• Dr. Raju

Musings on Medicine,Myth, and History- Introduction

What do you think of when you think of India?

Do you think of India, the second most populated country in the world?

Do you think of India, the home of an ancient and rich culture— and tasty cuisine?

Or do you think of India, the country struggling to feed its vast population?

Do you think of India, where the concept of zero was first used in calculations as early as the third century BC? Of India, where astronomers had already developed a sophisticated calendar that included a lunar leap month as early as 1200 BC?

Or do you think of India during the raj, the period of British colonial rule that has been romanticized in movies like Shirley Temple’s Wee Willy Winkie or poems like Rudyard Kipling’s “Gunga Din”?

Do you think of such amazing structures as the Taj Mahal or perhaps the Temple of Love at Khajuraho? Or do you think of India, the country where rich and poor live incredibly different lives?

When I think of India, I think of my birthplace—and of the birthplace of so many major medical developments. I think of a country that once flourished—a country whose ancient civilizations were amazingly sophisticated . . . a country from which other ancient civilizations borrowed ideas . . . and above all, a country that offered me a stellar medical education almost for free. I think of my home country often, and I keep returning there. And I believe that the history of India is linked inextricably to the history of the world at large, and that the country’s ancient contributions to medicine are in fact much more relevant to modern medicine than most people in the Western world realize. I believe that India should figure prominently in conversations about the present state of medicine and the field of medicine—and about their future.

Much of the practice of medicine—including cataract surgery and the treatments of diseases of the eye, such as trichiasis (ingrown eyelashes) and pterygium (a small growth on the front of the eye)—was first described in India some three thousand years ago. This work, revolutionary in its day, laid the groundwork for current practice in ophthalmology today. Modern scholars believe that the Ancient Indians and the Ancient Greeks might have freely borrowed from, and built upon, the others’ ideas. And many Greek works—including, one must imagine, medical works built upon Indian theories—were translated into Arabic between the eighth and tenth centuries AD. Thus, Indian contributions to medicine might have traveled much farther than most people realize.

Just as the ancient civilizations were connected, so, too, is health care in India connected with health care in the Western world today. An ailing American woman, for example, may travel to India to receive a holistic treatment not available in the United States or to take part in the growing area of medical tourism and receive a hip replacement at a lesser cost than in the United States. On the other side of the coin, an Indian man may spend his career developing and creating medical technologies that are imported to the United States. A team of American doctors may visit India to perform cataract surgeries on the people in rural towns, people who otherwise have limited access to such care. In doing so, they may enable children who otherwise would have lost their vision to receive an education, and perhaps to become doctors themselves.

Just as prospective physicians from India may seek their education in the West before returning home to practice, others who have graduated from Indian medical schools may seek further training or even permanent positions in nations throughout the world. A 20051 article in the New England Journal of Medicine reported that 60,000 Indian physicians were practicing elsewhere, making them the world’s largest emigré physician workforce.2 The same report placed physicians of Indian heritage among the most numerous foreign-trained doctors in the English-speaking West. They lead all other nations in the United States and the United Kingdom, comprising 4.9% and 10.9% of physicians, respectively. And they were among the top three categories in both Canada and Australia. These are just a few examples in which India and the West may both influence the practice of medicine, each in its own way.

The influences are, of course, not restricted to just medicine. Consider the political tactic known as passive resistance, taught and practiced by Mahatma Gandhi—even in the face of violent reprisals by the British colonial government—during the campaign for Indian independence. He drew his inspiration from Henry David Thoreau, the American author of Walden. In turn, Gandhi would influence Martin Luther King, Jr., whose followers endured beatings, police dogs, and water cannons during the turbulent civil rights struggle in the United States. So it is true that our respective countries are not as isolated as we may appear to be on a map.

That idea of interconnectedness—between the past and present, and between the peoples of different nations and cultures—is at the core of this book. Readers will discover how the development of medicine in India influenced both ancient and modern medicine, and how India’s healthcare system strives to improve access to quality health care for its many people.

Hinduism teaches that time is cyclical—that life does not start or finish, but instead only continues to happen. Each ending is also a beginning. One’s circumstances and choices in each past life determine the circumstances of the life to follow. Thus one’s present life reflects choices made in countless previous lives—and will also determine circumstances in the next life in the chain. Thus, life proceeds in a non-linear, eternally circular fashion.

An example of this concept can be found in the Kalachakra, or the “wheel of time” that operates throughout all of existence from the smallest scales (the rhythm of human lives) to the motions of planets and stars. Kalachakra “teaches the practice of working with the most subtle energies within one’s body on the path to enlightenment.”

This is a very different concept for believers in the Judeo-Christian tradition, who accept the notion of a “beginning” but who suppose that life proceeds in a linear fashion to its inevitable end. It also contrasts with the notion of the “timeline,” familiar to readers of Western history, on which events in the lives of people, of nations, and so forth are plotted as points on a straight line that moves inexorably from “past” through “present” to “future.” The linear nature of the timeline suggests that events widely spaced in time have little influence on one another. But in the Hindu view, past events exert an influence “forever,” as we progress from incarnation to incarnation.

As a nod to the Hindu concept of the “wheel of time”—which is at the core of my religion—I have written this book such that its essays may be read in any order, and again and again. I have written this book, too, for people from all walks of life. To read it, you need not be an ophthalmologist, a historian, or a student of world religions—it is not necessary, even, to know anything at all about India. The only requirements for reading this book are an open mind and a desire to learn.

Part One provides a brief introduction to Hinduism and to Ayurveda, the spiritual foundation of much of Indian medicine.

In Part Two, readers will learn of Susruta, sometimes called the Father of Surgery, who was successfully treating disorders of the eye some three thousand years ago. Part Three begins with the accidental discovery of the “Bower Manuscript,” a long lost example of Ancient Indian medical writing, then discusses how medical practice in India might have influenced Greek and Arabic cultures over two thousand years ago. It concludes on a humorous note, showing how physicians have not always been respected over the centuries. We move to the present day in Part Four, where the state of Indian medicine through the end of the British colonial period is discussed. We then turn to Ayurveda and its place in medical practice—both in India and worldwide—and an examination of the effects of globalization on Indians and their medical care. In concluding, we examine the effects of many decades of British rule over India, of British exploitation of Indian labor and resources, and its repression of Indian political aspirations. We look at the debate over whether the United Kingdom owes reparations to the Indian people for the still-lingering effects of British domination.

With these short essays, my heartfelt attempt is to bring to you a new perspective toward India, the world’s largest democracy and also a nation aspiring to achieve a modern, healthy, and productive life for all of its citizens. May it inspire you to look at India in a new and respectful light.

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