Buddhism has admittedly been the most powerful influence on the development of the culture if Sri Lanka from at least the 3rd century B.C. relieving the suffering of all living creatures – both human beings and animal – is one of the highest ideals of Buddhism. The ancient rulers of Sri Lanka as devout followers of Buddha naturally gave high priority to the physical wellbeing of the people. The fact that king provided medical facilities is borne out not only by numerous references in literary and epi-graphical sources, but also by archaeological remains.
The form of medicine practiced was of course Ayurveda, as modified to suit local conditions and needs. It is quite natural that Sri Lanka with its close geographical ethnic and cultural ties with India has also adopted the system of medicine practiced in the Sub-continent.
The ancient rulers played an active part in not only relieving the sufferings of the people when they the afflicted with disease, but also in ensuring that minimum standards of sanitation were observed.
Mahawamsa, the Great Chronicle of the Sinhalese refer to several kings who founded medical institutions. Mention is made of King Pandukabhaya (circa 4th century B.C.) as having set up a lying in home and a hospital. King Duttugamunu (circa 101-77 B.C.) bestowed food on the sick and provided medical attention for them.
Upatissa ΙΙ(426-468 A.D.) founded hospitals "for cripples, woman in travail, for the blind and the sick he erected great nursing shelters and alms halls."
Buddhadasa (398-426 A.D.) is by far the best known ruler as far as the ancient medical science in Sri Lanka is concerned. An eminent physician himself, he is said to have effected marvellouscures. He is also credited with the compilation of Sarasthasangrahaya a compendium of all existing handbooks, composed in Sanskirt. He appointed physicians to treat soldiers, horses and elephants. Special asylums were set up for the cripples and the blind.
DappulaII and Kassapa IV built hospitals both at Anuradapura and Polonnaruwa. Culavansa refers to the construction of a hospital at Anuradapura by KassapaV(913-923 A.D). This is confirmed by epigraphical evidence.
Parakramabahu 1(1153– 1186 A.D.) best known for the construction of numerous Irrigation works, is also credited with establishment of hospitals and care of the sick. He built a large hospital "for many hundred sick people fitted for their sojourn there, and had placed in it, the way described, a complete collection of all articles for use. There also he gave to each sick person a special slave (attendant.). "Two of the important officers in his administration were Mahavedana (Chief Physician) and Sulu Vedana (the Deputy Chief Physician). The royal hospitals were staffed with both male and female attendants.
Inscriptions belongings to early centuries of the Christian era make numerous references to physicians and medical facilities. "Vedana " (Physician) appears to have been a respected member of the community. Grant of medical facilities to Buddhist monks was considered an act of great charity as evidenced by references to such grants in inscriptions. By the 9th and 10th centuries A.D. there are references to hospitals; dispensaries to refer at this stage to the view held by some that Sri Lanka was the first country in the world to have established a hospital in the modern sense of the term.
The slab inscription at Mihintale belonging to the reign of Mahinda IV (956-972 A.D.) is of special interest to the students of the Ayurveda. It refers to the practice of application of leeches to get rid of impure blood, a practice followed to this day.
The remains of the monastic hospital at Mihintale of which a detailed description has been given by Mr. H.C.P. Bell in the Annual Report of the Archaeological Survey of Ceylon for 1910-II provides the best archaeological evidence of a medieval hospital in Sri Lanka. Of special interest is the sarcophagus-like trough of stone called "medicine boat" discovered at this place. Such troughs have also been discovered at Thuparama (in Anuradapura) and at Medirigiriya.
The people of ancient Sri Lanka have exhibited a high degree of technical skill in the matter of provision of sanitary facilities. There are remains of privies, urinals and bath rooms. There were bath rooms paved with stoneslabe and provided with well carved basins of stone for washing purposes.
Drainage was carefully planned. At DaladaMaligawa (Temple of the Tooth) in Anuradhapura a drain to the distance of 400 it has been traced. Dr. Senarat Paranavitharana while studying the excavations of Parakramabahu'spalace at Panduwasnuwara has discovered a very interesting type of latrine and urinal with acement floor. The solied water from closet was conducted along a conduit into a circular brick-built pit lined up with rings of terra cotta.
Meticulous attention was paid to the provision of clean drinking water. This is proved by the remains of numerous wells discovered. Clean water provided for bathing too. Remains of stone baths are found in Anuradhapura and Polonnaruwa. Water was brought into these from tanks and channels in the neighborhood by means of underground pipes of stone or terra cotta. Outlets, made of stone were provided to empty them when it was necessary.
Great care was exercised in keeping the cities clean. As early as the reign of King Pandukabhaya (4thcentury B.C.) a special officer called Nagaraguttika was appointed to look into the sanitation and public safety in the city.Chandalas(People of low caste) were especially employed to clean the streets and the sewers and to carry corpses.
During the period of the ruler of Sinhalese Kings, Ayurvedasystem of medicine flourished in this country. It received active royal patronage. The physicians enjoyed a pride of place in society. The Buddhist temples as the repository of knowledge preserved the religions as well as the medical texts.
With the establishment of the colonial rule, indigenous arts and sciences were neglected. Ayurveda received no official support from the rulers. The oriental languages were relegated to the background. This was a further blow to the Ayurveda as knowledge of Sanskrit is vital to the study of this system of medicine.
As Gunner Myrdal has said (Asian Drama Vol. III-page 1562) during the period of colonial rule,Most south East Asians did not have access to modern medical care.It was available mainly to colonial officials (both civil and military) other Europeans and to a very limited number of native born persons in upper strata of society. The facilities were however gradually extended to the plantation.Sri Lanka was however in a comparatively more advanced in this field when compared to many South East Asian countries. Professional medical training was begun in 1870. At the end of the colonial rule there was passed from generation to generation.
Though deprived of official support, Ayurveda did not pass from scene. Majority of the people particularly in the rural areas depended on Ayurveda, for treatment of their illnesses. There were "traditional" physicians who practiced this system of medicine. Though they lacked the formal training of a physician, the knowledge they acquired by years of patient study and practical training was passed from generation to generation.
This was an anomalous situation. The modern system of medicine which was adopted and encouraged by the government catered only to a small fraction of the population. The indigenous system which a great majority of the population practiced was not given the due recognition. There was very little awareness at least higher classes in society, faithfully imitating the West, looked down upon indigenous culture as something inferior. Even the practitioners of Ayurveda medicine were referred to by a term generally considered to be derogatory-quite in contrast to the position that prevailed some centuries previously. Such was the position Ayurveda was reduced to, till the early years of the present century.
THE REVIVAL OF AYURVEDA
Four centuries of foreign rule had led to a neglect of many aspects of indigenous culture. This was particularly true of indigenous medicine. Especially during the period of British rule allopathic medicine was greatly encouraged resulting in a decline and neglect of Ayurveda. From the second decade of the present century onwards, however there was a movement for revival. This movement came in the wake of an agitation for political independence. It derived the active support of some of the national leaders, who succeeded in enlisting the support of the administration for winning some concessions for the development of Ayurveda.
In 1925 there was a demand by some members of the Legislative Council for the allocation of a sum of money for the training of Ayurvedic physicians. This was followed by the passing of a resolution for the appointment of a committee to study the feasibility of this proposal. The Committee recommended, inter alia, that a Board of Indigenous Medicine be constituted to deal with the subject of training of physicians, and that a College is set up in Colombo for this purpose with a hospital and an outdoor dispensary attached to it.
The first Board of Indigenous Medicine constituted in pursuance of this recommendation consisted of following members. Mr. K. Balasingham (Lowyer and member of the Legislative Council-Chairman)Mr. A. F. (later Sir Francis) Molamure (subsequent by the speaker of the House of Representatives) Hon. D. S. Senanayaka (who became the first Prime Minister of Independent Sri Lanka) Hon. W. A. de Silva (who later became Minister of Health) Mr. (Later Sir) D. B. Jayathillaka (who became the Leader of the House in the State Council) Mr. Donald Obeysekara (Bar-at-law and chairman of the Oriental Studies Society) Mr. C. Mthukumara and Mr. M. S. P. Samarasinghe.
All of them are remembered for their untiring efforts to restore Ayurvedato its due place. Two of them however stand out prominently. They are-Mr. K. Balasingham,due to whose efforts the College and Hospital at Borella were founded and Mr. Donald Obeysekara who made a significant contribution for the promotion of Ayurvedic medical education.
The setting up of the College and the Hospital at Borella in 1929 is an important landmark in the movement for the revival of Ayurvedain this country. Between 1929 and 1961 when the Ayurveda Act was enacted is a formative period, the major part of which is marked by the role played byb Hon. S. W. R. D. Bandaranayake. His tenure of office as Prime Minister (1956-1959) gave him an ample opportunity to work for the upliftment of the indigenous system ofd medicine.
In the field of Ayurveda Hon. S. W. R. D. Bandaranayakeis chiefly remembered for his efforts in placing the College and the Hospital which were originally state aided organizations under direct state management, for the provision of administrative machinery for the registration of Ayurvedic practitioners and for the establishment of the Department for the Development of Indigenous Medicine.
He also made a substantial contribution to the development of the Ayurvedic curative services by initiating a programmer of construction of Ayurvedic hospitals under the management of the Department.
However, it is with the enactment of the Ayurveda Act No. 31 of 1961 that the solid foundation for the development of Ayurveda can said to have been laid. The legal framework and the administrative structure brought about as a result of the coming into operation of this Act have been dealt with in chapter 4.
Since the implementation of this Act the following important steps have been taken.
The subjects and functions pertaining to Ayurveda are in the charge of the Ministry of Health. Since their very inception the Department of Ayurveda, the Ayuvedic Drugs Corporation and the statutory bodies created under Ayurveda Act have come within the purview of this Ministry.
On the 14th of February 1980 the new project Ministry of Indigenous Medicine was created. To this Ministry were assigned the supervision and execution of policy in respect of institutions, subjects and functions categorized under "Ayurvedic Medical Services".
However the Ministry of Health retains control in policy matters and maintains a general supervision over these activities. In any statute pertaining to Ayurveda in which the term "Ministry" occurs it is construed as a reference to the Minister of Health. Appointments to statutory bodies under the Ayurveda Act and the Ayuvedic Drugs Corporation are made by the Minister of Health.
The establishment of a separate Ministry of Indigenous Medicine is regarded as an event of great significant for the development of Ayurveda in this country. This is the first time a separate Ministry for Indigenous Medicine was set up anywhere in the world. It is also of interest to note that Hon. Dharmasena Attygalle, M.P., who was appointed as the first Minister of Indigenous Medicine is a reputed Ayurvedic Physician, hailing from a family of well known physicians.
There are two institutions under the supervision of the new Ministry: the Department of Ayurveda,, in charge of the curative services, regulatory functions, research and certain matters pertaining to Ayurvedic Drugs Corporation engaged in the production and sale of Ayurveda Drugs.
The Department of Ayurveda executes some of the functions assigned to it through its own administrative network. The rest of the functions are performed through three statuary bodies set up under the Ayurveda Act, viz: the Ayurvedic Medical Council, Ayurveda Educational and Hospital Board and the Ayurvedic Research Committee, one non statutory committee, viz: the Ayurveda Formulary Committee and the Research Institute at Nawinna.
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