KAMALIKA PIERIS

Western medicine as we know it today was introduced to the island by the British. The western tradition did not recognize the Asian systems of medicine and most local doctors trained in western medicine avoided non western medicine. In 1858 Dr. W.C Ondaatje   wrote on the empiricism of Singhalese doctors and the advantage of European practice.”

This attitude continued. In 1974, Gananath Obeyesekera did a survey on the attitude of western medical practitioners to Asian medicine. He found that most were not interested in indigenous medicine. But 12 out of his sample of 38 doctors felt that   Sinhala vedakam was helpful in certain instances such as arthritis, and oil massage for fractures that has been set.

In the late 19^th   century, some Ceylonese doctors trained in western medicine had drawn attention to positive aspects of Sinhala Vedakam (Desiya Chikitsa). The first to do so, according to the available records was Dr John Attygalle. John Attygalle, MD (Aberdeen) was the first Sinhalese to qualify in western medicine. He came from a distinguished family of indigenous medical   practitioners in Madapatha.

Attygalle wrote Notes on Sinhalese medicine” (1888) and four ‘Notes on the Sinhalese materia medica’ (1887, 1888) to the   Journal of the Ceylon Branch of the BMA. He then gathered up all the information and wrote a landmark book titled ‘Sinhalese Materia Medica’ (1917).

Next came Dr. Emmanuel Roberts, whose name originally was Ratnajinendra Rabel Ratnaweera.   In 1909 he wrote ’Notes on native drugs’ in the Journal of the Ceylon Branch of the BMA. In 1919 he published a book on ‘Native remedies used in snake bites’

Emmanuel Roberts had a practice in Dehiwela where he prescribed rasakinda and other local herbs to his patients. The elite families of Colombo went to him for medicine,   and one of them, the painter Harry Pieris,  a descendant of Charles Henry de Soysa, told me that   the drugs provide by Dr.Roberts  were very palatable, unlike the usual decoctions and  that his remedies were available in a pharmacy owned by Roberts, the Oriental Drug Stores.  The other doctors used to laugh at him and call him vedarala.   Dr Hugh de Mel had also prescribed local remedies when he worked with Dr Roberts.

 Desiya Chikitsa practitioners, described as ‘vederala’ by practitioners of western medicine, had managed to hold on   despite the arrival of western medicine. Desiya Chikitsa practitioners gave evidence before the Commission on Indigenous Medicine, in 1947.

They emphatically stated that they were not a part of the Ayurveda system, which came from India. Desiya Chikitsa was a distinct medical system with its own treatment. It was particularly effective for snake bite and fractures. They also said  that Sinhala Vedakam was not a mere collection of prescriptions, evolved in Sri Lanka, and handed down from generation to generation, as popularly supposed.

John Attygalle had observed in his ’Sinhalese material medica(1917)’that the vedaralas of the historic  Udarata kingdom had  possessed valuable remedies handed down from father to son, kept strictly within the familyand taken with them  to the grave.  This would have been picked up and used by those who wished to replace Sinhala Vedakam   with India’s medical system, Ayurveda. But the allegation could be contested.  There would have been competition among those treating the royal family and secrecy may have been necessary, but secret medicines are simply not possible in a public health care system.

 The western trained doctors had looked at the ancient chronicles to see what they said about medicine. John Attygalle looked at medical descriptions in Dipavamsa and Mahavamsa (1917). Then in the 1970s, C de F Goonaratne wrote Some historical aspects of leprosy in the ancient medical literature of Ceylon. (Medical History 1973).

CG Uragoda wrote Medical gleanings from the Mahavamsa’ (1975) and Medical references in ancient inscriptions in Ceylon” (1977) in the Ceylon Medical Journal. Several ancient inscriptions had references to physicians and hospitals, he said. 

 In 1987, Uragoda wrote History of medicine in Sri Lanka from the earliest times to 1948, issued as the centenary publication of the Sri Lanka Medical Association. This had a chapter titled Medicine under Sri Lankan kings”, where Uragoda gathered together the information he had found in the ancient records.

Uragoda   said there was a liberal mention of medical facts in the Mahawamsa. These, taken together with information in the inscriptions,   gave fairly good picture of the medical system that prevailed in ancient Sri Lanka.

Uragoda observed that medicine was a respected profession in ancient Sri Lanka .Kings practiced medicine. King Buddhadasa was known as physician king, he appears to have been adept in medicine, surgery and midwifery as well as veterinary medicine. Aggabodhi VII had studied medical plants over the whole island to find out whether they were suitable for the sick. Parakrama bahu I   was ‘well versed in medical lore’.

There is mention of physicians in the inscriptions. Two cave inscriptions from Piccandiyava off the Puttalam-Anuradhapura road, dated to the early brahmi period, recorded donations by Gobhuti, who was physician and teacher to a king named Devanampiyatissa.  (This need not be the well known king of that name)

The second Dorabawila pillar inscription, of Dappula IV records grant of lands and immunities to a chief physician named Punalna. The lands were exempted of all taxes, an immunity which exceeds the immunities given even to lands owned by the sangha, observed Uragoda.  The Chief Physician was   a member of the Kings Council and an officer of state. Godakumbura thought that Chief Physician would have been the head of the medical service as well.

 There was a betge attached to the royal palace. The physicians of the royal betge were given lands for their use, maintained by the state. The appointments were usually given to the same family, generation after generation.

King Buddhadasa had appointed physicians to villages and given each the produce of ten fields as livelihood. Parakramabahu I had ordered people qualified in the art of healing to seek out villages and market towns and practice their art. ‘To discerning and skilful physicians who were quick at identifying diseases and knew the contents of medical textbooks, he gave maintenance according to their needs, and made them day and night practice the art in the best manner’.

This shows that there was a public health care service in the Anuradhapura and Polonnaruwa periods. Inscriptions also support this view.  There is there is at least one inscription for hospital, another for dispensary and one for medical halls in Anuradhapura, said Uragoda.

Slab inscription   of Mahinda IV says that the king established medical halls. Mahavamsa said that Kassapa IV built houses of medicine in different parts of the town.  It is not clear whether this refers to chemist’s shops where medicine could be purchased or to our patient treatment centers.   Inscriptions of Kassapa V found in Anuradhapura, Medirigiriya and Dorabawila indicate that he had established hospitals and medical halls. The inscription found at Abhayagiri stated that   Kassapa V had established royal medical halls near the southern gate of a particular high street.

The Kirbathvehera pillar inscription proclaims immunities bestowed on a dispensary.  Uragoda thinks that the paucity of references to outdoor treatment probably indicates that the physician paid home visits rather than the sick attending a central dispensary.

The ancient chronicles carried reference to medicines. Vihara Maha Devi had gifted medicine to the sangha. Dutugemunu had in 18 places constantly bestowed on the sick the food and medicine ordered by the physicians. Moggallana II had gifted medicines to the sangha. Mahinda IV had   distributed medicine and beds in all the hospitals and gave the earning from a mandapa to the sangha for purchase of medicines.

Archaeologists have found medicine troughs at Anuradhapura, Mihintale, Medirigiriya, Dighavapi and Polonnaruwa.  Uragoda said that these were probably used for immersion therapy. He observed that Sinhala texts on medicine, Yogarnavaya and Prayoga Ratnavaliya (13 century) speak of bath fluids, containing medicinal oils, milk, ghee, and vinegar .This was used for the management of skin disease, fever, and rheumatism. Uragoda thinks that in ancient times, some households would have had their own medicine baths.(continued)