KAMALIKA PIERIS

Pediatrician Manouri Senanayake researched into child hood and child care in ancient Lanka for her book titled Pediatrics and child care in Sri Lanka” (2007).  She found that the ancient literature yielded some information about childhood in ancient Sri Lanka.  Literary works emphasis the mother’s affection for her child. Childhood in ancient Sri Lanka was perhaps far safer and more secure than in many contemporary societies, she said.

Manouri found several other historical references. .Food and herbs to assist conception were given in the Sarartha Sangrahaya written by king Buddhadasa. This was therapy for sub-fertility. Sinhala Tupavamsa records that         Dutugemunu issued a royal command to supply all pregnant women with special provision of salt and pepper”. Manouri suggests that this was one of earliest records of a state welfare scheme for pregnant women. Dola duka is mentioned in the Mahavamsa with reference to Vihara Maha Devi when expecting Dutugemunu.

Midwifery received royal recognition; Mahavamsa described how King Buddhadasa attended on an expectant mother of Chandala caste. Pandukabhaya and Upatissa I built maternity centers, (timbirige). A rock inscription described a private citizen called Senalenakarna funding a timbirige.’

 An outstandingly beautiful wood carving at Embekke Devale shows a woman breast feeding a baby. Tupavamsa describes how to choose a suitable wet nurse. She must not be short, skinny, too fair or too dark in complexion.

The girl child was not resented, it was welcomed. Manouri points out that Kassapa V and Aggabodhi I have named monuments after their daughters. Also a princess of royal birth was selected to conduct many of the coronation rituals. This compulsory presence of a royal maiden at coronation ceremonies shows the high position young girls were held in, concluded Manouri.

The College of Surgeons of Sri Lanka celebrated its 50th anniversary by publishing, History of Surgical services in Sri Lanka from the earliest times to 2021.”This work has three chapters on surgery in ancient Sri Lanka.

The first is ‘Surgical anecdotes from the Culawamsa’. This chapter starts with king Buddhadasa. King Buddhadasa has practiced operative surgery. According to the Mahavamsa he had treated a snake that had a tumor in its belly.  King slit open the belly of the snake, took out the tumor, applied medicine to the wound and cured the snake.

Buddhadasa is also credited with impossible operations, said the College of Surgeons. Buddhadasa had performed an operation for correction of a mal position of a foetus. He had split the cranium of a patient and removed a toad who had grown inside it, then reconstructed the bisected cranium.  Surgeons did not think these operations were likely. 

The chapter then drew attention to Parakramabahu I who it appears, knew medicine, a fact which is rarely mentioned in accounts of this king. Mahavamsa says Parakramabahu I   had done a ‘ward round’ surrounded by physicians. He had checked on the medicine given to patients, instructed on mistakes made and by his own hand skillfully showed the use of instruments.

 

When Parakramabahu sent a military expedition to Burma, he also sent physicians and nurses. Different kinds of medicine were preserved in cow horns for healing of venomous wounds caused by poisoned arrows. Iron pincers were used to extract arrowheads. He also sent remedies for curing disease caused by infected water in swamps, concluded the Mahavamsa.

 

The second essay written by archaeologist Leelananda Prematilleke and surgeon Arjuna Aluwihare is on Alahana Pirivena, Polonnaruwa. This essay adds to the information already known about ancient hospitals.  Alahana was more elaborate than the hospital ruins found in Anuradhapura, said the authors. It was well landscaped, with medicinal trees. The hospital was cordoned off with a wall.  Building was designed   for maximum ventilation and free circulation of air within it. This was achieved by two open courts and windows.

At Alahana they found medicine grinders and a micro balance.   The micro balance indicated that strong medicines had been used. Medicine troughs were also found. The writers had much to say on the medicine troughs. These unique granite medicine bath tubs standing on a granite base have not been found in any other ancient civilization, they said.  They had human shaped hollows.  

The granite is carved to repeat the shape of the head, expand at shoulder and slightly tapering at the place where the hands end, thereby showing the perfect proportions of the human body. There is much scientific merit in this design as the patient could be immersed in it with the minimum amount of  fluid.  These troughs were intended for immersion therapy.

But the most important find at Alahana were the surgical instruments unearthed there.  They include probes, forceps, scissors, scalpels and lances. Probes were of different sizes. Forceps were made out of bronze or iron with a small percentage of steel. Forceps with short, strong jaws were found, perhaps for arrow head removal. Fine jawed forceps were not found. 

The third chapter in the book was on Surgery and surgical training in ancient Sri Lanka”. For the first time ever, scattered references available in the ancient literature on operative surgery were gathered together   and placed on record.

One statement on surgical training was found. In Visuddhimagga, Buddhagosa had made an observation on how surgeons were trained. Pupils are trained in the use of the scalpel by learning to make an incision on a lotus leaf placed in a dish of water, he said. They must make the incision without cutting the leaf in two or pushing the leaf into the water.

Several books on the art of healing have been written, observed the College of Surgeons. Bessajja Manjusa written in 13th century refers to   surgical topics such as   fistula,         carbuncle, bladder stone, fractures, goiter and surgical treatment for intestinal obstruction.

Kankavitarani referred to 8 kinds of surgical operations and provides a list of instruments for each type. They are use in excision, rubbing and scarificaiton,  in opening blood vessels and flesh,  in incision and drainage of body fluid,  in removing, scaling and probing. There was mention of small drilling needles   and needles used in puncturing,. There was also mention of scissors, thorn removers and an ax like instrument used for splitting.

Sararta sangrahaya carried diagrams  of instruments available at the time for specific procedures. Yogarnavaya and Prayoga –ratnavaliya referred to almost 20  surgical instruments.

Historical Manuscripts Commission, 1933 found dozens of medical manuscripts in personal collections and temples. Purana vihara Pelmadulla had a manuscript dealing with surgical operations copied in Sinhala in 1862 .( concluded)