Ethics in Ayurved classics

Ayurvedic aspect of medical ethics

1. Ethics as in classical Texts

INRODUCTION TO MEDICAL ETHICS

Medical ethics may be defined as a code of conduct accepted
voluntarily by medical practitioners within the profession.
Legally they are not enforceable by law but are defended by
the State Medical Council.

Medical ethics have evolved through the centuries. Some of
the ethics have evolved into present law, so both the terms,
medical ethics and medical law are synonymous.
Medical ethics in ayurveda

Hippocrates's Oath is considered to be the oldest code of
medical ethics (460-377 BC). But the Caraka's Oath 'seem to

2. be more ancient (1000 BC) and ever documented code of
medical ethics as the same is being propounded by lord
Atreya. In ancient texts of Ayurveda, such regulations are
observed in form of methods of teaching, training, duties and
responsibilities, privileges, codes of conduct and social status
of physicians in different contexts.

MEDICAL ETHICS ACCORDING TO ACHARYA
CHARAK:
(Charka viman sthana 8/13-16)
▪ Ethics should be instructed by teacher in presence of
wise persons
▪ He should live with celibacy.
▪ Should keep beard and moustaches
▪ Should not eat meat.
▪ Should not use pure and intellect- Promoting things
with- out jealousy
▪ He should never disobey the words of teacher except in
case which lead to king's wrath, loss of life, great
unrighteousness and other such calamity
▪ He should always surrender to teacher and regard him as
a head
▪ He should live with teacher as son, servant and sup
pliant. He should first make effort, as far as possible, to
collect things for the teacher.
▪ He should always think of the welfare of all the living
beings.

3. ▪ He should make effort to provide health to the patients
by all means.
▪ He should not think ill of the patients even at the cost of
your life.
▪ He should not approach the other's woman and any
others property even in imagination.
▪ His dress and accessories should be modest, but he
should not be modest.
▪ He should not be addicted to drinking, indulged in sins
and associated with sinners.
▪ He should speak smooth, pure, righteous, blissful,
thankful, truthful, useful and measured words.
▪ He should always keep place and time in mind, with
good remembrance; strive constantly for knowledge,
progress and excellence.
▪ He should never prescribe medicines for those disliked
by the king or disliking the king, disliked by wealthy
magnets or those who are excessively diseased, wicked
and also for the ladies in absence of their husbands or
guardians.
▪ He should never accept meat offered by the ladies
without permission of their husband or guardian.
▪ While entering into the patient's house he should take
along a known person whose entry is permitted.
▪ Any matter related to the patient matter should not be
disclosed outside.
▪ Even though he is learned enough, but he should not
boast too much of his knowledge because mostly the

4. people become irritated for the excessive boasting even it
comes from an authority.

TYPES OF VAIDYA

‘Veda’ + 'An' (suffix) = Vaidya. ‘An’etc. suffixes add to
denote those read or know the subject concerned. Thus,
adding 'An' suffix to Veda, from the Ayurveda) word 'Vaidya',
means who reads and knows the Veda.
In Ayurveda, different nomenclatures have been ornamented
to the quality physicians and disgraced to the quacks.Broadly
physicians are divided into two groups, i.e. one who is
promoter of life and the other promoter of diseases. They are
listed below:


a) Promoter of life (Pranabhisara) includes:

5. • Bhisagortama (C.So. 1.123)
• Sreptha bhipaja ( C & Su. 1.134)
• Cikitsätta - vaidya (Cs.Su. 2.36)
• Bhisagvara (C.Su. 4.29)
• Vaidyagunayukta Jivitábhisara (Cs.Su 11.50)
• Pranabhuisara (Cs. Su. 9.18; 29.7)
• Rajarha - bhisak (Cs Su.9.19; Ss Su. 347, As Su.29)
• Vaidya - trija (Cs.Ci. 1 - IV.53)


a) Promoter of diseases(Rogabhisara)includes:

• Rogabhisara (Cs Su. 29.8-9)
• Kuvaidya (Ss. Su. 3.52,25, 41: Ck Cs Su. L.134)
• Vaidyāpavada (Cs.Su. 1.140)
• Ajñobhisak (Cs.Su. 9.16)
• Bhisanmāni (Cs.Su. 9.17)
• Chadmacara bhișak (Cs.Su. 11.50)
• Sidhasādhita bhișak (Cs.Su. 11.50)
• Vaidya - vidagdha (Ss.Su. 10.8)
• Taşkara - vaidya (Ss.Su. 4.8, 17.6)

6. PRANABHISAR VAIDYA


तस्माच्छास्रेऽर्थविज्ञाने प्रिृत्तौ कमथदर्थने ।
भिषक् चतुष्टये युक्तः प्राणाभिसर उच्यते ॥
(Ch.su.9/18)

A physician duly engaged in the study of the science of
medicine, in mastering their actual implications, in the right
application of the therapy and having practical experience is
known as the Saviour of life (prāņābhisara).

Four qualifications of Prāņābhisara Vaidya the qualities of a
life promoter and disease destroyer categories; viz.
i) Knowledge of scriptures

7. ii) Experience of practical knowledge
iii) Application of therapeutic
iv) Understanding capability

According to charka acharya the pranbhisara vaidya should be
well versed with following qualities which are further
elaborated as bellow
( ch.su.29/7)
1. Three principles of the science of life (viz. Etiology,
symptomatology and management of good and bad health)
2. Statements in brief about fundamental principles and their
elaboration;
3. Three sources of drugs;
4. Thirty five roots and fruits; four types of fat; five types of
salt, eight types of wine, eight types of milk and six plants
whose latex and bark are useful;
5 .Various types of drugs used in five elimination therapies,
viz. Crrhines etc
6. Twenty eight types of gruel;
7. Thirty two types of powders and ointments;
8 .Six hundred types of purgatives;
9. Five hundred types of decoction;
10. Knowledge of the factors responsible for the maintenance
of positive health including diets, drug, regimen, residence,

8. movement, sleep, rest, quantity, drugs, collyrium, smoking,
inhalation, unction, washing, non - suppression of somatic
urges, suppression of psychic urges, physical exercise,
wholesomeness for examining the sense organs; sixteen
factors;
11. Knowledge of the four aspects of therapeutics having
12. Determination of the nature of diseases;
13. Three pursuits of life;
14. Various action of vayu;
15. Four types of unctuous substances prepared accord to
twenty four methods with drugs of various tastes permutation
and combination of which are of sixty four types;
16. Various methods of preparation of drugs and therapies for
oleation, fomentation, emesis and purgation;
17. Diseases of head etc;
18. Summary of diseases caused by permutation and
combination of various dosas.
19. Ailments like ojahksaya, carbuncle and obscess:
20. Three types of oedema and other diseases having swelling
in one or the other part of the body;
21. Forty eight types of diseases;
22. One hundred forty - types of diseases of nānātmaja variety
(diseases caused specifically by one doșa);

9. 23. Etiology, signs, symptoms and management of despisable
individuals who are either very carpulent or emaciated;
24. Useful and harmful nature of sleep, sleeplessness and
excessive sleep along with their etiology and management.
25. Six therapeutic measures like lightening therapy;
26. Signs, symptoms and treatment of diseases due to over -
nourishment; and

27. Under nourishment.
Diseases caused by the vitiation of blood, viz. intoxication,
fainting and syncope along with their etiology, signs and
symptom and treatment by medicines and regimen;
28. Rules of dietetics, food preparations which are whole
some and unwholesome by nature;
29. The diets and regimen which are foremost in nature
amongst their class;
30. Forty types of alcoholic preparation:
31. Determination of dravya (matter), guna (quality), karman
(action), primary and secondary tastes;
32. Various types of incompatible food ingredients;
33. Ingredients of food and drinks classified into twelve
groups along with their properties;
34. Properties of post - prandial drinks;

10. 35. Nine factors required to be examined for determining the
properties of food;
36. Digestive and metabolic processes;
37. Good and ill effects of wholesome and unwholesome
food;
38. Diseases caused by the vitiation of various tissue
elements along with their treatment in brief.
These are the qualities briefly described by charka acharya in
sutrashan 29 chapter.

ROGABHISAR VAIDYA

11. अतो विपरीता रोगाणामभिसरा हन्तारः प्राणानाां ,
भिषक्छाप्रततच्छन्नाः कण्टकिूता लोकस्य
प्रतत�पकसधमााणो राज्ाां प्रमादाच्चरन्न्त राष्ट्राणण ॥८ ॥
(ch.su.29/8)

Opposite to this are the pseudo - physicians who instead of
taking away the diseases, take away the life itself. Like thorns,
they torture the people. These traitors in the garb of
physicians move around the world due to the lack of vigilance
on the part of the rulers.



िैद्यिाण्डौषधैः पुस्तैः पालिैरिलोकनैः । लिन्ते ये
भिषक्शब्दमज्ास्ते प्रतत�पकाः ।। ५१ ॥
Those who come to be known as physicians simply by virtue
of the exhibition of the physicians ' box containing certain
drugs , medical books , by bluffing and posing ( as a physician
) belong to the first category . They are ignorant of the science

12. of medicine. They are simply counterfeits .This type of
physician is considered as rogabhisara also.

QUALITIES OF VAIDYA


श्रुते पयािदातत्िां बहुशो दृष्ट्टकमाता । दाक्ष्यां शौचभमतत
ज्ेयां िैद्ये गुणचतुष्ट्टयम् ॥६ ॥ (Ch.su9/6)
Excellence in medical knowledge , an extensive practical
experience, dexterity and purity , these arc the four qualities
of a physician .

13. विद्या वितको विज्ानां स्मृततस्तत्परता क्रिया । यस्यैते
षड्गुणास्तस्य न साध्यमततिताते ॥२१ ॥
विद्या मततः कमादृन्ष्ट्टरभ्यासः भसद्धधराश्रयः ।
िैद्यशब्दाभितनष्ट्यत्तािलमेकैकमप्यतः ॥२२ ॥
(Cs .Su. 9.21).
Vidyā (learning), vitarka (rationality), vignana (specific
knowledge), smrti (memory), tatparatā (devotion) and kriya
(action) are six optimum qualities of a physician deserves to
hold the honourable epithet 'Vaidy' to himself .

Shushruta acharya have mentioned qualities as:
(Ss .Su. 5.10).

Similar, six qualities have been mentioned for a surgeon as
saurya (fearlessness),
āśukriyā (prompt action),
sastrataiksnya (sharpness of instrument),
Asveda (absence of perspiration),
Avepathu (absence of trembling) and
Asammoha (not confusing )

14. Apart from these, the other qualities mentioned for the
physicians are:
i) Knower of pharmacognosy, pharmacological aspects of
drugs (Cs.Su. 1.122-123).
ii) ii) Knower of external and internal use of drugs,
combination and rational administration of drugs (Cs.Su.
4.29) happiness (Cs.Su. 11.53)
iv) Possessing 'quadrupled knowledge of disease cause,
symptoms, cure and prevention (Cs.Su. 9.19).
v) Abhedya (unopposed), anuddhata (famous), stabdha
(constant), sūnrtra (pleasant), priyadarśana (good looking and
well dressed), kālavedi (knower of status of patient / stage of
disease) etc. (As.Su. 2.6). Vaidya.

CHATURVIDHA VAIDYAVRUTTI

15. मैत्री का�ण्यमातेषु शक्ये प्रीतत�पेक्षणम् । प्रकृततस्थेषु िूतेषु
िैद्यिृवत्तश्चतुविाधेतत ॥ (ch.su9/23)


In his acharya has explained the relation of vaidya and patient.
Doctor should be sympathetic and kind to all patients should
be concerned with those who are likely to be cured and should
feel detached with those who are towards death. These are the
four disciplines for physician.

APUJYA VAIDYA
(REJECTABLE PHYSICIAN)

Apujya Vaidya (rejectable physician) except the prānābhisara,
all kinds of physician described under rogābhisara must be
rejected. A very clear indication of such rejectable physicians
are found in the texts as follows
• ििन्न्त चात्र भिषक्छद्म प्रविश्यैिां व्याधधताांस्तकायन्न्त
ये । िीतांसभमि सांधश्रत्य िने शाकुन्न्तका द्विजान्
॥१०॥

16. श्रुतदृष्ट्टक्रियाकालमात्राज्ानबहहष्ट्कृताः िजानीया हह ते
मृत्योश्चरन्त्यनुचरा िुवि ॥११ ॥
िृवत्तहेतोभिाषड्मानपूणाान् मूर्ाविशारदान् ।
िजायेदातुरो विद्िान् सास्ते पीतमा�ताः ॥१२ ॥

The wise patient should avoid quacks (rogābhisara etc.),
treating them like poisonous snake and always keeping
them away from one's vicinity as they are messengers of
death. (Cs.Su. 29.10-12; Ss.Su. 25.32)
• The quack surgeon, who acting in the worst way, injures
himself with the instrument while performing operation
should be avoided. (Ss.Su. 25.41)
• The physician skilled in practices but devoid of textual
knowledges, are despised by the wise and even get
capital punishment. (Ss.Su. 3.49, As.Su. 2.8)
• The wise desiring for long life and health should avoid
irrational physician (quack). It is better to opt for
serpent poison or swallow copper decoction or self -
immolation than to be treated by such physician.
(Cs.Su. 1.127–131, 9.15)

17. CODE OF CONDUCT

In Ayurveda more emphasize has been given on moral values
of human life. As a health profession, it is further discussed
many Code of ethical aspects a level above the other systems
for leading a holistic and healthy professional life in terms of
bhūta – dayā special care (putravat sneha) to orphan patient,
relationship with female patient etc. The codes can be
described as under
i) Social ethics: Restraining from evil ventures relating to
thought, speech and action as well as other misconducts
described therein
.

18. ii) Should make effort to provide health to the patients by
all means, even at the cost of own's life.
iii) In case of emergency (loss of life, natural calamity etc.),
a physician has right to act against the order of his / her
teacher.
iv) Must well behave to God, preceptors, elder and teacher.
v) Advertisement: Solicitation of patient by advertising in
any form is considered unethical. Physician involving in
such practice are referred as siddhasādhita and
chadmacara vaidya in the text.
vi) Payment for the professional services: The treated
patient, whether having promised or not, if does not
offer anything to the physician as professional fee, he
should be treated for on the ground of the welfare of
humanity. He / she may accept only food from the
patient. Ayurveda in general emphasizes on pursuit of
wealth (dhanaisanā), in the life for every individual.
Commentator interprets that earning wealth must be in
order to pursue ārogya (health) and dharma (virtue /
duties and responsibilities) as well as per prevailing
system of practice.
vii) Rebate and commission (Na arthamartha): In any form is
treated as unethical. Thus bhūtadayā is considered to be
highest virtue and earning any reward or rebate is
discarded.
viii) Evasion of legal restriction: A physician should observe
the law himself and bound other to follow the same.
This kind of description could be inferred by application
of the terms' na niyamam bhindyāt!