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APPENDIX A. SOME AYURVEDIC TECHNIQUES REFERRED TO IN THIS PAPER AS PRACTICED
AT AYURVEDIC DR. K.S.S. SAMARAWICKRAMA'S DISPENSARY ON 20 MARCH 1980
Marga researchers were present at
Ayurvedic Dr. K.S.S. Samarawickrama's dispensary in PAthegama, Kottegoda,
on Thursday, 20 March 1980. The day had been selected on
astrological grounds as being auspicious for administering cauterization
and blood-letting treatments.
Normally on such clinical days
patients are examined by Dr. Samarawickrama, and cauterization or
blood-letting is administered according to his instructions by his son.
On this particular day the son was out of town; so the father had
requested three experts to come and assist him. They were
Ayurvedic Dr. D.L.C. Jālat Muhandiram (age 77 years) of Agalaboda,
Kirama; his son, Ayurvedic Dr. S.P. Jālat Muhandiram (age 37 years),
also of Agalaboda; and Ayurvedic Dr. D.J.M. Abeysekera (age 54 years) of
Pathegama. Dr. Abeysekera, a relative of Dr. Samarawickrama,
specializes in treatment of dog bites. As part of his treatment he
cauterizes at the spot where the wound is left after a dog bite, using a
cuaterizing instrument called ratran bottama - 'golden button
instrument' - whose buttonlike tip is made of sovereign gold and whose
handle is made of iron. The father and son Jālat Muhandiram, Sr.,
and Jālat Muhandiram, Jr., are also well-known in the area.
Patients who got Dr. Jālat Muhandiram, Sr., to administer surgical
operations on them used to issue signed statements to that effect.
The researchers, from the
Micro-level Socio-economic Studies Division of the Marga Institute, were
Mr. Sunimal Fernando (Associate Director), Mr. Henry de Mel, Miss
Niloufer Abeysuriya, Miss Hemamala Munasinghe, Mr. U.F. Nimal Fernando,
and Mr. W.P.P. Abeydeera.
Three patients were present at the
dispensary when the Marga researchers arrived. Patient No. 1 was a
young man (age 24 years) from Kekanadura, Talalle North. Albinotic
pathes of white on his body enabled physicians to diagnose the illness
as sudu kabara (sveta kustha). As soon as he noticed
that white pathes were appearing on the lower lip he consulted his first
cousin, who is a western-qualified skin specialist practising in
Colombo. He treated the patient for one month. But there was
no satisfacttory improvement. Now white patches were also
appearing on other parts of the patient's body.
The patient thereafter gave up
taking western treatment and consulted Dr. Samarawickrama. He
treated him for two years prescribing medicinal decoctions. The
treatment was satisfactory to some extent. Most of the white
patches disappeared one by one during those two years but the original
white patch on the lower lip remained unchanged. Then Dr.
Samarawickrama suggested that the patient go through a course of
blood-letting. The suggestion was accepted.
Patient No. 2 (age 19 years) was a
youth from Pathegama, Kottegoda. For one year he had been
suffering from hernia and had been treated by Dr. Samarawickrama.
But the patient's condition had neither improved nor deteriorated.
He had not cared to consult western-qualified doctors as he had no faith
in western medicine. His impression was that the best that western
medicine could do was to pave the way for a temporary cure.
There came a stage when Dr.
Samarawickrama suggested that the patient undergo cauterization.
This was agreed to. The first cauterization was on 20 March.
Cauterization on two more occasions, with approximately a month's
interval between, was necessary to complete the course of treatment.
Days were to be selected after taking into account the operation of Kāla
and other mystic forces.
Patient No. 3 was a young man (age
20 years) from Pathegama. An eruption on his left foot had caused
him a great deal of inconvenience. He had not consulted allopathic
doctors as he had no confidence in western treatment. He said that
western treatment resulted in quick but temporary cures while
traditional treatment was a slow but sure path to good health.
He consulted Dr. Samarawickrama,
who gave him decoctions. After one month he felt relieved a
great deal. The eruption began to heal and in two more months
there was an apparently perfect cure. But some time later the
eruption emerged again. The the patient himself suggested that
blood-letting be administered. This was done on 20 March.
The instruments which were to be
used on that day were on the table in the ancient days instruments used
to be washed in water mixed with saffron before commencing surgical
operations. But now boiling water was used in order to 'destroy
the destructive element of sharp-edged metal' as the physicians
explained. Heat was also used directly.
Ayurvedic Dr. Abeysekera was
kindling a fire for this purpose. Faggots from wara trees
and pieces of dried cow-dung were heaped and were being lit. The
flames from them were considered capable of sterilizing the surgical
instruments and also of transferring heat which could nullify the
conditions of the ailments which were treated. A piece of plantain
leaf containing a medicinal paste was on the table. This paste had
been prepared from medicinal ingredients by Dr. Samarawickrama for
application on the wounds of patients No. 1 and No. 3 after
blood-letting was done.
Cotton wool and bandage rolls were
also on the table. They were to be used for dressing the wounds.
At 10.09 a.m. the three patients
were led to the back yard of the dispensary. Three chairs were
placed for them to sit by the drain so that blood oozing out when
treatment was administered could flow into the drain.
The other events are recounted
below with the clock time of each event. The times mentioned
merely occurred in their sequence and had no astrological importance.
| 10.10
a.m. |
Two narrow strips of cloth to
serve as tourniquets were tied on the patient's arm. The
puncturing instrument was further sterilized in a basin of
boiling water. |
| 10.12
a.m. |
Blood-letting of patient No.
1 was performed by Dr. Jālat
Muhandiram, Sr. The patient's hand which was bleeding
profusely was then immersed in a pot of lukewarm water. |
| 10.13
a.m. |
Dr. Samarawickrama marked
with a piece of lime chalk a spot near the big toe of the left
foot of patient No. 2. |
| 10.14
a.m. |
Dr. Abeysekera, who had by
now heated his instrument in the fire of wara sticks and
cow-dung, cauterized patient No. 2 at the spot marked by Dr.
Samarawickrama. Simultaneously Dr. Jālat
Muhandiram, Sr., was muttering incantations over a jug of water. |
| 10.15
a.m. |
The hand of patient No. 1 was
withdrawn from the pot of lukewarm water. Charmed water
from the jug was then sprinkled on the patient's hand by Dr. Jālat
Muhandiram, Sr. Then the bleeding stopped at once as if in
response to a mystic message from the charmed water. The
patient was given the charmed water to drink too. The
doctors inspected the colour of the blood that had oozed out and
agreed that impure blood had by that time almost completely left
the patient's body. From this it was inferred that it was
therefore correct to stop the bleeding. The wound was
dressed by Dr. Samarawickrama. Simultaneously Dr. Jālat
Muhandiram, Jr., brought a saucer of wara exudation ('wara
milk') and rubbed it on the wound at the spot where patient No.
2 was cauterized. It would enable the wound to fester.
Such festering is part and parcel of the curative process in the
traditional treatment of hernia. |
| 10.19
a.m. |
A piece of cloth was tied to
the leg of patient No. 2 to serve as a tourniquet. |
| 10.20
a.m. |
Dr. Jālat
Muhandiram, Sr., examined the leg of patient No. 3 and marked
with a piece of lime chalk a spot for blood-letting. |
| 10.21
a.m. |
On instructions from Dr. Jālat
Muhandiram, Sr., Dr. Jālat Muhandiram, Jr., punctured the leg of
patient No. 3 at the spot marked. The leg was not immersed
in water but blood from the punctured spot was allowed to flow
into the drain. When blood-letting was being done in this
manner the patient was standing and experiencing intense pain.
He was held by someone who stood near him. Soon afterwards
he was made to sit on a chair. Every few seconds a little
lukewarm water (not charmed) was thrown on the wound.
Meanwhile Dr. Jālat Muhandiram, Sr., was observing the colour of
the emerging blood. He was trying to decide when to stop
bleeding. |
| 10.24
a.m. |
Dr. Jālat
Muhandiram, Sr., began again to mutter incantations over a jug
of water. |
| 10.25
a.m. |
Dr. Jālat
Muhandiram, Sr., next sprinkled some of that charmed water on
the patient's wound. The patient was also given charmed
water to drink. Marga observers noticed that, unlike in
the case of patient No. 1, the bleeding of patient No. 3 did not
stop instantly. |
| 10.26
a.m. |
The medicinal paste prepared
by Dr. Samarawickrama was applied on the wound of patient No. 1
by Dr. Abeysekera. Cotton wool was placed on it. The
wound was then bandaged by Dr. Abeysekera. |
| 10.28
a.m. |
Medicinal paste was applied
on the wound of patient No. 3 by Dr. Jālat
Muhandiram, Jr. Cotton wool was placed on it and bandaged. |
| 10.30
a.m. |
All three Ayurvedic doctors
thereafter went into the dispensary while the three patients
remained seated on the chairs by the drain in the back yard. |
| 10.45
a.m. |
The three patients were given
drinks of young coconut. |
|
10.50 a.m. |
The three patients thereafter
came into the dispensary and received further instructions.
They were told two more visits would be necessary for
blood-letting or cauterization. There would be no need for
them to dress their wounds anew at home. They could remove
the present dressing after a few hours if they so desired. |
|
11.00 a.m. |
By this time there were other
patients who had come to consult Dr. Samarawickrama for various
ailments. While he attended to them, the other three
physicians conversed with the Marga researchers. |
|
11.45 a.m. |
Dr. Samarawickrama was now free,
as all the patients had left. He very kindly invited the
Marga researchers and the other physicians to have lunch with
him at his residence. All four physicians then left the
dispensary. |
It was clear
from what took place in the dispensary that these physicians were
co-operating to heal the sick. The popular belief that traditional
physicians in our country are always jealous of one another and that
they keep their techniques secret is therefore incorrect. Before
our very eyes we saw four physicians who were recognized as specialists
in their fields working together and pooling their knowledge and
experience for the common good.
Their sense
of ethical standards differed from those of western medical
practitioners in a significant way where fees were concerned. With
the latter, it is not unusual for a patient who pays a higher fee to get
better attention. But these traditional physicians gave their best
services to all patients irrespective of the fees paid to any of them.
The service did not therefore vary with the fee. From information
received, the Marga researchers could infer that each patient paid
whatever money could be conveniently spared. None of the
physicians insisted on the patients paying anything more.
APPENDIX B. THE SPREAD OF TECHNOLOGY WITHIN SEVEN ADMINISTRATIVE DISTRICTS
OF SRI LANKA
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