していた。

＜　3. Orthopedic surgery of a nose   ＞

A world's first orthopedic surgical operation was in ancient India.

It is orthopedic surgery of ear and nose, which was explained in detail by Susruta samhita.

In the upper class of Hindu society, they had a custom of making a hole in their earlobe and also outspreading it.

Moreover, as there was punishment that sliced off a nose, the recovery surgery was required.

The epoch-making method of this surgery was slicing off a skin of patient's jaw or the forehead, and transplanting to the patient's affected part.

Probably, it was carried out in several centuries B.C.

This operation becomes about 1500 years earlier than Europe.

The Indian orthopedic surgery and surgical instrument advanced very much.

However, the anatomy seems to have not advanced, because the dissection was prohibited by Manusmriti (Indian ancient social norm).

古代インドに世界初の外科手術がある。

それはスシュルタに詳述されている耳と鼻の整形手術です。

ヒンドゥー社会の上流階層では耳たぶに穴を開け、伸ばす習慣があった。

また鼻を削ぐ刑罰があったので、それらの回復手術が必要であった。

この手術の画期的な所は、患者の顎や額の皮膚を削ぎ取り、患部に移植することでした。

おそらく紀元前数世紀には行われていたのだろう。

これはヨーロッパより１５００年近く早い手術になる。

インドの整形手術と手術器具は非常に進んでいた。

しかしマヌ法典（インドの古代法典）により解剖が禁止されていたので、解剖学は進んでいなかったようです。

＜　4.  marma　＞

In India, there also is marma of body points resembling acupuncture points of China.

However, marma was not connected directly with organ and nerve, and the moxibustion or acupuncture was not provided.

インドにも中国の「つぼ」に似た体表面の点「マルマ」がある。

しかしマルマは臓器や神経と直結せず、お灸や針治療などは行われなかった。

The status of doctor

Early time, the doctors were only Brahman, later were able to be even from the low-ranking hierarchy.

If even a low hierarchy person became doctor, he was ranked the high rank, and tax was exempted from him.

The doctor at Imperial Court had achieved successful career, and he was able to become the important person of the country like Caraka.

The criminal punishments with unsuitable medical treatment by the doctor have been written in Manusmriti.

The cost of treatment was no charge for Brahman and poor, and others were charged according to the economic conditions.

Those who want to become doctor became pupil of teacher, recited Ayurveda, learned the treatment of medicinal herb, received training of the action method, etc.

The pupil had been recognized by the teacher, subsequently had the authorization of king, and became the full-fledged doctor.

医者の立場

初期の医者はバラモンであったが、後に下位の階層からでもなれるようになった。

低い階層出身者でも医者となれば、高位にランクされ、税金を免除されもした。

宮廷医師は出生街道を登りつめ、チャラカのように国の重要人物になり得た。

マヌ法典には、医師が不適切な治療による罰則が書かれている。

治療費はバラモン、貧困者などで無料であり、他は経済状態に応じて請求された。

医師になりたい者は教師に弟子入りし、アーユル・ベーダを暗唱し、薬草の扱い、処置法の訓練など受けた。

教師に認められた弟子は、次いで国王の認可をいただき、一人前の医者となった。