Monday, 14 February 2022

Ancient Hospitals in Sri Lanka

Ancient Hospitals in Sri Lanka
The Ruins of Ancient Hospital Complexes (Sinhala: ශ්‍රී ලංකාවේ පුරාණ රෝහල් සංකීර්ණ) have been discovered in a few large-scale Buddhist monasteries in Sri Lanka.

Literary sources
Sri Lankan chronicles such as Mahavamsa mention that Sinhalese kings built hospitals during their regnal years (Gamage & Thilakarathna, 2018). King Pandukabhaya (4th century B.C.) is said to have built a Sivikasala (maternity home) and Sotthisala (hospital) for the benefit of the people (Gamage & Thilakarathna, 2018). King Dutugemunu (161-137 B.C.) constructed 18 hospitals for sick people and King Buddhadasa (340-369 A.D.) who was a reputed medical practitioner for both humans and animals built a hospital for blind and cripples (Gamage & Thilakarathna, 2018; Kannangara, 2016; Prematilleke, 1996). King Upatissa I (369-410 A.D.), Mahanama (410-432 A.D.), Datusena (459-477 A.D.), Mahinda I (495-512 A.D.), Silakala (522-535 A.D.), Dappula (659-662 A.D.), Mahinda II (777-797 A.D.), Udaya I (797-801 A.D.), Sena I (833-853 A.D.), Sena II (853-887 A.D.), Kassapa IV (909-914 A.D.), Kassapa V (914-923 A.D.), and Parakramabahu I (1153-1186 A.D.) are also said to have erected hospitals or provided necessary facilities to improve the health care system of the country (Gamage & Thilakarathna, 2018; Kannangara, 2016; Mueller-Dietz, 1996).

Malwatu Oya, Ambagahawewa, Anuradhapura eastern gate, Mihintale (no.1) & Polonnaruwa Nissankamalla Council Chamber inscriptions of Udaya II (887-898 A.D.), Mihintale (no.2), Kiribath Vehera & Puliyankulama inscriptions of Kassapa IV (909-914 A.D.), Medirigiriya, Thunukai, Bolana & Abhayagiriya (slab) inscriptions of Kassapa V (914-923 A.D.), Dorabavila, Murunkan, & Siva Devale No.2 inscriptions of Dappula IV (923-935 A.D.) and Medirigiriya & Abhayagiriya (slab) inscriptions of Mahinda IV (956-972 A.D.) mention about physicians, hospitals and dispensaries located at several places in the country including Mihintale, Medirigiriya and Thuparamaya (Ranawella, 2001; Ranawella, 2005; Ranawella (Ed.), 2005; Wickremasinghe, 1928). 
The oldest archaeological evidence of hospitals in the world?
There is no archaeological evidence to prove that hospitals have existed in very early civilizations of the world despite their medical systems being older than that of Sri Lanka (Gamage & Thilakarathna, 2018). The concept of the hospital was unknown in these civilizations and the ancient Sinhalese are perhaps responsible for introducing it to the world (Gunawardana, 2010; Kannangara, 2016). Of the archaeological ruins, the 9th-century Hospital at Mihintale is considered the oldest hospital discovered in Sri Lanka and is perhaps the oldest archaeological evidence of a hospital in the world (Kannangara, 2016; Mueller-Dietz, 1996).
Ruins of hospital complexes
There is several literary and epigraphical evidence to prove the existence of residential hospitals, maternity hospitals, outdoor dispensaries and veterinary hospitals in Sri Lanka in ancient times (Prematilleke, 1996). Although not many ruins of these hospitals remain today, Sri Lankan archaeologists have been able to excavate and expose a few hospital sites in some large-scale Buddhist monastic complexes situated in old cities such as Anuradhapura and Polonnaruwa (Prematilleke, 1996).
Ruins of ancient hospital complexes have been identified from the monastery premises of Mihintale, Medirigiriya, Maha Viharaya, Thuparamaya, Alahena Pirivena and Dighavapi (Gamage & Thilakarathna, 2018; Prematilleke, 1996; The National Atlas of Sri Lanka, 2007). Of them, the hospital complex at Mihintale is considered the oldest one built during the reign of King Sena II [(853-887 A.D.) Jayasuriya, 2016]. The hospital at Medirigiriya is considered the second-oldest while the Hospital at Alahana Pirivena in Polonnaruva is assumed to be the latest structure of this kind unearthed in Sri Lanka (Mueller-Dietz, 1996; Prematilleke, 1996). Of these sites, the structures at Mihintale (9th century) and the one at Polonnaruva (12th century) are considered significant for the study of the layout of the ancient hospital architecture. 
Excavations carried out in these sites have unearthed stone troughs (Beheth Oruwa) and some surgical and medical instruments such as probes, forceps, scissors, scalpels, lancets, herb grinding stones, micro-balances, spoons, and storage jars. 
Stone troughs
Stone troughs, probably used as medicinal baths, were an essential part of an ancient hospital (Mueller-Dietz, 1996; The National Atlas of Sri Lanka, 2007). Hewn from a monolith, it has a cut-out shape of a man in which a man (patients) can be placed and immersed in medicinal oil to perform the immersion therapy. A Pali commentary of the 5th century A.D. and two Sri Lankan scriptures written by a Buddhist monk in the 13th century have mentioned some details about this therapy (Mueller-Dietz, 1996).
The first stone trough of this kind was discovered near the ruins of Thuparama monastery by H.C.P. Bell in 1896 (Mueller-Dietz, 1996). He has described it as a sarcophagus because it resembled the stone troughs in which Egyptian mummies had been found (Mueller-Dietz, 1996). Four more similar troughs were discovered later from Mihintale, Medirigiriya, Dighavapi and in the ancient city of Polonnaruwa (Mueller-Dietz, 1996). It was a notable fact that all these troughs were discovered in places where epigraphs and other accompanying finds indicated the existence of ancient hospitals (Mueller-Dietz, 1996).
Hospital complexes of the colonial period
The Dutch Hospital in Colombo and the buildings in Galle and Delft are a few examples of edifices used for health services during the Dutch Period (1640-1796 A.D.). The present circuit bungalow at Anuradhapura which is used by the Department of Archaeology is an example of a British Period (1796-1948 A.D.) hospital (De Silva & Chandrasekara, 2009).
1) De Silva, N.; Chandrasekara, D.P., 2009. Heritage Buildings of Sri Lanka. Colombo: The National Trust Sri Lanka, ISBN: 978-955-0093-01-4. p.18.
2) Gamage, U. and Thilakarathna, N.T.S., 2018. Hospital Complexes in Ancient Sri Lanka: An Observational Study of Mihinthale Hospital Complex. International Journal of Liberal Arts and Social Science, 6(1), pp.35-44.
3) Gunawardana, V.D.N.S., 2010. The ancient hospital complex at Mihinthale in Sri Lanka. 3rd International congress, Society of South Asian Archaeology (SOSAA), Centre for Asian Studies, University of Kelaniya, Sri Lanka.
4) Jayasuriya, E., 2016. A guide to the Cultural Triangle of Sri Lanka. Central Cultural Fund. ISBN: 978-955-613-312-7. pp.60-61,80-81. 
5) Kannangara, A.P., 2015. The history of dermatology, venereology, and dermatopathology in different countries-Sri Lanka. Global Dermatology, 2(7).
6) Mueller-Dietz, H.E., 1996. Stone „Sarcophagi” and Ancient Hospitals in Sri Lanka. Medizinhistorisches Journal, (H. 1/2), pp.49-65.
7) Prematilleke, L., 1996. Ancient monastic Hospital System in Sri Lanka. Ancient trades and cultural contacts in Southeast Asia, Bangkok, The Office of the National Culture Commission, pp.115-126.
8) Ranawella, S., 2001. Inscription of Ceylon. Volume V, Part I. Department of Archaeology. ISBN: 955-9159-21-6. pp.xlviii-xlix,326-328.
9) Ranawella, G.S., 2004. Inscription of Ceylon: Containing pillar inscriptions and slab inscriptions from 924 AD to 1017. Volume V, Part II. Department of Archaeology. pp.1-3,22-25,113-115, 245-252,285-295.
10) Ranawella, S., 2005. Inscription of Ceylon. Volume V, Part III. Department of Archaeology. ISBN: 955-91-59-57-7. pp.36-39,135.
11) Ranawella, S. (Ed.), 2005. Sinhala inscriptions in the Colombo National Museum: Spolia Zeylanica. Vol 42. (2005). Department of National Museums, Sri Lanka. pp.59-63.
12) The National Atlas of Sri Lanka, 2007. (2nd ed.) Survey Department of Sri Lanka. ISBN: 955-9059-04-1. p.104. 
13) Wickremasinghe, D. M. D. Z., 1928. Epigraphia Zeylanica: Being lithic and other inscriptions of Ceylon (Vol, II). Published for the government of Ceylon by Humphrey Milford. pp.25-33.
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