Several phrases and words that were uncommon a month ago, e.g., COVID-19, flattening the curve, draconian measures, and social distancing have become part of everyday vocabulary now. Images of world leaders including Prince Charles and Donald Trump opting to use the “namaste” greeting, an Indian greeting in which one bows slightly and puts their hands in a prayer-like gesture, instead of a handshake, have gone viral. The Indian greeting namaste is performed with folded hands, with one keeping a physical distance and thus help reduce the transmission of germs.
Many of these acts of personal hygiene and physical distancing are deeply embedded in Indian culture, and it makes one wonder whether the customs and rituals were enacted intentionally to maintain public health in ancient India.
To begin with, public health practices were part of ancient societal infrastructure. The archaeological evidence found at Mohan-jo-Daro and Harappa, dated 4000 BC- 3500 BC, revealed multi-storied buildings made of baked bricks. The large roads were also paved with baked bricks, well-laid drainages, private and public baths, and other sanitary amenities. The bathrooms were sloped towards the street from which a channel lead all the water into city drains. Such careful and elaborate civic and domestic sanitary arrangements certainly indicate strong awareness of public health in ancient India.
Beyond the archaeology of ancient India, there is a complex list of dos and don’ts in ancient Sanskrit scriptures, known as Dharma Shastras. These encompass a vast body of religious and civil law, as well as ideas about the right course of conduct in various situations from birth to death. Events of both birth and death were thought to be the source of impurity for family and relatives, and the days it took to become free of the impurity depended on many circumstances. Several scriptures lay down varying periods – ten days, twelve days, fifteen days, a month – for impurity among Brahmans, Kshatriyas, Vaishyas, and Sudras (castes), respectively. The lower down people were on the caste ladder, the more uncleanliness they were associated with. Furthermore, as long as a corpse was not removed from a village, the whole village was in a state of impurity – there could be no eating, no Vedic study, and no rituals. The Chandalas (Untouchables) were those who dealt with corpses, dirt, and dead materials such as leather. They were expected to live outside the village, perhaps because it was known that the work they did had the potential to spread disease. And according to the sacred law, the mourners were also to keep a social distance for several days, due to the fear that they may be carrying germs by being in the vicinity of a corpse.
Purity rules were as much about isolating defiling substances as about social distancing. A daily bath was stipulated as universally necessary. Cleaning up with water and lumps of the earth was also prescribed. Every history of personal hygiene tells us that the world is divided into “washers” and “wipers”. Most ancient people were wipers, but ancient Indians were always washers (Basham A. 2004; Lahiri N. 2018).
Sushruta and Charaka the authors of the ancient Ayurvedic scripture Sushruta Samhita (BC 2500) and ‘Charaka Samhita’ (BC 1500), respectively noted that if an organism fails to adjust and adapt either due to some inherent deficiencies or due to environmental stresses, the result is the diseased condition. However, the organism can be taught to adjust and prepare against the stress. Ayurveda has a holistic approach to public health. It lays down more importance on the prevention of diseases rather than curation and accordingly, prophylactic measures such as personal hygiene and civic maintenance of a pollution-free environment were established to sustain public health (Pushpangadan P., Sharma J. and Kaur J., 1987)
Additionally, Ancient Indians practiced social medicine, which focuses on family structure and functioning to minimize the health risks in the life of an individual from conception to death. The extended family system was prevalent in ancient India and was very conducive to maintaining the physical, mental, social, and spiritual health of its people. Family happiness was a pre-requisite for individual and social well being. Ancient Indians also believed that the happiness of the family depended upon marital bliss, and therefore a proper selection of marriage partners was of utmost importance for the growth and development of future generations. For this reason, marriage partners were and still are usually selected by the parents. Also, the children were sent to Gurukuls (residential public schools) at the age of 5 or 6 for education which lasted for twenty years. In these Gurukuls, besides general education, students learned about the basic principles of physical, mental, and spiritual health. These Gurukuls made children health-conscious and disciplined citizens.
Ancient Indian sages advocated for leading a healthy and happy life by following a hygienic and spiritual life which later evolved into customs and value-oriented traditions. They tactfully implemented these traditions through certain rituals and prohibitions and made the people observe it as a spiritual duty; the violation of which was dreaded as anti-spiritual. For example, people removed their shoes and washed their hands before entering a temple or their house, as shoes were considered impure. The rationale for removing shoes was that the soles absorb all sorts of impurities in the outside world and keeping them outside maintained cleanliness of the living space. Furthermore, all domesticated animals were kept outside of the house, as far away from residential areas as possible to avoid the spread of microbes through animals.
Planting medicinal trees like Neem, Camphor, etc., were used as deterrents for insects (e.g. mosquitoes, etc.), and kept the air clean of impurities. It was common to hang neem twigs on the door of a house as it was said to offer protection against pollution and disease. So, for centuries Indians have planted Neem trees in the vicinity of their homes; the breeze that blew through the branches of the tree was believed to keep their homes free of bacteria and viruses.
Neem Tree Flowers and Leaves (Azadirachta indica)
Image source: J.M.Garg, CC BY 3.0, via Wikimedia Commons
Furthermore, many Indians hang chilies and whole lemons on a string in the doorway to keep insects as well as microbes outside of the house, thereby maintaining hygienic conditions within the home. It is thought that the pungent aroma acts as an insect repellant and as an anti-microbial agent. Similarly, Indians that practice Hinduism keep a pot of Tulsi (Holy basil) in front of their home, which again has an anti-microbial effect through the release of volatile oils from the plant. Individuals also walk around the Holy basil plant, inhaling its aroma and thereby potentially disinfecting themselves. Lastly, Ancient Indians practiced a lot of food preservation methods such as pickling, drying, enriching with salt, and different types of oils along with spices derived from medicinal plants. Although many of these methods were preferred because of the taste, proper food preservation allowed the prevention of microbial growth and food poisoning.
Ancient Indians also practiced a ritual called Yagya (Havan), which is intended to purify the environment, and it is still prevalent today. Preliminary evidence suggests that Yagya reduces air pollution generated by SO2 and NO2 levels along with biological air pollutants such as microorganisms. (Saxena M., Kumar B., Matharu S. 2018). Some scientific aspects of Yagya and its effect on the environment and health have been explained in terms of combustion products from wood such as formaldehyde, formic acid and acetic acid that act as disinfectants, and sublimation of antiviral and antiseptic substances like thymol, pinene, terpineol, etc. from the mixture of medicinal herbs (havan samigri ) into the environment (Akhand Jyoti, 2003).
Additionally, a certain sect of Ancient Indians practicing Jainism wear “muhapattis”, essentially cloth masks around their face to avoid interactions with micro-organisms. They believe by covering their mouth, they will avoid accidentally inhaling micro-organisms and thus protecting themselves.
Individuals practicing Jainism with muhapattis (Image source: English.newstracklive.com)
Ancient Indians depended on notification, isolation, and quarantine for control of communicable diseases. Certain practices used in the past which are now considered traditions or superstitions had some rationale: A tumbler full of water or a bunch of Neem twigs was placed on the cross-roads by the family to notify the public about the occurrence of a case of smallpox in the vicinity and the need for social distancing; In the event of cholera, a flag was put up on top of the highest tree in the village to signal to the public about the occurrence of cholera in the village. In the case of a plague, the village or township used to be vacated to control/prevent the disease (Gupta, S.C. 1970).
Ancient Indian customs and rituals are still practiced in India today and may have (maybe inadvertently) some positive impact on public health.
About the Author
Alok Goel is a scientific leader with a Ph.D. in organic chemistry and over 20 years of experience in pharmaceutical and biopharmaceutical industries. He enjoys travelling, cooking and reading ancient history.