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Indian influences on early Chinese ophthalmology: glaucoma as a case study1

Published online by Cambridge University Press:  05 February 2009

Vijaya Deshpande
Vijaya Deshpande
Affiliation:
School of Oriental and African Studies, London.
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Extract

Allusions to Indian medicine appear in Chinese literature from the fifth century A.D. onwards. At first through translated Buddhist texts, and then through the incorporation of material by later Chinese authors in the form of medical theories, diagnostic, surgical methods and prescriptions, a substantial element of Indian medical knowledge permeated into Chinese medicine. Ophthalmology held a unique position in these transmissions. It was invariably associated with the famous name of Nāgārjuna, which is connected with almost all kinds of protoscientific activity in early medieval India. This has given rise to a longstanding debate among scholars regarding the origin of this material, as well as the credibility of its attribution to Nāgārjuna.

Type
Research Article
Information
Bulletin of the School of Oriental and African Studies , Volume 62 , Issue 2 , June 1999 , pp. 306 - 322
Copyright
Copyright © School of Oriental and African Studies, University of London 1999

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References

2 See Xianlin, Ji, ‘Yin du yan ke yi shu chuan ru zhong guo kao’ ‘A study of the entry of Indian ophthalmological techniques into China’, Guo Xue Yan jiu (Researches in Chinese Studies), 1, 1994, 555.Google Scholar

3 Mingju, Chen. Yanke wenxian chu kao ‘A preliminary study of ophthalmological literature’, Journal of the Shan Dong Medical Institute , 4, 1981, 48.Google Scholar

4 Pi Huade and Li Tao write about the creation of the special textbook on ophthalmology as follows:

In 1076 the Song regime began the establishment of the Imperial Board of Medicine Tai yi ju, which had nine different departments, including an independent eye department. Long Shu's treatise on eye diseases was a required course of study for students of ophthalmology. To make the work easy to memorize, one physician, Liu Hao by name, rendered 72 prescriptions for the 72 eye diseases into popular rhymes. These verses were incorporated into Long Mu's Secret treatise on eye diseases by later students. (Huade, Pi and Tao, Li, ‘Ophthalmology in traditional Chinese medicine’, Chinese Medical Journal, 77, 1958, 269.)Google Scholar

5 See Ahmed, E., A textbook of ophthalmology (Calcutta: Oxford University Press, 1993), 248.Google Scholar

6 ‘ The old men both happen difficulty and hardness of breathing, distillations causing a cough, stranguries and disuries, aches of the joynts, pain in the reins, giddiness, apoplexies, evil dispositions of the body, watchfulness, moistness of the belly, eyes and nostrils, dimness of sight, glaucoma, and dullness of hearing.’ (Section 3, Aphorism 31, in Aphorisms of Hippocrates—Prince of physicians, London, 1655.)Google Scholar

7 (Suśrutasamhitā, Uttaratantra [SS. UT], 7.) (See Singhal, G. D. and Sharma, K. R., Ophthalmic and otorhinolaryngological considerations in ancient Indian surgery (Allahabad: Singhal Publications, 1976).)Google Scholar

8 They are listed under the category of diseases called timira (darkness) and linganasa (destruction of the basic, essential faculty, here visual). The general term for glaucoma-like diseases, however, is adhimantha (‘ that which produces an excessive churning sensation or pain’).

9 In the bibliography of the Sui dynasty (A.D. 581–618), there is an entry with the title Tao Hongjing Shen Nong bencao jing ji zhuf In addition, there are number of entries by the titles Shen Nong bencao and Shen Nong bencao jing. Unschuld is of the opinion that the one ending in ‘jing’ was written by Tao Hongjing (A.D. 456–536). (See Unschuld, P., Medicine in China: a history of pharmaceutics Berkeley, Los Angeles, London: University of California Press, 1986, 17.)Google Scholar

The writings of Tao Hongjing showed the influence of the Buddhist Si da fourelement theory—for the first time. The four elements, viz. earth, water, fire and wind, were supposed to give rise to 101 diseases each, thus presupposing a total of 404 diseases.

10 Hakim, M. S., Medicine in China, revised ed. (Pakistan: Hamdard Academy, 1981), 348.Google Scholar

11 Huade, Pi, ‘History of glaucoma in traditional Chinese medicine’, Chinese Medical Journal, 81, 1962, 404.Google Scholar

12 The original text is no longer extant. Nimi–the king of Videha (mentioned in Carakasamhitā [CS], 1.15, and also SS, 6.1)—described 30 eye diseases. Some 150 verses are extant in various later texts like Vydkhydkusumdvati, Vydkhyamadhukośa, Bhāvaprakāśa, Nibandhsamgraha, etc. These are compendia of early centuries of the second millennium A.D. Almost all the verses give prescriptions for eye diseases.

13 The six paṭalas (layers, coverings or coats) are described as follows: ‘ The two paṭalas should be known to be in the eyelids and the other four in the eye proper itself in which timira, a most formidable disease, occurs. Of them the outermost paṭala subsists in the tejas (fire) and the jala (water), the next one in the muscles, the third paṭala in the fat, and the last one in the bone. Their thickness is said to be equal to one-fifth of the pupil’ (SS.UT, 1.17–19).

14 Zhu bing yuanhou lun of Chao Yuanfang , (Taipei: Guoli zhongguo yiyao yanjiusuo 1964).Google Scholar

15 The empty organs, such as the stomach, gall-bladder, uterus, large intestine, small intestine and urinary bladder are called the fu or eliminating organs, the solid organs such as liver, heart, spleen, lungs and kidneys are called as the zang or storing organs.

16 See ZBYHL, qing mang, first category.

17 See Jingfeng, Cai, ‘The pre-Tang exchange of medical knowledge between India and China’, Chinese Historical Material on Science and Technology, 7/6, 1986, 18.Google Scholar

18 Tatz, M., Buddhism and healing: Demieville's article ‘Byo ’ from Hobogirin (Lanham, New York and London: University Press of America), 1985, 94.Google Scholar

19 See ‘Sun Simiao dui zhongyi yankexue de gongxian’ ‘Sun Simiao's contribution to Chinese ophthalmology’, Zhongguo zhongyi yon ke za zhi , i, 1991.

20 Huang di nei jing ‘ Huang Di's classic of internal medicine’, which was earlier considered to have been written by the legendary ruler Huang Di four thousand years ago, is now known to have been written during the Han dynasty. It is a compilation of works by several authors over a long period of time. (For an explanation of the Nei jing theory, see below, and n. 42.)

21 Simiao, Sun, Qianjin yaofang, 96.Google Scholar

22 See Chaudhury, R. C., Netra cikitsā vijñana (Chaukhambha Orientalia, Delhi: Varanasi, 1993), 299.Google Scholar

23 These are cited as treatments suggested by Nimi in Vydkhydkusumdvati, a twelfth-century compilation.

24 SS.UT, 9–3, 10–3, 11–3, 12–8.

25 Longshu pusa yanlun, in Yifang lei zhu. first published in Korea in A.D. 1445 (repr. by t he Dong Yang medical college, Seoul, 1965), ch. 65, section ‘Liao yan tang wan, son, qian, gao fang’ ‘Prescriptions of decoctions, pills, powders, extracts and ointments for the treatment of eyes’.

26 ibid., 27.

27 ibid., 26.

28 ibid.

29 Tianzhu jing lun yan' in Wai tai mi yao by Wang Tao , (Hua xia chubanshe, 1993), 402.

30 Han ying zhong yiyao fenlei ci dian (Classified dictionary of traditional Chinese medicine) (Beijing: New World Press, 1994), 323.Google Scholar

31 Chopra, R. N., Nayar, S. L. and Chopra, I. C., Glossary of Indian medicinal plants (New Delhi: Council of Scientific and Industrial Research, 1956), 53.Google Scholar

32 See Nadkarni, A. K., Indian Materia Medica (Bombay: Popular Book Depot, 1954), i, p. 282–292.Google Scholar

33 Nadkarni, , Indian Materia Medica, i, 291.Google Scholar

34 ibid., 285.

35 Siddha medicine is a system of medicine practised in South India which includes elements of Ayurvedic medicine, mercurial medicine as well as Tantra. (See Bose, D. M. et al. (ed.): A concise history of science in India, New Delhi: Indian National Science Academy, 1971, 335.)Google Scholar

36 See note 13 on paṭala, above.

37 Tianzhu jing lun yan, in Wai tai mi yao by Tao, Wang, (Huaxia xia chubanshe, 1993), 402.Google Scholar

38 Hakim, , Medicine in China, 352.Google Scholar

39 Huade, Pi, ‘The history of glaucoma in traditional Chinese medicine’, 406.Google Scholar

40 See Ahmed, , Textbook of ophthalmology, 248Google Scholar: ‘At the beginning of 19th century the first excellent description of glaucoma with raised ocular tension was given by Antoine-Pierre Demours. Gunthrie (1823) recognised hardness of the eye as characteristic. The essential feature, raised ocular tension, was firmly proved by Mackenzie (1835). Von Graefe (1857) divided the affliction into three groups acute, chronic and secondary. Otto Barkan (1938) established the concept of acute glaucoma. He was mainly responsible for classification of primary glaucoma into two varieties, open angle and closed angle.’

41 See Tianzhu jing lun yan’, 391.

42 Huang di nei jing su wen, ‘The yellow emperor's classic of internal medicine, plain questions’ (Beijing: People's Hygiene Publications 1963), ch. 10, 73.Google Scholar

43 According to the tridoṣsa theory, the body is sustained by these three elements or dhātu. They are essential for the growth and maintenance of the body. A balance of the three keeps the body in a good, healthy state. An imbalance of the three, on the other hand, causes illnesses. When a dhātu is creating an adverse effect due to its being in deficit or excess, the malfunction is called a doṣa. Any illness is characterized by either one or more of the doṣas. Sometimes all three doṣas together cause a disease, in which case it is said to be due to sannipata or concurrence of the doṣas.

44 Medicine in China: a history of ideas (Berkeley, Los Angeles and London: University of California Press, 1985), 146.Google Scholar

45 Yi xin fang (Beijing: Renmin weisheng chubanshe , 1993), ch. 5, 125Google Scholar. This description of qing mang is given in the section ‘Zhi mu qing mang fang di shī si’ . It then goes on to quote a ‘yanlun’ . This seems to be the first of the 30 cases described in LSPSYL.

46 LSPSYL, section 64, 2.

47 ibid., section 64, 5.

48 SS.UT, 6.10.19. (See Singhal, and Sharma, , ‘Ophthalmic and otorhinolaryngological considerations in ancient India’, 61.)Google Scholar

49 Ahmed, , Textbook of ophthalmology, 249.Google Scholar

50 This is expressly stated in LSPSYL, no. 2. (See above.)

51 For inflammation see Asṭāṅgahrdaya samhitā [AHS].UT, 15.9,13; SS.UT, 6.14.15; shrinking of the eyeball, AHS.UT, 15.6;' SS.UṪ, 6.23,26; extrusion of the eyeball, AHS.UT, 15.12; SS.UT, 6.24; head whirling, AHS.UT, 15.4; SS.UT6.14,15; secondary glaucoma, AHS.UT, 15.15.4; SS.UT, 6.10; loss of eyesight, AHS.UT, 15.24; SS.UT, 6.20; stiffness of the eyelid, AHS.UT, 16; SS. UT, 6.26.

52 Ahmed, , Textbook of ophthalmology, 267.Google Scholar

53 LSPSYL, no. 5 of the 30 diseases discussed (hatādhimantha (?)). See Singhal and Sharma, ‘Ophthalmic and Otorhinolaryngological considerations’, 57, 64 (= SS.UT, 6.23, 24).

54 See n. 43 above for the tridoṣa theory.

55 SS.UT, 6, 10–19. (See Singhal and Sharma, 61.)

56 SS. UT, 6, 24–6. (Singhal and Sharma, 64.) v. 24, Hatādhimantha.

When Vata located in the internal channels causes bulging of the eyeball, the condition hatādhimantha is produced, which is regarded as incurable by the wise people, v. 25, Vātaparyāya (ocular pain).

When vitiated vata circulates in both the lids, eyeballs and the brows and produces pain in them (alternately or) in succession, the condition is called vātaparyāya. v. 26, Suṣkakṣipāka (xerophthalmia)

When the eye is (contracted and) closed, the lids are stiff and dry, vision is blurred and opening of the eye is difficult, it should be regarded as afflicted by śuṣkakṣipāka.

57 Longmu zong lun (see next section) cases 14, 17, 18, 19, 20.

58 Baoguang daoren michuan yanke longmu lun (Beijing: Renmin weisheng chubanshe 1964).( = LMZL).Google Scholar

59 Yinhai jing wei (Beijing: Renmin weisheng chubanshe , 1956).Google Scholar

60 This book contains an introduction by an official named Qi Yijing, who was a deputy-inspector of the judicial administration in Honan province, an office first established under the Yuan dynasty. It was first mentioned in the ‘Compendium of medicine’, by Lou Ying, who lived between the last years of t he Yuan and the early years of the Ming. From these two facts, one may reasonably infer that the YHJW was written during the Yuan dynasty. (See Hakim, , Medicine in China, 355).Google Scholar

61 YHJW, 22.

62 Pide, Hua, ‘A resume of an ancient Chinese treatise on ophthalmology (Yinhai jing wei , National Medical Journal of China, 17, 1931, 131–149.Google Scholar

63 YHJW, 23.

64 ibid., 33.

65 ibid., 46.

66 ibid., 61.

67 ibid., 65.

68 ibid., 67.

69 Chen Yaozhen ‘Zhongguo yankexue fazhan shi’ The general development of Chinese ophthalmology, Yanke Xuebao (Eye Science), 3/3, 1987, 141.

70 The English-Chinese encyclopedia of practical traditional Chinese medicine (Beijing: Higher Education Press, 1994), 160.Google Scholar

71 See the LMZL, classification of glaucoma-like diseases.

72 Beijing: Science Publications, 1994.

73 See, e.g., Chen Mingju, ‘Yanke wenxian chu kao’ (‘a preliminary study of ophthalmic literature’).