Jivaka Kaumara-Bhrtya

The story is some 2500 years old. The place is Taksasila (Taxila, now in Pakistan, about 35 kms north-west of Rawalpindi), a famous centre of learning at that time. A young boy of sixteen had come from far away Rajagha (capital of Magadha) to study medicine there from a 'world-renowned physician'. He spent full seven years to complete his education. But before declaring that his training was complete, his teacher prescribed for him a practical examination, and said to him : "Take this spade and seek round about Taksasila a yojana (approximately 14 kms) on every side and bring to me any plant which did not possess medicinal properties."The student examined the plants of the entire region specified by his teacher, but could not discover a single one which was devoid of curative properties and useless to living beings. He reported this finding to his teacher. Satisfied with the answer of the pupil, the teacher said to him : "You have done your learning well. Now go home and start practice." The teacher also gave him some money for his travelling expenses.

So Jivaka also came to be called Komarabhaccha (Kaumarabhrtya), meaning the one brought up by the prince. This word also indicated  Kaumarabhtya (paediatrics), one of the eight branches of syurveda. Later Jivaka learnt of his antecedents and without telling prince Abhaya left for Taksasila to study medicine from a famous scholar-physician whose name in some Buddhist texts is given as streya.

Mahavagga, a Buddhist text, attributes many miraculous cures to Jivaka. When Jivaka was given permission by his teacher to return to Rajagha, his teacher also gave him some money to meet the expenses for the journey. This money lasted him up to Saketa (near Faizabad, U.P.), and there he was forced to halt and earn money by his practice.

At that time, in the city of Saketa, a rich merchant's wife had been suffering for seven years from a chronic disease of the head which many great and renowned physicians could not cure, though they received much gold as their fees. Being young and inexperienced, Jivaka was given permission to examine her with reluctance and on the condition that no fees would be paid to him if the patient was not cured. Jivaka began the treatment. He took a handful of clarified butter (ghee), mixed it with various drugs, boiled it and administered the medicine to the patient through her nose while she was lying on her back in the bed. Ghee given by the nose came out through the mouth. The patient was completely cured by this one dose. For this Jivaka received 16,000
kahapanas (silver coins), two servants and a horse-coach. After reaching Rajagha, Jivaka presented his first earnings to his patron, prince Abhaya. The prince, however, refused the offer and asked Jivaka to establish himself within the palace area.

Stone Structure in the excaveted Jivakamravana, Rajagrha

At that time king Bimbisara was suffering from an anal fistula. His queens, when they noticed blood on his garments, ridiculed him. The king, desperate to get cured, asked prince Abhaya to search a competent physician. Abhaya suggested Jivaka's name, and the king agreed. Taking prince Abhaya's orders, Jivaka took some medicament in his nail, and with just one application of that he cured king Bimbisara. The king gave him as reward a large amount of ornaments and appointed him as the Royal physician and also the physician of the Buddha and his Sangha (fraternity of monks).

Jivaka, according to the Mahavagga, also performed surgical operations. At that time the Setthi (merchant-prince) of Rajagrha had been suffering for seven years from a head disease and he had been told by eminent physicians that he will die on the fifth or the seventh day. Then a certain Rajagha merchant went to the Magadhan king Bimbisara, and said, "That Setthi, Sire, does good service both to Your Majesty and to the merchants' gild. May it please Your Majesty to order the Royal physician Jivaka to cure the Setthi ."
Accordingly Jivaka was ordered to cure the Setthi .

After examining the Setthi, Jivaka told him that after he had been operated upon his head, he would have to lie on his left side, right side and back for seven months in each position, to which the patient agreed. Then Jivaka performed the operation : "He ordered the Setthi to lie down on his bed, tied him fast to his bed, cut through the skin of the head, drew apart the flesh on each side of the incision, pulled two worms out of the wound, ... then he closed up the sides of the wound, stitched up the skin on the head, and anointed it with salve."

After the operation the Setthi could only lie for seven days in each of the above positions and expressed his inability to further rest. jivaka then told the Sehi, that was enough, and said : "If I had not spoken thus to you, you would not have lain down even so long at a time. I knew beforehand that 'after three times seven days' you will be restored to health. Arise my good Gahapati (householder), you are restored." Then the Sehi gave a hundred thousand kahapanas to the king and one hundred thousand to Jivaka.

According to another Mahavagga story, Jivaka also performed an abdominal operation. At that time the son of the Setthi of Varanasi, by gymnastic feat, got an entanglement of his intestines. The patient could not digest anything, nor could he ease himself in the regular way, and looked discoloured with the veins standing out upon his skin. The Setthi of Varanasi  went to Rajagrha and requested king Bimbisara to give orders to Jivaka to cure his son. The king gave the orders.

After that Jivaka thought about a proper purgative to be given to a holy person like the Buddha. He selected three lotuses which he treated with various drugs. Then they were given to the patient to be smelt by him. Each lotus produced ten purges. After the purgative had its full effect, the Buddha was bathed in warm water and was asked to abstain from liquid food for some time. When the Buddha was completely recovered, Jivaka presented

to him the sivi cloth that had received as a gift from king Pajjota of Ujjayini. Jivaka often had to attend upon the Bhikkhus of the Sangha. Once, in Vaishali, the Bhikkhus were offered too much 'sweet food' for a long time, and became very sick with superfluity of humors in their body. Luckily, Jivaka at that time was present in that city. He attended upon the ill Bhikkhus and cured them all. As a famous physician, Jivaka was always loaded with engagements, but he never neglected the Buddha and his Sangha.

The Buddha's favourite retreat in Rajagha was a small peak called Gijjakuta (Gdhrakuta), the Vulture Peak, and the VeSuvana, gifted to him by king Bimbisara. A devoted supporter of the Buddha, Jivaka one day thought to himself : "I have to wait upon the Buddha two or three times a day. Both Gdhrakuta and Vesuvana are too far away. My mango grove is closer. Why don't I build a dwelling there for the Buddha ?" Accordingly, he built "night quarters and day quarters, cells, huts, pavilion, ...and a Fragrant Hut for the Buddha, and surrounded the mango grove with high walls." That place, called Jivakambavana (Jivakamravana), was some of the most important of the Buddha's discourses. It was here that one beautiful moonlit night, kind Ajatasatru, who had killed his father Bimbisara recently, came to visit the Buddha and listened to his discourse, the Samaaphala Sutta, the Sutra of the Fruit of Asceticism. The Buddha also delivered another two important discourses here, both of them to Jivaka.

All ancient sources agree that the Jivakamravana was outside the east gate of Rajagha, somewhere between the east gate and the Gdhrakuta hill. The famous Chinese traveller Yuan Chwang or Hiuen Tsiang, who travelled in India during 429-45 AD, describes his visit to Rajagha: "North-east from Shrigupta's Fire-pit, and in a bend of mountain wall, was a tope (stupa) at the spot where Jivaka, the great physician, had built a hall for the Buddha. Remains of the walls and of the plants and trees within them still existed. Tathagata often stayed here. Beside the tope the ruins of Jivaka's private residence still survived." (Watters On Yuan Chwang's Travels in India, Vol. II, p.150.) The Jivakamravana, built by Jivaka, was discovered and excavated in 1803-57. Although only the foundations remain, the complex is interesting in that it includes three long elliptical and oblong halls built of stone and bricks. A visitor to Rajagha has to proceed first along the main road towards the south and then take the road that turns to the left. Soon he will arrive at a clearing in the jungle containing the ruins of Jivakamravana. From there, about 2.5 kms towards the east, is the Gdhrakuta hill, where the Buddha stayed off and on for many years.

Next important place in Jivaka's life was Takshasila (Taxila of the Greeks), where he spent full seven years to complete his medical education under 'a world-renowned' physician, whose name in some Chinese and Tibetan texts is given as streya. In the 6th-5th century BC, Takshasila was a famous centre of education in the country. It attracted students from distant parts of India. Pasendi of Kosala, Mahali of Vaisali, Grammarian Panini, Canakya (Kautilya), who wrote the Arthasastra - all had received their higher training at Takshasila. Apart from medicine, the city was also a famous centre of education in other sciences, in arts and crafts and in the humanities. We have seen that how Jivaka had to go through a severe practical examination. Every medical student was expected to have a first hand knowledge of Medical Botany. Also, difficult operations were performed like those upon the skull or belly. Akasagotta, another surgeon contemporary to Jivaka, was a specialist in anorectal operation, which the Buddha disapproved.

In Gautama Buddha's time, Takshasila was, indeed, a famous centre of learning. It was, however, not a University town with its big campus, lecture halls and residential quarters as we notice in Nalanda. References to the students' life in the Buddhist Jataka stories suggest that at Takshasila the teachers' houses were the actual seats of leraning. Students were generally admitted at the age of sixteen. Pupils from rich families boarded with the teacher and paid him handsomely for their food and instructions. pupils from royal families had their separate independent lodgings. Poor pupils, not being able to pay their expenses, attended on their teacher and his family.

For nearly a thousand years the city of Takshasila existed successively at three sites - Bhir mound, Sirkap and Sirsukh -- representing its ancient, Greek and Kushana phases of political history. All the three places have been extensively excavated, but archaeologists have not found any site which could be the campus of this ancient seat of learning. This also confirms that only the hermitage of the teacher was the place of study, at least till the time of Jivaka. Later a number of Buddhist monasteries came up at Takshasila and they were also seats of learning.

In the Buddhist monasteries it was laid down that the monks must undertake the nursing of the sick. According to a story in the Mahavagga, the precept was first shown by the Buddha himself. On day, when he was taking his daily round in the monastery (Vihara), he noticed a monk was suffering from stomach disorder, fallen in his own excreta, and unattended by any one. The Buddha immediately asked snanda to fetch water and himself washed the monk with that water, while snanda wiped him down. The Buddha taking hold of him from the head and snanda at the feet, they lifted him up and laid him down upon his bed. Then the Buddha addressed the monks: "Ye, O Bhikkhus, have no mother and father to wait upon you. If you wait not one upon the other, who is there, indeed, who will wait upon you? Whosoever, O Bhikkhus, would wait upon me, he should wait upon the sick."

In the Buddhist scriptures the Buddha is also called as Bhaisajya-Guru and Mahabhisak i.e., great physician. The VIth Book of the Mahavagga, called Bhaisajya-Skandhaka, gives valuable information about a number of common diseases and their treatment. Diagnosis of disease and charitable distribution of medicines was the regular programme of the Buddhist Sanghas and was implemented by the monks in the monasteries.

The Buddha nursing a sick Bhikkhu :painting in Nava jetavana vihar, Sravsti

The Buddhist monk often served as a doctor among the lay-folk from whom he obtained his food. This Buddhist tradition flourished under the patronage of emperor Asoka (272-232 BC) who initiated measures for the relief of suffering of both men and beasts. Asoka's Rock Edict II tells: "Everywhere king Piyadars  has arranged for two kinds of medical treatment, viz., medical treatment for men and medical treatment for animals. And, whenever there were no medical herbs beneficial to men and beneficial to animals, they have been caused to be imported and planted. Wherever there were no roots and fruits, they have been caused to be imported and planted. On the roads, wells have been caused to be dug and trees have been caused to be planted for the enjoyment of animals and men." Along with Buddhism, Indian medicine also spread to other Asian countries. For all these endeavours the inspiration, indeed, came from the compassionate acts of the Buddha and the wonderful cures of his personal physician Jivaka Kaumara-Bhtya.

Kaumarabhtya means 'expert in children's diseases'. In ancient times this included all the elements of paediatrics, and was one of the eight parts of syurveda. In the early period there existed a large body of literature on the subject. DalhaSa, the 12th century commentator of the Susruta Samhita, says that Jivaka's compendium was regarded as one of the authoritative texts on the subject. But today no text of Jivaka is available. The Kasyapa Samhita, discovered in Nepal in 1938, is now the only text on ancient Indian paediatrics, and that too fragmentary.

Another text that quotes Jivaka's formulae is the Navan_taka (meaning 'butter'), a part of the Bower MSS discovered in 1880 from Kuchar in Chinese Turkistan. Based on earlier standard sources, this medical compilation of the 4th century AD, attributes two formulae dealing with children's disease to Jivaka, saying 'Iti hovaca Jivakah, i.e. thus it spoke Jivaka. One formula is :

Another text that quotes Jivaka's formulae is the Navan_taka (meaning 'butter'), a part of the Bower MSS discovered in 1880 from Kuchar in Chinese Turkistan. Based on earlier standard sources, this medical compilation of the 4th century AD, attributes two formulae dealing with children's disease to Jivaka, saying 'Iti hovaca Jivakah, i.e. thus it spoke Jivaka. One formula is :  i.e. , Bhargi, long pepper, Paha, payasya, together with honey, may be used as a linctus against emeses due to deranged phlegma. So says Jivaka.   From ancient India we have a number of monumental medical texts such as the Caraka Sahita and the Susruta Sahita, but almost nothing definite is known about their authors or compilers. Jivaka, on the contrary, is the only physician of ancient India about whom we know anything for certain. True, some of the cures effected by Jivaka may be exaggerations, but they indicate the importance attached to accurate observation and deduction in ancient

India's medical profession. For the first time in the history of Indian medicine we have records of case-taking and accounts of a number of cases treated by a great physician   Jivaka Kaumara-Bhtya.

Sources

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- Gunakar Muley