Free ebooks ==> www.Ebook777.com Well-Mannered Medicine This page intentionally left blank www.Ebook777.com Well-Mannered Medicine Medical Ethics and Etiquette in Classical Ayurveda DA GMA R W UJA ST Y K www.Ebook777.com Oxford University Press is a department of the University of Oxford It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide Oxford New York Auckland Cape Town Dar es Salaam Hong Kong Karachi Kuala Lumpur Madrid Melbourne Mexico City Nairobi New Delhi Shanghai Taipei Toronto With offices in Argentina Austria Brazil Chile Czech Republic France Greece Guatemala Hungary Italy Japan Poland Portugal Singapore South Korea Switzerland Thailand Turkey Ukraine Vietnam Oxford is a registered trademark of Oxford University Press in the UK and certain other countries Published in the United States of America by Oxford University Press 198 Madison Avenue, New York, NY 10016 © Oxford University Press 2012 All rights reserved No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission in writing of Oxford University Press, or as expressly permitted by law, by license, or under terms agreed with the appropriate reproduction rights organization Inquiries concerning reproduction outside the scope of the above should be sent to the Rights Department, Oxford University Press, at the address above You must not circulate this work in any other form and you must impose this same condition on any acquirer Library of Congress Cataloging-in-Publication Data Wujastyk, Dagmar Well-mannered medicine : medical ethics and etiquette in classical Ayurveda / Dagmar Wujastyk p cm Includes bibliographical references (p ) ISBN 978–0–19–985626–8 (hardcover : alk paper) — ISBN 978–0–19–985996–2 (pbk : alk paper) — ISBN 978–0–19–985627–5 (ebook) Medicine, Ayurvedic Medical ethics—India I Title R605.W85 2012 2011041072 174.2 95538—dc23 ISBN 978–0–19–985626–8 ISBN 978–0–19–985996–2 Printed in the United States of America on acid-free paper Free ebooks ==> www.Ebook777.com Contents Acknowledgments vii Abbreviations ix Introduction 1 The Pillars of Treatment 26 On Becoming a Physician 68 On Continued Learning and Interaction with Peers 106 To Care or Not to Care 110 The Rewards of Medical Practice 117 Veracity in the Doctor–Patient Relationship 124 Ethical Elisions 142 Concluding Reflections 147 Appendices: Sanskrit Text Passages 155 A The Pillars of Treatment 157 B On Becoming a Physician 168 C On Continued Learning and Interaction with Peers 176 D To Care or Not to Care 177 www.Ebook777.com Free ebooks ==> www.Ebook777.com vi Contents E The Rewards of Medical Practice 179 F Veracity in the Doctor–Patient Relationship 182 Notes 186 Bibliography 221 Index 229 www.Ebook777.com Free ebooks ==> www.Ebook777.com Acknowledgments writing a book can be a challenging undertaking, and I am grateful for the encouragement and support I have received from family, friends, and colleagues over the years My special thanks go to Professor Konrad Klaus for his supervision of my doctoral thesis I would also like to thank Dr Elizabeth de Michelis, Dr Mark Singleton, Rajashree Dhanaraj, Professor Frederick Smith, Dr Suzanne Newcombe, Dr Rick Weiss, Professor Martha Selby, Professor Jan Gerrit Meulenbeld, Professor Kenneth Zysk, Dr Philipp Maas, Professor Karin Preisendanz, Katrin Wellmann, and Dr Dominik Wujastyk, who all have contributed either directly or indirectly to this volume www.Ebook777.com Free ebooks ==> www.Ebook777.com This page intentionally left blank www.Ebook777.com Free ebooks ==> www.Ebook777.com Abbreviations Ah As Bhel Bh¯av Ca Cik H¯a HIML Ind K.A K¯as´ Madh M¯adh Manu MW Ni Purv ¯ ´ a S¯ ´ ar S¯ Skt Si Su Su ¯ Utt As.t.a¯ ngahr ˙ dayasam hit¯a As.t.a¯ ngasam ˙ graha Bhelasam hit¯a Bh¯avaprak¯a´sa Carakasam hit¯a Cikits¯asth¯ana, or Cikitsasth¯ana in the case of the K¯a´syapasam hit¯a H¯ar¯ıtasam hit¯ a History of Indian Medical Literature Indriyasth¯ana Kaut.il¯ıya Artha´sa¯ stra K¯a´syapasam hit¯a Madhyakhan.d.a M¯adhavanid¯ana M¯anavadharma´sa¯ stra/ Manusmr.ti Monier-Williams: A Sanskrit–English Dictionary Nid¯anasth¯ana Purvakhan ¯ d.a ´ ar¯ırasth¯ana S¯ ´ arngadharasam S¯ ˙ hit¯a Sanskrit Siddhisth¯ana Su´srutasam hit¯a Sutrasth¯ ¯ ana Uttarasth¯ana, or Uttaratantra in the case of the Su´srutasam hit¯a www.Ebook777.com Free ebooks ==> www.Ebook777.com 224 Bibliography Leslie, Charles (ed.) (1998 [1976]) Asian Medical Systems: A Comparative Study Indian Medical Tradition Delhi: Motilal Banarsidass Leslie, Julia, and Dominik Wujastyk (1991) “The Doctor’s Assistant: Nursing in Ancient Indian Medical Texts.” In Pat Holden and Jenny Littlewood (eds.), Anthropology and Nursing, 25–30 London: Routledge Liétard, Gustave (1858) “Essai sur l’histoire de la médicine chez les Indous.” Ph.D Diss Reprinted in Ros¸u 1989, 5–62 ——— (1862) Lettres historiques sur la médecine chez les Indous Paris: Victor Masson et Fils Reprinted in Ros¸u 1989, 63–140 ——— (1864?) “Sus¸ruta.” In Dictionnaire encyclopédique des sciences médicales publié sous la direction de A Dechambre, 634–675 Paris: P Asselin, Sr de Labé, V Masson et Fils Reprinted in Ros¸u 1989, 141–180 Lipner, Julius J (1989) “The Classical Hindu View on Abortion and the Moral Status of the Unborn.” In Coward et al (1989), chap Maas, Philipp A (2006) Sam¯adhip¯ada: Das erste Kapitel des P¯atañjalayoga´sa¯ stra zum ersten Mal kritisch ediert Vol of Geisteskultur Indiens: Texte und Studien; Indologica Halensis Aachen: Shaker Dissertation Bonn, Univ., 2004 ——— (2009) “The Concepts of the Human Body and Disease in Classical Yoga ¯ and Ayurveda.” Wiener Zeitschrift für die Kunde Südasiens 51: 123–162 Magner, Lois N (1997) Doctors, Nurses, and Medical Practitioners: A Biobibliographical Sourcebook Westport, Conn Greenwood Press Includes bibliographic references and index Maithrimurthi, Mudagamuwe (1999) Wohlwollen, Mitleid, Freude und Gleichmut: Eine ideengeschichtliche Untersuchung der vier apram¯an.as in der buddhistischen Ethik und Spiritualität von den Anfangen bis hin zum frühen Yog¯ac¯ara Vol 50 of Alt- und neu-indische Studien Stuttgart: Steiner Malamoud, Charles (2002) “Doctors as Characters in Sanskrit Narrative Literature.” ¯ In Ana Salema (ed.), Ayurveda at the Crossroads of Care and Cure: Proceedings of the Indo-European Seminar on Ayurveda held at Arrábida, Portugal, in November 2001, 24–30 Lisbon: Centro de História del Além-Mar, Universidade Nova de Lisboa Mazars, Guy (1995) La médecine indienne Que Sais-je? Paris: Presses Universitaires de France ——— (2006) A Concise Introduction to Indian Medicine Vol of Indian Medical Tradition Delhi: Motilal Banarsidass Menon, I A., and H F Haberman (1970) “The Medical Students’ Oath of Ancient India.” Medical History 14: 295–299 Meulenbeld, Gerrit Jan (1974) The M¯adhavanid¯ana and Its Chief Commentary: Chapters 1–10 Introduction, Translation, and Notes Leiden: Brill ——— (1987) “Reflections on the Basic Concepts of Indian Pharmacology.” In Gerrit Jan Meulenbeld and Dominik Wujastyk (eds.), Studies on Indian Medical History, 1–17 Groningen: Forsten www.Ebook777.com Free ebooks ==> www.Ebook777.com Bibliography 225 ——— (1999–2002) A History of Indian Medical Literature vols Groningen: E Forsten ——— (2008) The M¯adhavanid¯ana with “Madhuko´sa,” the Commentary by ´ ıkan.t.hadatta (Ch 1–10) Introduction, Translation, and Notes Vijayaraks.ita and Sr¯ 2nd ed Indian Medical Tradition, New Delhi: Motilal Banarsidass Monier-Williams, Monier (1993) A Sanskrit – English Dictionary Etymologically and Philologically Arranged with Special Reference to Caognate Indo–European Languages New Edition, Geatly Enlarged and Improved Delhi: Motical Banarsidass Publish Private Limited Mookerji, Radha Kumud (1947) Ancient Indian Education (Brahmanical and Buddhist) London: Macmillan Müller, R F G (1934) “On Sattva, Rajas and Tamas in the Old Indian Medicine.” Journal of Ayurveda 10(8): 295–302 Nadkarni, A K (1954) Dr K M Nadkarni’s Indian Materia Medica, with Ayurvedic, Unani-tibbi, Siddha, Allopathic, Homeopathic, Naturopathic & Home Remedies, Appendices & Notes vols Bombay: Popular Prakashan Norman, K R (1992) The Group of Discourses (Sutta-Nip¯ata) Vol Revised Translation with Introduction and Notes Pali Text Society Translation Series No 45, Oxford: Pali Text Society Nutton, Vivian (2004) Ancient Medicine Series of Antiquity London: Routledge Oberlies, Thomas (2002) “Milch und Soma: Die Formalien eines Vertragsschlusses.” Studien zur Indologie und Iranistik 23: 71–90 Oldenberg, Hermann (1886) The Grihya-Sutras ¯ Rules of Vedic Domestic Ceremonies Pt 1, Sankhayana-Grihya-Sutra; Asvalayana-Grihya-Sutra; Paraskara-GrihyaSutra; Khadira-Grihya-Sutra No 29 in Sacred Books of the East, Oxford: Clarendon Press Olivelle, Patrick (1999) Dharmasutras ¯ The Law Codes of Ancient India A New Translation by Patrick Olivelle World’s Classics Oxford: Oxford University Press ——— (2005) Manu’s Code of Law A Critical Edition and Translation of the M¯anavaDharma´sa¯ stra South Asia Research Oxford: Oxford University Press Pandya, S K (1999) “Medical Ethics in India: Then and Now.” In H August van Alphen, (ed.), Neurosurgery and Medical Ethics, 35–46 New York: Springer Pollock, Sheldon (1985) “The Theory of Practice and the Practice of Theory in Indian Intellectual History.” Journal of the American Oriental Society 3(105): 499–519 ——— (1989) “M¯ım¯am s¯a and the Problem of History in Traditional India.” Journal of the American Oriental Society 109(4): 603–610 Preisendanz, Karin (2007) “The Initiation of the Medical Student in Early Classical ¯ Ayurveda: Caraka’s Treatment in Context.” In Karin Preisendanz (ed.), Expanding and Merging Horizons: Contributions to South Asian and Cross-cultural Studies in Commemoration of Wilhelm Halbfass Vienna: Verlag der Oesterreichischen Akademie der Wissenschaften www.Ebook777.com Free ebooks ==> www.Ebook777.com 226 Bibliography ——— (2009) “Logic, Debate and Epistemology in Ancient Indian Medicine and Philosophy—an Investigation.” Indian Journal of History of Science 44(2): 261–312 Prets, Ernst, and Joachim Prandstetter (1991–) Terminologie der frühen philosophischen Scholastik in Indien: Ein Begriffswörterbuch zur altindischen Dialektik, Erkenntnislehre und Methodologie Österreichische Akademie der Wissenschaften, Philosophisch-Historische Klasse, Denkschriften, 223, band 1–2 Vienna: Verlag der Österreicheischen Akademie der Wissenschaften Band (1991): A–I, Band (1996): U–Pu ¯ Puschmann, Theodor (ed.) (1891) A History of Medical Education from the Most Remote to the Most Recent Times London: H K Lewis Raghavan, V., K Kunjunni Raja, C S Sundaram, N Veezhinathan, and N Gangadharan (1949–) New Catalogus Catalogorum, an Alphabetical Register of Sanskrit and Allied Works and Authors Madras University Sanskrit Series, Madras: University of Madras References to vol.1 are to the revised 1968 edition Raison, Alix (1974) La H¯aritasam hit¯a: Texte médical sanskrit Publications de l’Institut franc¸ais d’indologie; no 52 Pondicherry: Institut franc¸ais d’indologie Ramachandra Rao, S K., and S R Sudarshan (1985–87) Encylopaedia of Indian Medicine Bombay: Popular Prakashan Ros¸u, Arion (1989) Un demi-siècle de recherches a¯ yurvédiques Gustave Liétard et Palmyr Cordier: Travaux sur l’histoire de la médecine indienne Paris: Institut de Civilisation Indienne Roth, Rudolph (1872) “Indische Medicin Caraka.” Zeitschrift der Deutschen Morgenländischen Gesellschaft 26: 441–452 Scharfe, Hartmut (1999) “The Doctrine of the Three Humors in Traditional Indian Medicine and the Alleged Antiquity of Tamil Siddha Medicine.” Journal of the American Oriental Society 119(4): 609–629 ——— (2002) Education in Ancient India No 2: South Asia, 16 in Handbuch der Orientalistik Leiden: Brill Selby, Martha Ann (2005) “Narratives of Conception, Gestation, and Labour in ¯ Sanskrit Ayurvedic Texts.” Asian Medicine, Tradition and Modernity, 1(2): 254–275 Sharma, Priya Vrat (1999–2001) Su´sruta-Sam hit¯a, with English Translation of Text and D.alhan.a’s Commentary Alongwith [ sic] Critical Notes vols Vol of Haridas Ayurveda Series Varanasi: Chaukhambha Visvabharati ——— (2003) Caraka-Sam hit¯a: Agnive´sa’s Treatise Refined and Annotated by Caraka and Redacted by Dr.d.habala (Text with English Translation) vols Delhi: Chaukhambha Orientalia Siegel, Lee (1985) “How Many Vaidyas Does It Take to Change a Lightbulb? The Satire of Physicians in Sanskrit Literature.” Bulletin d’Études Indiennes 3: 167–193 ——— (1987) Laughing Matters: Comic Tradition in India Chicago: University of Chicago Press ¯ Singhal, G D., and Pt Damodar Sharma Gaur (1963) Surgical Ethics in Ayurveda Chowkhamba Sanskrit Studies Vol 40 Varanasi: Vidya Vilas Press www.Ebook777.com Free ebooks ==> www.Ebook777.com Bibliography 227 Sivarajan, V V., and Indira Balachandran (1994) Ayurvedic Drugs and Their Plant Sources New Delhi: Oxford & IBH Smith, Frederick M (2006) The Self-Possessed: Deity and Spirit Possession in South Asian Literature and Civilization New York: Columbia University Press Srikantha Murthy, K R (1991–95) V¯agbhat.a’s As.t.a¯ ñga Hr.dayam: Text, English Translation, Notes, Appendix, and Indices vols Varanasi: Krishnadas Academy ——— (1993) M¯adhava Nid¯anam (Roga Viniscaya) of Madhavakara (a Treatise on ¯ Ayurveda) Text with English Translation, Critical Introduction and Appendices Delhi: Chaukhambha Orientalia ——— (1995–97) As.t.a¯ ñga Samgraha of V¯agbhat.a: Text, English Translation, Notes, Indices etc vols Varanasi: Chaukhambha Orientalia ——— (1998–) Bh¯avaprak¯a´sa of Bh¯avami´sra (Text, English Translation, Notes, Appendices, and Index) Varanasi: Krishnadas Academy One volume published to date Staal, Frits (2008) Discovering the Vedas New Delhi: Penguin Books India Subrahmanya Ayyar, K V (1984) “The Tirumukkudal Inscription of Virarajendra.” In Epigraphia Indica, vol 21, 1931–32, chap 38, 220–250 Calcutta: Superintendent of Government Printing Reprinted 1984 Tewari, Premvati (1996) K¯a´syapa-sam hit¯a or Vr.ddhaj¯ıvak¯ıya Tantra: Text with English Translation and Commentary Varanasi: Chaukhambha Visvabharati Trautmann, Thomas R (1971) Kaut.ilya and the Artha´sa¯ stra: A Statistical Investigation of the Authorship and Evolution of the Text Leiden: Brill ¯ arya, J¯adavji (ed.) (1992a) Carakasam Trikamji Ac¯ hit¯a, ´sr¯ıcakrap¯an.idattaviracitay¯a a¯ yurvedad¯ıpik¯avy¯akhyay¯a sam valit¯a 5th ed New Delhi: Munshiram Manoharlal ——— (1992b) Su´srutasam hit¯a, ´sr¯ıd.alhan.a¯ c¯aryaviracitay¯a nibandhasam grah¯akhyavy¯akhyay¯a nid¯anasth¯anasya ´sr¯ıgayad¯as¯ac¯aryaviracitay¯a ny¯ayacandrik¯akhyapañjik¯a¯ aryop¯ahvena trivikram¯atmajena y¯adava´sarman.a¯ vy¯akhyay¯a ca samullasit¯a Ac¯ sam ´sodhit¯a 5th ed Delhi: Caukhambh¯a Oriyant.a¯ liy¯a Valiathan, M S (2007) The Legacy of Su´sruta Chennai: Orient Longman ——— (2003) The Legacy of Caraka Chennai: Orient Longman ´ arngadhara-Sam Vidyasagar, Parashuram Shastri (1986) The S¯ ˙ hit¯a by Pan.d.ita ´S¯arngadhar¯ ˙ ach¯arya Son of Pan.d.ita Damodara with the commentaries Adhamalla’s “Dipika” and Kashirama’s “Gudhartha-Dipika.” Edited with footnotes Krishnadas Ayurveda Series 14 Varanasi: Krishnadas Academy Warrier, P K., V P K Nambiar, and C Ramankutty (eds.) (1994–96) Indian Medicinal Plants: A Compendium of 500 Species Vaidyaratnam P S Varier’s Arya Vaidya Sala, Kottakal vols Madras: Orient Longman Wezler, A (2003) “Sampad of Bhagavadg¯ıt¯a XVI Reconsidered.” In Har¯anandalahar¯ı: Volume in Honour of Professor Minoru Hara on His Seventieth Birthday, 433–455 Reinbek: Dr Inge Wezler Verlag für Orientalistische Fachpublikationen www.Ebook777.com Free ebooks ==> www.Ebook777.com 228 Bibliography Wezler, Albrecht (1984) “On the Quadruple Division of the Yoga´sa¯ stra, the Caturvyuhatva ¯ of the Cikits¯as´ a¯ stra and the ‘Four Noble Truths’ of the Buddha.” Indologica Taurinensia 12: 289–337 Wilson, H H (1823) “Medical and Surgical Sciences of the Hindus.” Asiatic Journal and Monthly Register for British India and Its Dependencies 16: 207–212, 349–356 Wise, Thomas A (1845) Commentary on the Hindu System of Medicine Calcutta: Thacker Woodward, F L., E M Hare, and Pali Text Society (1986–92) The Book of the Gradual Sayings: Anguttara-Nik¯aya, or, More-Numbered Suttas Translation series no 22, 24–27 Reprint London: Pali Text Society Originally published: London: Luzac, 1932–36 Wujastyk, Dominik (1993) “Indian Medicine.” In W F Bynum and Roy Porter (eds.), Companion Encyclopedia of the History of Medicine, vol 1, chap 33, 755–778 vols London: Routledge ¯ ——— (2003) The Roots of Ayurveda: Selections from Sanskrit Medical Writings 3rd updated ed., London Penguin Group ——— (2004a) “Agni and Soma: A Universal Classification.” Studia Asiatica: International Journal for Asian Studies 4–5: 347–370 ——— (2004b) “Medicine and Dharma.” Journal of Indian Philosophy 32(5): 831–842 ——— (2007–8) “Post-classical Indian Traditions of Medical Debate and Argumentation.” eJournal of Indian Medicine 2(3): 67–81 ——— (in preparation) “The Rog¯arogav¯ada of V¯ıre´svara: A Critical Edition and Translation.” Young, Katherine K (1989) “Euthanasia: Traditional Hindu Views and the Contemporary Debate.” In Coward et al (1989), chap Zimmer, Henry R (1948) Hindu Medicine Baltimore: Johns Hopkins University Press Posthumous publication Zimmermann, Francis (1999 [1987]) The Jungle and the Aroma of Meats: An Ecological Theme in Hindu Medicine Vol of Indian Medical Tradition Delhi: Motilal Banarsidass Originally published Berkeley: University of California Press, 1987 Zysk, Kenneth G (1998 [1991]) Asceticism and Healing in Ancient India: Medicine in the Buddhist Monastery, vol of Indian Medical Tradition 2nd ed Delhi: Motilal Banarsidass Originally published 1991 ——— (1999) “Mythology and the Br¯ahman.ization of Indian Medicine: Transforming Heterodoxy into Orthodoxy.” In Folke Josephson (ed.), Categorisation and Interpretation, 125–145 Göteborg: Meijerbergs institut för svensk etymologisk forskning, Göteborgs universitet ——— (2000) Asceticism and Healing in Ancient India: Medicine in the Buddhist Monastery Vol of Indian Medical Tradition 3rd ed Delhi: Motilal Banarsidass Originally published 1991 www.Ebook777.com Free ebooks ==> www.Ebook777.com Index A abortion and contraception, 143–145, 212n382 action, medical context of, 195n100 adhvaryu, 194n85 advertising, permission for, 49 “Aghastier Vytia Anyouroo,” Ainslie, Whitelaw, 8, 186n8 anaesthetics, availability of, 32–33 Ancient Indian Education: Brahmanical and Buddhist (Mookerji), 11 an.ga, 26, 38 anr.ta (dishonesty), 126 appearance of practitioner after graduation, 104–105 as prerequisite to physician’s practice, 49 as prerequisite to student acceptance, 75, 76 of student at initiation, 80–81 aris.t.a (foreshadowing of death), 111, 112 Artha´sa¯ stra punishment for failed treatment, 114–115 relation between theory and practice in, 41 assisted suicide, 145 As.t.a¯ ngahr ˙ dayasam hit¯a four pillars and, 26, 33–34, 190n64 history of text, 17–18 translation source for study, 24 As.t.a¯ ngasam ˙ graha description of student’s conduct, 88–89 four pillars and, 26, 33–34, 190n64 history of text, 18 Athavale, K V., 14 Athavale, V B., 14 attendants acting as a diversion, 62 characteristics desired in, 59 four pillars and, 59–67 as friends, 64 Ka´syapa’s perfection in, 35 midwives, 64–65 non-nursing personnel, 63–64 professional status of, 60–61 quartet of good qualities, 27 relationship with patient, 60 role of in ayurvedic medical ethic, 151–152 as servants of patient, 61–62 as servants of physician, 61 societal status of, 33, 60 those who know plants, 66 wet-nurses, 65–66 authority, claims of, in medical market competition, 42 autonomy, respect for, defined, 124 ¯ Ayurveda modern practice of, 15 mythic origins of, 110 precepts of, 1–2 suitable classes to practice, 118–119, 213n394 ayurvedic medical ethic allowance for dishonesty in, 148–149 benevolent paternalism in, 150 common code of professional conduct, 147 compared to Greek concept, compassion, 150 correspondence with societal rules, 148 difference by class, 152–153 divergence from brahmanic law, 148 doctor-patient interaction, 150–151 duties of the patient in, 151 www.Ebook777.com Free ebooks ==> www.Ebook777.com 230 Index ayurvedic medical ethic (cont.) link to Buddhist thought, 150, 207n296 literature on, 7–16 moral implications of, 149 philanthropy, 149 physician’s dharma and, 153 role of attendants in, 151–152 role of colleagues in, 152 search for, similarity to brahmanic literature, 147–148 similarity to good conduct in general, 147 trustworthiness, 150 virtues required in, 149–150 ayurvedic tradition connection to Greek medicine, continuity of, core texts of, 1–2 literary evolution of, medical vs general ethics, 3–4 ayurvedic treatises commentaries on, 20–22 contents of, evolution of, 3–4 link to brahmanic religious law, 23 medical ethic in, orthodoxy of, parallel with Buddhist literature, 22–23 similarities between, 4–5 works included, 16–20 B Basham, A L., 11 Beauchamp, Tom L., 124 beneficence, defined, 124 Benner, Dagmar See Wujastyk, Dagmar Bh¯avami´sra pillars of treatment and, 36–39 on quacks, 49 Bh¯avaprak¯a´sa contraceptives, 144 seven components of treatment, 26, 36–39 Bhelasam hit¯a four pillars of treatment, 26 history of text, 20 bhis.ak vs vaidya, 43 bhis.anm¯ ˙ anin, translation of, 196n109 biomedical ethics, Beauchamp and Childress on, 124 blood See bodily fluids bodily fluids in diagnosis, 53 and divine offerings, 100 effect on attendant-patient relationship, 33, 60 book learning, vs oral tradition, 70–71, 73–74 brahmac¯arin fire-ritual of initiation, 82 household duties of, 99 initiation compared to medical student, 100 items for initiation ceremony, 81 prescription of dress, 80 rules for conduct and appearance, 85–86, 88, 104, 148, 207n287 rules on salutation for, 207n288 sam sk¯ara right of, 81 status of twice-born, 100, 209n317 brahmac¯arya (celibacy) early source of term, 209n316 in medical students, 77, 88 translation of, 207n287 brahmanic culture acceptance of medicine, 103 adherence to food laws, 135–136 appropriation of medical knowledge, 100–101, 209n322 attendant-patient relationship in, 60 in Caraka’s instructions to students, 91–92 characteristics desired in patients, 52–53 conduct compared to medical students, 104–105 formal contracts in, 103–104 initiation compared to medical student, 99–100 literary tradition in, view of physicians, 100 brahmanic law, ayurvedic medical ethic and, 148 brahmin, 194n85 Buddhist literature ayurvedic treatises and, 22 happiness for all beings in, 207n296 image of physicians in, 209n321 C Cakrap¯an.idatta, interpretation of “knowledge,” 39–40 Caraka on adherence to food laws, 135–136 www.Ebook777.com Free ebooks ==> www.Ebook777.com Index on affordability of treatment, 117–118 on the “always ill” person, 54 on attaining virtue, 121–122 on attendants, 61–62 on categories of physicians, 42–43 on continued learning, 106–109 on deception, 134 on dishonesty, 53–54 on earning a livelihood, 121, 214n406 on impulse control, 131 on initiation ceremony, 82–83, 104 on initiation of student, 78–80 on instruction for student’s behavior, 85–89 on method of study, 72–73 on pillars of treatment, 27–31 on refusing treatment of terminally ill, 113–114 on relation between theory and practice, 40 on risky procedures, 115 on savers vs destroyers of life, 43–44 on selection of medical students, 74–75 on selection of study materials, 68–70 on selection of teachers, 71 on student’s future behavior, 89–90 on teachers speech, 84–85 on treatment of madness, 137–138 Caraka’s Oath, 102 Carakasam hit¯a four pillars and, 26, 27–31, 190n64 history of text, 16–17 human conduct and disease, 126–127 translation source for study, 24 Carnegie, Dale, 93 case histories, 198n135 catus.p¯ada, 26, 190n63 celibacy See brahmac¯arya (celibacy), Su´sruta’s instructions to students on, 96 Central Council for Indian Medicine, 15 chadman and upadh¯a (deception), 126 charity cases, 118–119 Chattopadhyaya, Debiprasad, 11–12 Childress, James F., 124 cikits¯a´sa¯ stra, 192n74 “Classical Hindu View on Abortion and the Moral Status for the Unborn, The” (Lipner), 144 colleagues Ka´syapa’s instructions to students on, 97–98 231 role of in ayurvedic medical ethic, 152 colors, for student initiation, 80–81 Commentary on the Hindu System of Medicine (Wise), compassion (karun.a¯ ) parallel in Buddhist and ayurvedic literature, 23 as prerequisite to physician’s practice, 110, 211n354 compendia (sam hit¯a), compensation, non-monetary, 55 Concise Introduction to Indian Medicine, A (Mazar), 13 confidentiality Caraka’s instructions to students on, 90, 93 Ka´syapa’s instructions to students on, 97 conformity, Caraka’s instructions to students on, 93 continued learning/peer interaction Caraka and Su´sruta on, 106 Caraka’s instructions to students on, 90, 92 role of debate in, 106–107 role of discussion in, 107–109 Sanskrit text passages, 176 See also knowledge (vidy¯a) contraceptives, 144–145 Cordier, Palmyr, 10 Crawford, Cromwell, 14–15 cycles of existence, 6–7 D Dash, Bhagwan, 13 death, signs of impending, 111–112 deception, as therapeutic tool, 137–141 deception (chadman and upadh¯a), 126 deontological ethic, 94 Desai, Prakash N., 13 Deshpande, Madhav M., 6–7 devotion, medical context of, 195n100 dharma ¯ attainment through Ayurveda, 118 in M¯ım¯am sa philosophy, dharma literature, 23, 189n58 dh¯atu, translation of, 190n65 diagnosis, 53 disease causes of, 44 mythic origins of, 126–127 treatable vs untreatable, 112 www.Ebook777.com Free ebooks ==> www.Ebook777.com 232 Index dishonesty allowance for, 53–54, 93, 97, 105, 124–125, 133, 136–137 in ayurvedic medical ethic, 148–149 justification for, 149 roles of, 140–141 dishonesty (anr.ta), 126 disobedience, requirement for medical students, 86 doctor-patient relationship allowance for dishonesty in, 53–54, 93, 97, 124–125 Caraka’s instructions to students on, 93 Caraka’s view of, 31, 89–90, 91 parallel with societal relationships, 58 paternalism in, 54 patients’ duty to inform, 36, 52–53 patients’ duty to obey, 53 physicians’ duty to elicit information, 53 Su´sruta on, 125 Su´sruta’s view of, 33 Doctor–Patient Relationship in Ancient Indian Medicine (Lavekar), 13 “Doctors as Characters in Sanskrit Literature” (Malamoud), 14 dos.a See humors dr.s.t.akarmat¯a, 30 E Education in Ancient India (Scharfe), 14 emesis as preventative treatment, 62 See also bodily fluids Eragrostis cynosuroides Beauv., 204n233 ethics Caraka’s instructions to students on, 89–90 deontological ethic, 94 vs etiquette, 45 knowledge as part of, 92 as synonym for morality, etiquette Caraka’s instructions to students on, 89–90, 92, 93–94 defined, vs ethics, 45 lack of in quacks, 47 Su´sruta’s instructions to students on, 95–96 euthanasia, 145–146 F fate (daiva), 191n73 feces See bodily fluids fees amounts and types, 119–120 Caraka’s instructions to students on, 91 obligation of patient to pay, 121 pro-bono, 55, 117 unease about, 50–51 firewood, as insignia of student, 81 food poisoning, avoidance of, 63 foods, of student at initiation, 81 forbidden foods use in treatment, 135–136, 216nn441, 217nn442–443 See also meat, use of Foundation for the Revitalization of Local Health Traditions (FRLHT), 25 Four Noble Truths, 192n74 four pillars See pillars of treatment fraudulent physicians See quacks friends (suhr.d), 64 FRLHT (Foundation for the Revitalization of Local Health Traditions), 25 Fundamentals of Ayurvedic Medicine (Dash), 13 G garments, for student initiation, 80–81 Gaur, Damodar Sharma, 11 GBIF (Global Biodiversity Information Facility), 25 gerundives, Caraka’s lack of use of, 30 Global Biodiversity Information Facility (GBIF), 25 gocarmam¯atra, translation of, 206n271 good conduct in brahmanic culture, 104–105 comparison of medical authors on, 104 lay person vs physician, 94, 95, 96, 110, 139–140, 147 “great threesome,” 16 Greek medicine connection to ayurvedic tradition, use of case histories in, 198n135 grief (´soka), Caraka’s view of, 199n157 Gupta, Madhusudan, 187n14 H H¯ar¯ıtasam hit¯a, history of text, 20 Hars.ak¯ırti, 144 www.Ebook777.com Free ebooks ==> www.Ebook777.com Index Hastiruci, 145 Health and Medicine in the Hindu Tradition (Desai), 13 Hindu Bioethics for the Twenty-First Century (Crawford), 14–15 Hindu Medicine (Zimmer), 10 Hindu philosophy, 208n311 Hippocratic Oath, 3, 102, 124 history, mythical version of, 6–7 History of Indian Medical Literature (Meulenbeld), 18 honesty degree of in doctor-patient relationship, 132–133 epistemology of in doctor-patient relationship, 125–132 gun.as and, 129–130 human agency and, 130 human conduct and disease and, 126–127, 130–131 human typologies and, 127–129 impulses and, 131 intoxicating substances and, 129 physician’s honesty, 132–133 trust and, 125–126 hotr (sacrificer), 194n85 “how to win friends and influence people” (Carnegie), 93 hres.an¯ ˙ ıy¯am , translation of, 209n314 human agency, 130, 140 human conduct and disease Carakasam hit¯a on, 126–127 honesty and, 130–131 predetermination and, 191n73 human typologies, Su´sruta on, 127–129 humors imbalance of, 27, 190n65, 193n77 removal of excess, 194n86 I imperative mode, Caraka’s lack of use of, 30 impurity in physicians’ practice, 93 See also bodily fluids Indian pharmacology, 191n69 See also medicines Indu, on treatment of terminally ill, 114 initiation of medical students See medical students intelligence, medical context of, 195n100 233 J jit¯atman See self-controlled jñ¯anah¯ına (without knowledge), 43 Jolly, Julius, 3, 10 Jones, William, Jonsen, Albert A., 13 Jungle and the Aroma of Meat, The (Zimmermann), 133, 142–143 justice, defined, 124 K K¯amasutra ¯ (V¯atsy¯ayana), 145 karan.a, translation of, 204n230 karma, predetermination and, 191n73 karmadar´sana, 30 karmadr.s.t.i, 30 Ka´syapa on initiation ceremony, 83–84 pillars of treatment and, 34–36 on professional conduct, 96–98 on selection of teachers, 72 on student’s behavior, 88–89 K¯a´syapasam hit¯a four pillars and, 26, 34–36 history of text, 19–20 Kaut.il¯ıya Artha´sa¯ stra (Kaut.ilya), connection to medical treatises, 22 Kaut.ilya, 22 on relation between theory and practice, 41 kindness (maitr¯ı), parallel in Buddhist and ayurvedic literature, 23 kings ensuring safety of, 63 malpractice and, 48 as patients, 55–56 responsibility in malpractice, 48 kitchen staff, 63 knowledge (vidy¯a) effect of debate on, 108 expectations of in non-specialists, 70 formal transferal of, 41–42 as inextricable part of physician’s life, 106 medical vs general, 39–40 as part of physician’s ethic, 92 possibility of incorrectness, 108–109 as prerequisite to physician’s practice, 34, 75 Kokokka, 145 kr.tayuga, translation of, 215n420 kulina ¯ See well-born www.Ebook777.com Free ebooks ==> www.Ebook777.com 234 Index L land grants, as reward of medical practice, 119–120 Lavekar, G S., 13 Law Code of Manu, 23 Legacy of Caraka (Valiathan), 14 “lesser threesome,” 18 Liétard, Gustave, 10 life span, predetermination of, 191n73 Lipner, Julius, 144 logic (ny¯aya), as prerequisite to physician’s practice, 34, 36 long life span, as a component of medicine, 38–39 M Maas, Phillip, 23 madness, treatment of, 137–139 Mah¯avagga attendant-patient relationship in, 60 characteristics desired in patients, 52–53 place in Buddhist literature, 22 Malamoud, Charles, 14 Manusmr.ti, view of physicians, 100 Materia Medica of Hindoostan (Ainslie), 8, 186n8 Mazars, Guy, 13 meat, use of brahmanic law and, 148, 216nn434–437 medical classics and, 133–135 Zimmermann on, 142–143 See also forbidden foods “Medical and Surgical Sciences of the Hindus” (Wilson), medical education See physician training medical error, 146 medical ethics defined, Greek concept of, relativity of, 3–4 “Medical Ethics of Professionalized Ayurveda, The” (Benner), 15 medical license, awarded by king, 95, 115 medical paternalism, 54 shift toward autonomy, 124–125 veracity and, 124–125 medical practice, guidelines in ayurvedic textbooks, medical practice, rewards of attainment of virtue, 121–122 for avoiding unrighteous persons, 58 charity cases and, 118–119 compensation from patients, 55, 121 land grants, 119–120 necessity of wealth, 117–118 non-fiscal rewards, 122–123 Sanskrit text passages, 179 sponsorship of treatment, 120 medical students honesty in, 140 initiation ceremony for, 82–84, 102–103, 204n235 initiation compared to Vedic student, 99–100 instructions for behavior as practitioner, 89–105 instructions for behavior as student, 85–89, 206n274 preparation for initiation, 78–81 selection of, 74–78, 202n213, 203nn214–215 self-evaluation of, 69 vow of, 84–85 medical student’s oath, 102 “Medical Teaching in Ancient Times India” (Puschmann), medical training See medical students medical treatises authorship of, 41, 188n33 mythical origins of, 110 Medicin (Jolly), 10 “Medicine and Dharma” (Wujastyk), 188n22 medicines affordability of, 117 dispensed by quacks, 197n122 ethical use of, 26 harvesting of plants, 37–38, 190n61, 200n181 ineffectiveness in undeserving, 57 modern applications of, 188n33 quality of, 191n69 suitability of, 191n68 translation source for study, 25 use of food as, 148 messengers Bh¯avami´sra’s view of, 36–37 as representation of omens, 38, 112 Meulenbeld, Jan, 18–19 military medicine, agents in, 32 M¯ım¯am sa philosophy, modesty, Caraka’s instructions to students on, 93 www.Ebook777.com Free ebooks ==> www.Ebook777.com Index money as a component of medicine, 37, 38, 39, 54–55 lack of in patients, 55 necessity for patients, 117, 213n387 Mookerji, Radha Kumud, 11 moral expectations, of physician to treat, 115–116 moral implications, of ayurvedic medical ethic, 149 moral principles, Beauchamp and Childress on, 124 muhurta, ¯ translation of, 204n231 N naks.atras, in which initiation ceremonies are carried out, 204n235 “natural state,” interpretation of, 193n77 non-fiscal rewards, 122–123 nonmaleficence, defined, 124 nurses See attendants ny¯aya See logic Ny¯aya system of logic, 208n311 O Oberlies, Thomas, 103–104 obstetric practice, Ka´syapa’s instructions on, 36 omens of impending death, 111–112 representation by messengers, 37, 38 optative mode, Caraka’s lack of use of, 30 oral tradition, vs book learning, 70–71, 73–74 P p¯ada, 38, 190n63 p¯adacatus.t.aya, 26, 190n63 pain, mental as moral dilemma to physician, 143 treatment of mental illness and, 143 pain, physical alleviation of, 110, 150, 153, 192, 211n354 childbirth and, 64 the king as patient and, 56 lack of acknowledgment of, 143 as moral dilemma to physician, 143 perfect patient and, 35, 52 physicians’ practice and, 37, 53, 121 treatment of mental illness and, 137–138, 139 235 P¯ali Canon, 22, 198n135, 207n296 palliative care, 113 P¯atañjala Yogasutra, ¯ 23 paternalism, 54, 150–151 patient compliance, veracity and, 133–137 patients to be avoided, 56–57, 111, 198n142, 199n145, 199n155, 213n387 Bh¯avami´sra’s view of, 36 characteristics desired in, 52 duties of in ayurvedic medical ethic, 151 duty to avoid quacks, 45 duty to be equipped, 47 duty to inform, 36, 52–53 duty to obey, 53 Ka´syapa’s perfection in, 35 kings as, 55–56 as most important pillar, 53 noncompliance of, 47–48 pillars of treatment and, 51–59 quartet of good qualities, 27 refusal to treat poor, 55 wealth in, 117, 213n387 philanthropy, 149 physician training costs of, 188n28 initiation ceremony, 82–84 initiation preparation, 78–81 instructions for behavior as practitioner, 89–105 materials for study, 68–71 method of study, 72–74, 202n206 Sanskrit text passages, 168–175 selection of medical students, 74–78 selection of teacher, 71–72 teacher’s speech and students vow, 84–89 physicians advertising and, 49 appearance as prerequisite to practice, 49 Bh¯avami´sra’s view of, 37 Caraka’s view of, 27–31 categories of, 42–43 dharma and, 153 duty to elicit information, 53 established vs itinerant, 49–50 formal training of, 41–42 good vs bad, 43 hard vs soft skills of, 39–40 image in Buddhist literature, 209n321 importance of knowledge in, 32 instructions for behavior as practitioner, 89–105 www.Ebook777.com Free ebooks ==> www.Ebook777.com 236 Index physicians (cont.) Ka´syapa’s view of, 34–36 to the king, 56 lineage as prerequisite of practice, 44 malpractice and, 48 patients to avoid, 56–57 pillars of treatment and, 39–51 place in medical hierarchy, 120 public perception of, 102 quacks, 45–48 relation between theory and practice in, 40–41, 74 responsibility over kitchen staff, 63 savers vs destroyers of life, 43–44, 196n110 self-evaluation of, 69, 109 societal status of, 32, 48 success as prerequisite of practice, 41 Su´sruta’s views on, 31–33, 59–60 See also physician training; surgeons physicians’ manuals, 70–71 pillars of treatment, 26–67 according to Bh¯avami´sra, 36–39 according to Caraka, 27–31 according to Ka´syapa, 34–36 according to Su´sruta, 31–33 according to V¯agbhat.a, 33–34 the attendant, 59–67 described, 26 the patient, 51–59 the physician, 39–51 Sanskrit text passages, 157–167 translation of “p¯ada,” 190n63 poison, as medical treatment, 115 Pollock, Sheldon on ahistoricality of Sanskrit literature, 5–6 on relation between theory and practice, 41 practice, medical context of, 195n100 prakr.ti, interpretation of, 193n77 predetermination, 191n73 Preisendanz, Karin, 7–8 Principles of Biomedical Ethics (Beauchamp and Childress), 124 pro-bono treatment, 55 professional interactions at initiation ceremony, 103 Ka´syapa’s instructions to students on, 97–98 purgation as preventative treatment, 62 See also bodily fluids purification, for student initiation, 80–81 pus See bodily fluids Puschmann, Theodor, Q quacks avoidance of, 45, 197n122 behaviors of, 47–48 Bh¯avami´sra’s views of, 49 Caraka on, 42–43, 45, 46 fees of, 50–51 prevalence of, 50 Sanskrit terms for, 199n145 as “thorns” (kan.t.aka), 48 quartet of good qualities, in physicians, 27 quartet of pillars See pillars of treatment R rajas personality, 127–131 Ratirahasya (Kokokka), 145 reason, medical context of, 195n100 religious students description of student’s conduct, 89 duties of, 87 initiation compared to medical student, 99–100 respect for autonomy, defined, 124 righteousness, as central to medical practice, 153 ris.t.a (signs foreshadowing of death), 111 Roots of Ayurveda (Wujastyk), 13 Roth, Rudolph, rulers See kings S sam hars.a, translation of, 211n342 sam pad, translation of, 191n69, 195n92 sam sk¯ara rites, 200n178 Sanskrit text passages, on physician training, 168–175 ´ arngadharasam S¯ ˙ hit¯a, translation source for study, 24 ´sa¯ stra, ´sa¯ stra (manual), 70–71 sattva personality, 127–128, 131 satya (truth), 126 Scharfe, Hartmut, 14 Science and Society in Ancient India, 11–12 self-controlled (jit¯atman), as prerequisite to physician’s practice, 44 www.Ebook777.com Free ebooks ==> www.Ebook777.com Index seven pillars of treatment, 26 Shastri, J¯ıvar¯ama K¯alid¯asa, 187n16 shaven heads, for student initiation, 80 Short History of Aryan Medical Science (Singh Jee), 10 Short History of Medical Ethics (Jonsen), 13 Singh Jee, Bhagvat, 10, 187n16 Singhal, G D., 11 snake poison, as medical treatment, 115 societal rules, ayurvedic medical ethic and, 148 societal status of attendants, 33, 60 avoidance of patients based on, 57 ayurvedic medical ethic and, 152–153 of medical students, 75, 76, 77–78, 100 of physicians, 32, 48, 50, 93, 93–94, 100, 148 of religious students, 100 of students, 101 through orthodox practice of medicine, upon failure of treatment, 114 of wet-nurses, 66 South Asian culture, “sponsored” physicians Caraka on, 42–43 vs quacks, 44–45 study selection of materials, 68–71 selection of methods, 72–74 subservience, requirement for medical students, 86–87 success as prerequisite of practice, medical context of, 195n100 suhr.d See friends support, medical context of, 195n100 surgeons development of skills, 74 physical abilities of, 32–33, 39, 76 place in medical hierarchy, 120 ¯ Surgical Ethics in Ayurveda (Singhal and Gaur), 11 Su´sruta on abortion, 144 on deception, 135 on doctor-patient relationship, 125 on human typologies, 127–129 on initiation ceremony, 82–83 on medical license, 115 on method of study, 73–74 pillars of treatment, 31–33 on pro-bono treatment, 118 on professional conduct, 95–96 237 on refusing treatment of terminally ill, 114 on relation between theory and practice, 40–41 on student’s behavior, 87–88 on treatment of madness, 139 Su´srutasam hit¯a four pillars and, 26, 31–33, 190n64 history of text, 17 poison as medical treatment, 115 translation source for study, 24 T tamas personality, 128–131 Tarkapanchanan, Abhaycharan, 187n14 tatra, translation of, 190n67 teachers initiation speech of, 84–89, 207n292 selection of, 71–72 terminally ill patients compassion in, 110–111 incurable illnesses in, 112–113 limits of medicine and, 115–116 permission for risky treatments, 115 punishment for treatment failures, 114–115 Sanskrit text passages, 177–178 signs of impending death, 111–112 withholding treatment of, 113–114 The Ideal Physician (Athavale and Athavale), 14 thrice-born, 101 training See medical students; religious students treatment affordability of, 117–118 charitable care, 119 deception as therapeutic tool, 137–141 of incurable illnesses, 112–113 limits of medicine, 115–116 malpractice and, 48 patients to avoid, 56–57, 198n142, 199n145, 199n155, 213n387 permission for risky, 115 pro-bono, 55, 117, 118, 213n394 punishment for failed, 114–115 sponsorship of, 120 violence in, 142–143 withholding, 113–114 tret¯ayuga, translation of, 215n420 Trimallabhat.t.a, 145 www.Ebook777.com Free ebooks ==> www.Ebook777.com 238 Index truth (satya), 126 twice-born, on completion of medical studies, 101 U udg¯atr (chanter), 194n85 unrighteous persons, reward for avoiding, 58 upanayana, earliest use of, 209n316 upanayavad, translation of, 208n311 urine See bodily fluids V vacana´sakti, translation of, 201n199 V¯agbhat.a on deception, 134 pillars of treatment and, 33–34 on pro-bono treatment, 118 on professional conduct, 98–99 on refusing treatment of terminally ill, 113 on terminal prognosis, 112–113 vaidya vs bhis.ak, 43 translation of, 199n145 vaidyam¯anin, translation of, 196n109 Vaidyarahasya (Vidy¯apati), 145 Vaidyavallabha (Hastiruci), 145 vai´sya community, charitable medical care, 119 Valiathan, M S., 14 V¯atsy¯ayna, 145 Vedas, 5–6 Vedic Engineering, 24–25 Vedic sacrifices, 194n85 Vedic student conduct and appearance of, 80, 88–89 initiation compared to medical student, 99, 101, 147–148 vegetarianism, medical classics and, 133–135 veracity, in doctor-patient relationship Caraka’s instructions to students on, 93 deception as therapeutic tool, 137–141 degree of honesty, 132–133 epistemology of, 125–132 medical paternalism and, 124–125 patient compliance and, 133–137 Sanskrit text passages, 182–185 See also honesty vidy¯a See knowledge Vidy¯apati, 145 violence, 142–143 virtue ¯ attainment through Ayurveda, 121–122 required in ayurvedic medical ethic, 149–150 Visuddhimagga (Buddhaghosa), 23 W wealth See money, as component of medical care, 117–118 Weiss, Rick, 187n11 ¯ as prerequisite to well-born (kulina), physician’s practice, 44 wet-nurses as attendants, 65–66 Wilson, Horace H., Wise, Thomas, WMA (World Medical Association), 15 women Ka´syapa’s instruction to students on, 97 refusal to treat, 92 Su´sruta’s instructions to students on, 95–96 Wonder That Was India, The (Basham), 11 World Medical Association (WMA), 15 Wujastyk, Dominik, 13, 107, 188n22 Y Yogacint¯aman.i (Hars.ak¯ırti), abortifacients in, 144 Yogaratn¯akara, 145 Yogataran.gin¯ı (Trimallabhat.t.a), 145 Z Zimmer, Henry, 10–11 Zimmermann, Francis, 133, 142–143 Zysk, Kenneth G., 22 www.Ebook777.com ... (1982), Medical Ethics, History of: India,” the article Medical Ethics in India: Ancient and Modern,” by C M Francis (1997), published in the online journal Issues in Medical Ethics, and the... competing kingdoms fighting for hegemony and social dominance, borders moving constantly, political and religious allegiances changing along with the dominant ruling powers Bearing this in mind,... author and no beginning and no reference to things that occur in time and in place Therefore, anonymity and a lack of reference to specific times and places are markers of transcendence, and thus indicative