SUSHRUTA

 

Sushruta

Internet Image of Sushruta

Sushruta, popularly regarded as the ‘Father of Indian Medicine’ and ‘Father of Plastic Surgery’ for inventing and developing surgical procedures, was probably born during 700 – 600 BC. Some authors mentioned the period as before as 1000 BC. The Sushruta Samhita (Sushruta's Compendium) is considered the oldest text in the world on plastic surgery. It is highly regarded as one of the Great Trilogy of indian Ayurvedic Medicine - the other two being the Charaka Samhita and the Astanga Hridaya, which followed it.

Ayurvedic Medicine is considered as the oldest medical systems in the world. Its practice started during the Vedic Period of India dating back to 5000 BC. The term Ayurveda is translated roughly as ‘life knowledge’ or ‘life science’. It emphasizes the holistic way of treatment, incorporating standard medical knowledge with spiritual concepts and herbal remedies for healing as well as prevention of diseases. It was practiced in India for centuries even before the Greek physician Hippocrates ( 460-375 BC), known as the Father of Medicine, was even born. The Great Trilogy of Ayurvedic Medicine describes surgical, diagnostic and treatments techniques and methodologies for various illnesses and injuries. They even contain instructions for physicians on ascertaining how long a patient would survive.

The work of Sushruta standardized earlier knowledge in the field through careful studies and observances with further advices to the physicians as to how they should practice the art as well as specific procedures for healing physiological disorders.

Sushruta the Physician

The literature is silent about the personal life of Sushruta and his work focused principally on the application of medical techniques without any details regarding his birth, upbringing etc. Even his original name is also unknown. The term ‘Sushruta’ is an epithet, meaning ‘renowned’. There is a mention of the name ‘Sushruta’ in the Mahabharata as the son of Saint Vishwamitra. Some people equate this name with the Physician Sushruta. But most of the scholars do not find any merit in their claim.

Sushruta significantly developed different surgical techniques and invented the practice of cosmetic surgery. Based on certain ancient documents experts in the field assumes that he practiced medicine in northern India around the region of modern-day Varanasi (Banaras) by the banks of the river Ganga.

The practice of surgery was in vogue in India prior to the Sushruta era, but in less-advanced state. He significantly developed different surgical techniques and, most notably, invented the practice of cosmetic surgery. He was apt in rhinoplasty, the reconstruction of the nose. His book contained instructions for others on exactly how a surgeon should proceed:

Rhinotomy, or amputation of the nose, was a prevalent practice in India as a form of punishment to criminals or enemies. Owing to this, rhinoplasty too become a specially important development in this country.

During the process of rhinoplasty wine was used as an anesthetic. The patients were encouraged to drink heavily before a procedure. When the patient was drunk to a point of insensibility, he or she used to be tied to a low-lying wooden table to prevent movement. The operation would begin with the surgeon sitting on a stool and having tools on a nearby table. The use of wine alongwith cannabis led to the development of an anesthetic that would either induce sleep or dull the senses to a patient during procedures such as rhinoplasty.

Sushruta attracted a number of disciples who were known as Saushrutas and were required to study for six years before they even began hands-on training in surgery. They began their studies by taking an oath to devote themselves to healing and to do no harm to others; very like the later Hippocratic Oath from Greece. Thereafter they were taught different medicinal procedures and surgical techniques with sufficient exposure to practical situations.

Sushruta on Medicine and Physicians

Sushruta Samhita was an instruction manual composed by Sushruta for physicians to treat their patients with a holistically holistic approach. He propagated the idea that disease was caused by imbalance in the body, and it was the duty of physician's to help patients maintain balance or to restore it if it had been lost. The physician's instructions had to be followed without question, because of the level of knowledge and expertise he would possess. According to Sushruta, the practice of medicine was a journey of understanding for which a physician needed a keen intelligence to recognize what was required for good health and how to apply that knowledge in different circumstances.

Sushruta emphasized that optimal health could only be possible through harmony of the mind and body. This state could be maintained through proper nutrition, physical exercise and purity of thoughts. However in certain cases, when the patient's imbalance was severe, surgery was considered to be the best course of action. On the basis of his research and experience, Sushrata advised his fellow physicians and disciples to view surgery was the highest good in treatment, because it could produce the most positive results more quickly than other methods.

The Sushruta Samhita

The Sushruta Samhita, a compendium made by Sushruta still remains a matter of great surprise before us. It devotes chapter after chapter to surgical techniques, listing over 300 surgical procedures and 120 surgical instruments. In this great work Sushrata identified 1,120 diseases, injuries, conditions, and their treatments, and over 700 medicinal herbs and their application.

As mentioned earlier, Sushruta Samhita is regarded as one of the 'Great Trilogy of Ayurvedic Medicine' (Charaka Samhita, Sushruta Samhita and Astanga Hridaya) . It is the creditable foundation work of the ancient Hindu form of medical treatment known as ‘Ayurveda’.

Sushruta Samhita relates to the school of surgery and contains principles of surgery, besides descriptions of surgical instruments and operative procedures. The compendium not only provides insights into a plethora of medicinal plants and drugs, it also includes may other sophisticated issues like anatomy, embryology, toxicology, and therapeutics.

The Sushruta Samhita is organized into five major sections:

• Sutrasthana: This section is directed towards the basic principles of medical sciences and pharmacology.

• Nidana: It deals with pathological concepts.

• Sarirasthana: It is associated with human anatomy.

• Chikitsasthanam: This section is identified with medical and surgical management.

• Kalpasthanam: In this section one can learn a lot about toxicology.

 

Contribution of Sushruta

The contributions of Sushruta are not only limited to the surgical field but also extended to the different branches of anatomy, embryology, gynaecology, obstetrics, paediatrics, toxicology, medicine, etc.

Surgery: Sushruta is known as the ‘Father of Surgery’. He strongly advocated that for proper understanding, surgical students should learn about the human body and its organs by dissecting a dead body, which was unthinkable during his time.

Sushruta induced anaesthesia using intoxicants like wine, cannabis and henbane for a successful surgery. He was a specialist in rhinoplasty and ophthalmology. India was the first place where rhinoplasty was invented and used. It was Sushruta, who made such plastic surgery possible. Even modern science agrees with his concept and procedure not only in rhinoplasty, but also in multitude of other issues.

Sushruta described surgery under the following eight heads:

 

• Chedya (excision)

• Lekhya (scarification)

• Vedhya (puncturing)

• Esya (exploration)

• Ahrya (extraction)

• Vsraya (evacuation)

• Sivya (suturing)

Anatomy: Sushruta was one of the first known physicians in the world to develop in depth kowledge in human anatomy. In the Shusruta Samahita, he describes in detail the study of anatomy with the aid of a dead body.

• The Sarirasthana in Susruta Samhita covered the study of anatomy through ten chapters.

• His work contained significant anatomical considerations of the ancient Hindu society.

• Enough evidence is also there to conclude that Sushruta revealed his knowledge of human anatomy through both surface inspection of the human body and human dissection. Because he fostered the idea that students aspiring to be surgeons should have good knowledge and understanding of the structure of the human body.

Author’s Note

In addition to the trauma involving general surgery, Sushruta also provided detailed outline for the treatment of 12 different types of fractures and 6 different types of dislocations of bones. He made thorough discussions over the the principles of-traction, manipulation, apposition, stabilization, and postoperative physiotherapy. As a physician he not only concentrated on medication and surgery but also recommended methods for stimulating growth of hair as well as the removal of unwanted hair.

Sushruta Samhita in its extant form consists of 186 chapters. This is an enormous volume of work spanning a wide range of topics to make one wonder. When we think of medical treatment today, we can visualize different types of modern equipments, devices, computers and procedures. When Sushruta learned and practiced surgery, medicines etc., the world was very different. In spite of that he not only did all these jobs, but also wrote Sushruta Samhita. The ways of treatment prescribed by him is still bear relevance. His concept of holistic way of treatment for the patients, instead of piecemeal approaches is widely upheld even by the most advanced countries.

Given the enormity of his work and lack of information regarding his personal being, a question naturally crops up as to whether Sushruta was a single person, or a school of medical perceptions carried forward by the ancient physicians of India (Bharat) and their disciples through centuries. Whatever may be the fact, the importance of Sushruta as a physician, researcher, and also as a biologist will continue to remain unabated through centuries ahead.

(Source: Used multiple sources for gathering and rationalizing informations).