Jivaka

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.

The student who studied medicine from the renowned teacher of
Taksasila was Jivaka, the most famous physician of Gautama Buddha's
time (563-483 BC). Much of what we know about him is from the
Buddhist canonical texts. His patients included the Buddha, monks,
emperors, rich merchants and common people.

Jivaka was the son of Salavati, a courtesan of Rajagrha (present
Rajagira in Bihar, about 100 kms south-east of Patna) which was the
capital of the Magadhan empire in the reign of king Bimbisara After
his birth the child was thrown on a dust-heap where prince Abhaya,
son of Bimbisara, noticed that he is still alive (jivati). The
prince, therefore, named him Jivaka and had brought him up under his
own care.

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.

Miraculous Cures of Jivaka

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.

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.

Jivaka went to Varanasi and examined his patient carefully.
Then, "he ordered the people to leave the room, drew the curtain,
tied him fast to a pillar, placed his wife in front of him, cut
through the skin of his belly, drew the twisted intestines out, and
showed them to his wife...Then he disentangled the twisted
intestines, put the intestines back into their right position,
stitched the skin together, and anointed it with salve."It did not
take long for the Setthi 's son to regain his health. Jivaka got his
hefty fees and returned to Rajagrha.

Jivaka's perhaps most difficult patient was king Pajjota (Pradyota)
of Ujjen (Ujjayini) who was suffering from jaundice. Bimbisara lent
Jivaka's services to him. When Jivaka went all the way from Rajagha
to Ujjayini, he found that the patient was a very difficult subject
of treatment, worse than his disease. The medicine that he had to
prescribe had to be prepared by boiling ghee, to which the king had
an aversion and a distaste. Then Jivaka boiled some ghee with varies
drugs so that it took the colour, the smell and the taste of an
ringent decoction. Still, fearing untoward happenings, and
anticipating that the king later might vomit the medicine, and
detect in it the ghee which he loathed, and then punish him. So
Jivaka did not wait for the effects of the treatment, but made
arrangements for his escape. On the pretext of drawing out roots and
gathering medicinal drugs, he effected his escape by choosing and
riding on the fastest elephant of the king. Meanwhile the treatment
began to have its effects and the king was eventually cured. Finding
that the physician was away, he sent Jivaka, as a token of his
favour, a suit of sivi cloth.

Jivaka was contemporary of the Buddha and was very much attached to
him. It is recorded that once the humors of the Buddha's body were
out of order. The Buddha wished to take a purgative. snanda, the
faithful attendant of the Buddha, conveyed the matter to Jivaka. The
physician suggested fat to be rubbed to the Buddha's body for a few
days. This was done.

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.

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 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.

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 :