Do no harm: A 3000-year old medical students’ oath

While doing background research on the history of the conception of disease and its propagation, I came across a translation from Sanskrit of a pledge an Indian medical student had to take more than 2000 years ago.

The oath can be found in the Charaka Samhita, one of India’s most ancient texts on medicine. It is believed to have been written around 300–200 BCE, but may have been a redacted version of an earlier, but lost work Ayurveda (Life Knowledge) compiled by Agnivesa about 1000 BCE. The written version handed down through the ages is therefore younger than the Hippocratic Oath (about 400 BCE), but just like the Manu Smrti—the Laws of Manu (about 200 BCE), a collection of Ancient Indian prescriptions that includes the oldest known record of an interdiction against the use of poison in combat—it draws on much older teachings.

The oath of initiation

  1. The teacher then should instruct the disciple in the presence of the sacred fire, Brahmanas [Brahmins] and physicians.
  2. [saying] ‘Thou shalt lead the life of a celebate, grow thy hair and beard, speak only the truth, eat no meat, eat only pure articles of food, be free from envy and carry no arms.
  3. There shall be nothing that thou should not do at my behest except hating the king, causing another’s death, or committing an act of great unrighteousness or acts leading to calamity.
  4. Thou shalt dedicate thyself to me and regard me as thy chief. Thou shalt be subject to me and conduct thyself for ever for my welfare and pleasure. Thou shalt serve and dwell with me like a son or a slave or a supplicant. Thou shalt behave and act without arrogance, with care and attention and with undistracted mind, humility, constant reflection and ungrudging obedience. Acting either at my behest or otherwise, thou shalt conduct thyself for the achievement of thy teacher’s purposes alone, to the best of thy abilities.
  5. If thou desirest success, wealth and fame as a physician and heaven after death, thou shalt pray for the welfare of all creatures beginning with the cows and Brahmanas.
  6. Day and night, however thou mayest be engaged, thou shalt endeavour for the relief of patients with all thy heart and soul. Thou shalt not desert or injure thy patient for the sake of thy life or thy living. Thou shalt not commit adultery even in thought. Even so, thou shalt not covet others’ possessions. Thou shalt be modest in thy attire and appearance. Thou shouldst not be a drunkard or a sinful man nor shouldst thou associate with the abettors of crimes. Thou shouldst speak words that are gentle, pure and righteous, pleasing, worthy, true, wholesome, and moderate. Thy behaviour must be in consideration of time and place and heedful of past experience. Thou shalt act always with a view to the acquisition of knowledge and fullness of equipment.
  7. No persons, who are hated by the king or who are haters of the king or who are hated by the public or who are haters of the public, shall receive treatment. Similarly, those who are extremely abnormal, wicked, and of miserable character and conduct, those who have not vindicated their honour, those who are on the point of death, and similarly women who are unattended by their husbands or guardians shall not receive treatment.
  8. No offering of presents by a woman without the behest of her husband or guardian shall be accepted by thee. While entering the patient’s house, thou shalt be accompanied by a man who is known to the patient and who has his permission to enter; and thou shalt be well-clad, bent of head, self-possessed, and conduct thyself only after repeated consideration. Thou shalt thus properly make thy entry. Having entered, thy speech, mind, intellect and senses shall be entirely devoted to no other thought than that of being helpful to the patient and of things concerning only him. The peculiar customs of the patient’s household shall not be made public. Even knowing that the patient’s span of life has come to its close, it shall not be mentioned by thee there, where if so done, it would cause shock to the patient or to others. Though possessed of knowledge one should not boast very much of one’s knowledge. Most people are offended by the boastfulness of even those who are otherwise good and authoritative.
  9. There is no limit at all to the Science of Life, Medicine. So thou shouldst apply thyself to it with diligence. This is how thou shouldst act. Also thou shouldst learn the skill of practice from another without carping. The entire world is the teacher to the intelligent and the foe to the unintelligent. Hence, knowing this well, thou shouldst listen and act according to the words of instruction of even an unfriendly person, when his words are worthy and of a kind as to bring to you fame, long life, strength and prosperity.’
  10. Thereafter the teacher should say this—’Thou shouldst conduct thyself properly with the gods, sacred fire, Brahmanas, the guru, the aged, the scholars and the preceptors. If thou hast conducted thyself well with them, the precious stones, the grains and the gods become well disposed towards thee. If thou shouldst conduct thyself otherwise, they become unfavourable to thee’. To the teacher that has spoken thus, the disciple should say, ‘Amen.’

According to an accompanying commentary by I. A. Menon and H. F. Haberman, it is not inconceivable that the Hippocratic Oath was influenced by Ancient Indian teachings and practices via the Pythagorean school, whose doctrine is believed to be highly influenced by Eastern thought.

Sources:

And for further background to the documents:

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About JP Zanders

Jean Pascal Zanders (Belgium) has worked on questions of chemical and biological weapon (CBW) armament and disarmament since 1986. He was CBW Project Leader at the Stockholm International Peace Research Institute (SIPRI), Director of the BioWeapons Prevention Project and Senior Research Fellow responsible for disarmament, arms control and non-proliferation questions at the European Union Institute for Security Studies. He now owns and runs The Trench.