Health&life

Father of Indian Surgery

Reading about Indian history and culture has always been a source of inspiration for me. The more I dig into the pages of Indian antiquity, the more enthralled I feel about the knowledge and wisdom of our ancient scholars and saints. Modern-day science and technology have their own set of advanced achievements, but the vision and feats which Indian scholars had attained in the times when the resources were limited and raw are incomparable.

My latest research on Indian medical history enlightened me about the rich medicinal heritage of our country and revealed the fact that the modern surgical procedures practiced currently were invented much earlier in India in 600 BC.

When the world was unaware about the surgical procedures of treating human illness, an Indian saint was flawlessly performing plastic surgical procedures using the tools which are valid till day in the modern science procedures of surgery. He was “Sushruta”, the “Father of Indian Medicine” or “Father of Plastic Surgery” in India. His compendium is known as “Sushruta Samhita” which is considered to be the oldest text in the world on plastic surgery. His work is a detailed account on surgical art and how a physician should practice these specific procedures for treating the patient’s illness. One of the oldest Sushruta Samhita palm-leaf manuscripts is preserved at the Kaiser Library in Nepal.

Sushruta was believed to practice medicine in northern India by the banks of Ganges River around the region of Kashi, now known as Varanasi. He was regarded as a great healer and sage and was the first man who performed the surgical procedures in human history specially the plastic surgical procedures. His speciality was “Rhinoplasty” in which he used to perform fabulous nose job by taking the living skin from cheeks and setting it to restore the nose of the patients.

In ancient times, nose amputation was considered as the hardest punishment for the convicted criminals and also for women who were found guilty of adultery. With a stigma of their crime and an amputated nose they had to survive the hardships of their lives. But, Sushruta’s Rhinoplasty procedure gave them a hope of recovery and normalcy. Interestingly, the method used by Sushruta for anaesthetising the patient was very unique. The patient was made to drink wine heavily before the surgical procedure so that his senses remain tranquilized and he does not feel any pain during the surgery. He was then tied with a low lying wooden bench so that he does not move during the process. The surgeon would sit on a stool with surgical instruments on a nearby table. An extract from Sushruta Samhita on how exactly a surgeon should proceed with Rhinoplasty, reconstruction of nose is produced here.

“The portion of the nose to be covered should be first measured with a leaf. Then a piece of skin of the required size should be dissected from the living skin of the cheek and turned back to cover the nose keeping a small pedicle attached to the cheek. The part of the nose to which the skin is to be attached should be made raw by cutting the nasal stump with a knife. The physician then should place the skin on the nose and stitch the two parts swiftly, keeping the skin properly elevated by inserting two tubes of eranda (the castor-oil plant) in the position of the nostrils so that the new nose gets proper shape. The skin thus properly adjusted, it should then be sprinkled with a powder of liquorice, red sandal-wood, and barberry plant. Finally, it should be covered with cotton and clean sesame oil should be constantly applied. When the skin has united and granulated, if the nose is too short or too long, the middle of the flap should be divided and an endeavor made to enlarge or shorten it. (Sushruta Samhita, I.16)”

Another instant of his intellect and wisdom which mesmerised me was his study of human body without dissecting a single human corpus. According to Hindu belief, the human body is considered to be sacred in death and not even a single cut or wound is acceptable and that persons older than 2 years of age must be cremated in their original condition. This law became an obstacle for Sushruta. But, this great scholar had found out a unique way to dissect human body without putting a single incision on it. He suggested to wrap the human corpus in grass and put it in a cage to protect it from animals. That cage should then be immersed in cold water for seven days. After seven days the corpus was taken out from the cage. During this process the skin of the human corpus started decomposing. Sushruta developed a special brush made of grass with which he used to shed away the decomposed layer of skin from the corpus and the remains were available for studying the human body functions without making any incision. This was a commendable art which Sushruta practised to study anatomy and attained highest levels in surgical art with great precision. The following is the method that Susruta explained in his book that enabled him to work within the confines of laws.

“Therefore for dissecting purposes, a cadaver should be selected which has all of whose parts of the body present, of a person who had not died due to poisoning, but not suffered from a chronic disease (before death), had not attained a 100 years of age and from which the fecal contents of the intestines have been removed. Such a cadaver, whose all parts are wrapped by any one of “munja” (bush or grass), bark, “kusa” and flax, etc. and kept inside a cage, should be put in a slowly flowing river and allowed to decompose in an unlighted area. After proper decomposition for seven nights, the cadaver should be removed (from the cage) and then dissected slowly by rubbing it with the brushes made out of any of usira (fragrant roots of plant), hair, bamboo or “balvaja” (coarse grass). In this way, as previously described, skin, etc. and all the internal and external parts with their subdivisions should be visually examined.”

Not only, Rhinoplasty, Sushruta is also known as the performer of first Cataract eye surgery in India. He invented various surgical remedies of the diseases like prostate in men and also performed the surgeries of removing dead foetus from women womb. Sushruta describes 120 surgical instruments in his compendium and had advocated the use of dilators, irrigating syringes and catheters.

He wrote “Sushruta Samhita” in Sanskrit on birch bark which explained about every aspect of medical art. But, this ocean of medical and surgical knowledge was unknown to the world until it was first translated into Arabic by Caliph Mansur in around the 8th century CE. Even then, the text remained unknown to the West until the late 19th century CE when the Bower Manuscript was discovered which mentions Sushruta by name in a list of sages. It is also claimed that British officers and soldiers in India during 19th century had written home about the startling surgical procedures they had witnessed in India which were conducted on the guidelines of Sushruta Samhita. An English translation of the Sushruta Samhita was done by the scholar Kaviraj Kunja Lal Bhishagratna between 1907 and 1916 CE but, it did not receive the deserved attention from the West. By this time, Hippocrates theory of medicine had hit the world and he was accepted as the Father of Medicine.

Although, the advent of surgical art took place in India but Sushruta’s name remained relatively unknown to the world until Ayurvedic medical practices have become more widely recognised and accepted. In “The source book of plastic surgery’‘, Frank McDowell aptly described Sushruta as follows: “Through all of Sushruta’s flowery language, incantations and irrelevancies, there shines the unmistakable picture of a great surgeon. Undaunted by his failures, unimpressed by his successes, he sought the truth unceasingly and passed it on to those who followed. He attacked disease and deformity definitively, with reasoned and logical methods. When the path did not exist, he made one.”

Sushruta is now acknowledged as the first surgeon in the human history who took surgery in ancient India to admirable heights. As a result of his astonishing discoveries and achievements, that era is now recognised as “The Golden Age of Surgery” in ancient India.

– Neha Singhal

Picture Credits: worldhistory.org

Sources:

1) worldhistory.org/sushruta

2) ncbi.nlm.nih.gov/pmc/articles/PMC3039177/#b16

3) ispub.com/IJPS/4/2/8232



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