a tribute to ancient indian surgery

SURGICAL LEGACY OFSURGICAL LEGACY OFSUSHRUTHA’S IN ANCIENT SUSHRUTHA’S IN ANCIENT

INDIA…INDIA…

Dr.ANIL PANDEDr.ANIL PANDENeurosurgeon,VHS Hospital, Chennai, Neurosurgeon,VHS Hospital, Chennai,

India.India.

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The beginning of the medical sciences The beginning of the medical sciences in India have been traced to the in India have been traced to the proficiency of the Indus valley people proficiency of the Indus valley people in town planning, sanitation, and in town planning, sanitation, and hygiene, hygiene, representing the oldest representing the oldest surviving examples of town surviving examples of town planning…… indicate remarkable planning…… indicate remarkable concern for public health..concern for public health..

D.P.SINGHAL D.P.SINGHAL India and world civilization India and world civilization


PAVED BATHROOM AND BRICKWALL PAVED BATHROOM AND BRICKWALL MOHENJO-DARO (c.3300BC)MOHENJO-DARO (c.3300BC)


SUSHRUTHA,SUSHRUTHA, SURGEON OF ANCIENT INDIA, SURGEON OF ANCIENT INDIA, PERFORMING AN ARTIFICIAL EAR LOBE PERFORMING AN ARTIFICIAL EAR LOBE (BY ROBERT ATHOM).(BY ROBERT ATHOM).

A DESCENDENT OF A DESCENDENT OF VISWAMITHRA?VISWAMITHRA?


WHEN DID HE LIVE ?WHEN DID HE LIVE ?

MENTIONED IN THE MENTIONED IN THE MAHABHARATHA (1000 BC).MAHABHARATHA (1000 BC).

WESTERN SCHOLARS PLACE WESTERN SCHOLARS PLACE HIM 2HIM 2ndnd TO 4 TO 4thth CENTURY A.D. CENTURY A.D.

--- NOT ACCEPTED BY MANY.--- NOT ACCEPTED BY MANY.


SUSHRUTHA SAMHITASUSHRUTHA SAMHITAORIGINSORIGINS

ATHARVA VEDAATHARVA VEDA

AYURVEDAAYURVEDA (The fifth Veda) (The fifth Veda) CHARAKA CHARAKA

(Knowledge of life)(Knowledge of life) SUSHRUTHA SUSHRUTHA VAGABHATAVAGABHATA

SSAAMMHHIITTAASS

VIRDDHA VIRDDHA TRAYITRAYI “TRIAD OF “TRIAD OF ANCIENTS”ANCIENTS”


TRADITIONAL TRADITIONAL AYURVEDIC AYURVEDIC

GENEOLOGY GENEOLOGY BRAMHABRAMHA

DAKSHAPRAJAPATIDAKSHAPRAJAPATI

ASHWINI KUMARSASHWINI KUMARS

INDRAINDRA

BHARADWAJA BHARADWAJA

ATREYAATREYA

AGNIVESHAAGNIVESHA

DHANAVANTRIDHANAVANTRI

DIVADOSADIVADOSA

SUSHRUTHASUSHRUTHA


DHANVANTARIDHANVANTARI HOVERING HOVERING ABOVE VISHNU BAS – RELIEF ABOVE VISHNU BAS – RELIEF FRAGMENT FROM ANGKOR WAT FRAGMENT FROM ANGKOR WAT

MANUSCRIPT PAGE MANUSCRIPT PAGE FROM FROM ATHARVAVEDA ATHARVAVEDA TUBINGENTUBINGEN


““THE ENCYCLOPEDIC WORKS OF THE ENCYCLOPEDIC WORKS OF CHARAKA AND SUSHRUTHA ARE CHARAKA AND SUSHRUTHA ARE

THE PRODUCTS OF A FULLY THE PRODUCTS OF A FULLY EVOLVED SYSTEM WHICH EVOLVED SYSTEM WHICH

RESEMBLES THOSE RESEMBLES THOSE OF HIPPOCRATES, AND GALEN IN OF HIPPOCRATES, AND GALEN IN

SOME RESPECTS; AND SOME RESPECTS; AND WHICH IN OTHERS WHICH IN OTHERS

HAD DEVELOPED BEYOND THEM”.HAD DEVELOPED BEYOND THEM”.A.L. BASHAM A.L. BASHAM

““The Wonder that was India” The Wonder that was India”


SUSHRUTHA SAMHITASUSHRUTHA SAMHITATEACHING INITIALLY BY WORD OF MOUTH TEACHING INITIALLY BY WORD OF MOUTH

-- THEREFORE THE TIME OF ORIGIN IS -- THEREFORE THE TIME OF ORIGIN IS STILL CONTROVERSIAL. STILL CONTROVERSIAL.

PRESENT THOUGHT: 10 – 6PRESENT THOUGHT: 10 – 6THTH BC. BC. Revised by Revised by NAGARJUNA NAGARJUNA 2 2ndnd – 4 – 4ththcentury BCcentury BC

KITAB-I-SUSRURD 8KITAB-I-SUSRURD 8thth Century AD Century AD (Mentioned by Rhazes as authority on (Mentioned by Rhazes as authority on surgery)surgery)


SUSHRUTHA SAMHITA SUSHRUTHA SAMHITA INCORPORATES IN IT ALL THE INCORPORATES IN IT ALL THE

CLASSICAL 8 LIMBS OF AYURVEDA.CLASSICAL 8 LIMBS OF AYURVEDA.

SALYASALYA (MAJOR SURGERY)(MAJOR SURGERY) SALKYASALKYA (SUPRACLAVICLE (SUPRACLAVICLE

SURGERY)SURGERY) KAYACIKITSAKAYACIKITSA (MEDICINE)(MEDICINE) BHUTAVIDYA BHUTAVIDYA (DEMONOLOGY)(DEMONOLOGY) KUMARABHRTYA KUMARABHRTYA (PAEDIATRICS & OBSTETRICS)(PAEDIATRICS & OBSTETRICS) AGADATANTRA AGADATANTRA (TOXICOLOGY)(TOXICOLOGY) RASAYANATANTRA RASAYANATANTRA (STUDY OF ELIXIRS)(STUDY OF ELIXIRS) VAGIKARNATANTRAVAGIKARNATANTRA (SCIENCE OF FERTILITY (SCIENCE OF FERTILITY

AND VIRILITY)AND VIRILITY)


SUSHRUTHA SAMHITASUSHRUTHA SAMHITA VRADDHA SUSHRUTHAVRADDHA SUSHRUTHA

120 120 ChaptersChapters

SSUTRA STHANAUTRA STHANA Fundamental principlesFundamental principlesNIDANANIDANA EtiologyEtiologySARIRA STHANASARIRA STHANA Anatomy and PhysiologyAnatomy and PhysiologyCIKITSA STHANACIKITSA STHANA Therapeutics TherapeuticsKALPA STHANAKALPA STHANA ToxicologyToxicology

Other notable chapters are on Other notable chapters are on # training and attributes of a surgeon # training and attributes of a surgeon

# surgical instruments # surgical instruments # dreams# dreams


SUSHRUTHA SAMHITASUSHRUTHA SAMHITA

UTTARA TANTRAUTTARA TANTRA

An addendum An addendum

? Work of later authors and ? Work of later authors and commentators.commentators.


Sushrutha SamhitaSushrutha SamhitaSUTRA STHANASUTRA STHANA

THERE ARE FOUR DIFFERENT TYPES OF DISEASES.THERE ARE FOUR DIFFERENT TYPES OF DISEASES.# # AGANTUKAAGANTUKA TRAUMATIC OR TRAUMATIC OR EXTRANEOUS ORIGINEXTRANEOUS ORIGIN# SARIRA# SARIRA BODILY BODILY # MANASA# MANASA ? MENTAL? MENTAL# SWABAVIKA# SWABAVIKA NATURALNATURAL

(Excessive anger, grief, fear, joy, despondency, (Excessive anger, grief, fear, joy, despondency, envy,misery, pride, greed, lust, desire, malice, envy,misery, pride, greed, lust, desire, malice, are included within the category of manasa are included within the category of manasa disorders.) disorders.)


FACT OR MYTHFACT OR MYTH ??

““ANOTHER SIGNIFICANT ANOTHER SIGNIFICANT FEATURE OF HINDU MEDICINE WAS THE FEATURE OF HINDU MEDICINE WAS THE ABSENCE OF ANY ATTEMPT TO ABSENCE OF ANY ATTEMPT TO RECOGNIZE DISEASES OF THE BRAIN”. RECOGNIZE DISEASES OF THE BRAIN”.

H.J.J WINTER H.J.J WINTER

In A.L.BASHAM ’s In A.L.BASHAM ’s A cultural History of India 1974, Oxford.A cultural History of India 1974, Oxford.


Rare mention about the Rare mention about the Brain?!Brain?! SARIRA STHANASARIRA STHANA

In the fifth month the fetus is endowed with the In the fifth month the fetus is endowed with the mind and wakes up from the sleep of his mind and wakes up from the sleep of his subconscious existence.subconscious existence.

In the sixth month cognition (Buddhi)comes in.In the sixth month cognition (Buddhi)comes in.

In the seventh month all the limbs and members of In the seventh month all the limbs and members of its body are markedly developed.its body are markedly developed.

SANUKA says that probably the head of the fetus is SANUKA says that probably the head of the fetus is the first developed since head is the only organ the first developed since head is the only organ that makes the functions of all other organs that makes the functions of all other organs possible.possible.


SHIROROGA --- Disorders of the SHIROROGA --- Disorders of the HeadHead

VATAVYADHI --- Disorders of “Vayu”VATAVYADHI --- Disorders of “Vayu”AKSHEPAKAAKSHEPAKA C0NVULSIONSC0NVULSIONS

PAKSHAVADHAPAKSHAVADHA HEMIPLEGIAHEMIPLEGIAARDITAARDITA TOTAL PARALYSISTOTAL PARALYSISDANDA PATANKADANDA PATANKA ?PARKINSONS?PARKINSONSMANYA STAMBHAMANYA STAMBHA STIFF NECKSTIFF NECKJIHAVASTAMBHAJIHAVASTAMBHA PARALYSIS OF TONGUEPARALYSIS OF TONGUEGRIDHARASIGRIDHARASI SCIATICASCIATICAMURCHAMURCHA FAINTINGFAINTINGDHANUSH STAMBHADHANUSH STAMBHA TETANUSTETANUSAPASMARAAPASMARA EPILEPSYEPILEPSYUNMADAUNMADA MADNESSMADNESS


SUSHRUTHA CONSIDERED THE SUSHRUTHA CONSIDERED THE

HEAD AS THE CENTER OF ALL HEAD AS THE CENTER OF ALL

SPECIAL SENSES, AND SPECIAL SENSES, AND

DESCRIBES CERTAIN CRANIAL DESCRIBES CERTAIN CRANIAL

NERVES CONNECTED WITH NERVES CONNECTED WITH

SPECIFIC SENSORY SPECIFIC SENSORY

FUNCTIONS. FUNCTIONS.


# two nerves lower down at the back of ear # two nerves lower down at the back of ear (vidhura) which if cut produce deafness. (vidhura) which if cut produce deafness.

# a pair of nerves inside the two nostrils # a pair of nerves inside the two nostrils which if cut cause anosmia. which if cut cause anosmia.

# a pair of nerves below the end of the # a pair of nerves below the end of the eyebrow which if cut causes blindness.eyebrow which if cut causes blindness.

-Keswani.N.H.-Keswani.N.H. Medical Heritage Medical Heritage

of Indiaof India


““Ten nerves maintain the Ten nerves maintain the functions of the body by carrying functions of the body by carrying impulses of sound,touch,vision, taste, impulses of sound,touch,vision, taste, smell, respiration, sighing, yawning, smell, respiration, sighing, yawning, hunger, laughing, speech, and crying…” hunger, laughing, speech, and crying…”

““A pair of nerve each A pair of nerve each responds to sound, touch, vision, taste, responds to sound, touch, vision, taste, and smell.”and smell.”

Sushrutha SamhitaSushrutha Samhita


Total no of instruments Total no of instruments mentioned in the Sushrutha tantra mentioned in the Sushrutha tantra

125 125

Forceps Forceps 20 types20 types

SpeculaSpeculaScalpelsScalpelsScissorsScissors

SawsSawsCauteriesCauteriesSyringesSyringesNeedlesNeedlesTrocarsTrocarsCathetersCatheters


SVASTIKA YANTRASSVASTIKA YANTRAS

SURGICAL INSTRUMENTS SURGICAL INSTRUMENTS DESCRIBED IN SUSHRUTHA DESCRIBED IN SUSHRUTHA SAMHITASAMHITA


SURGERYSURGERYSpecific fumigation techniques, Specific fumigation techniques, Cautery with fire and alkali,Cautery with fire and alkali,Use of Ants to staple wounds,Use of Ants to staple wounds,

POORVAKARMAPOORVAKARMA PRADHANAKARMAPRADHANAKARMA PACHATHAKARMA PACHATHAKARMA

# Pre operative sedation.# Pre operative sedation. # Sammohini.# Sammohini. # Sanjivini.# Sanjivini.


Influence on the Influence on the worldworld

The patronage of the Abbasid Caliphs at The patronage of the Abbasid Caliphs at BAGHDAD 762.A.D. and most especially BAGHDAD 762.A.D. and most especially HARUN AL RASHID (786-809) kept the torch HARUN AL RASHID (786-809) kept the torch of learning alive during the dark ages. of learning alive during the dark ages.

Indian Physicians were in charge of their Indian Physicians were in charge of their hospitals, and one Manak translated the hospitals, and one Manak translated the SUSHRUTHA SAMITHA into ARABICSUSHRUTHA SAMITHA into ARABIC (8(8thth century AD).century AD).


HINDU MEDICINE WAS AN HINDU MEDICINE WAS AN INDEPENDENT DEVELOPMENT; ARAB INDEPENDENT DEVELOPMENT; ARAB

MEDICINE WAS FOUNDED ON MEDICINE WAS FOUNDED ON TRANSLATION OF SANSKRIT TRANSLATION OF SANSKRIT

TREATISE, AND EUROPEAN MEDICINE TREATISE, AND EUROPEAN MEDICINE DOWN TO THE SEVENTH CENTURY DOWN TO THE SEVENTH CENTURY

WAS BASED UPON THE LATIN WAS BASED UPON THE LATIN VERSION OF THE ARABIAN VERSION OF THE ARABIAN

TRANSLATION.TRANSLATION.

-SIR WILLIAM HUNTER (1718-1783)-SIR WILLIAM HUNTER (1718-1783)


THE DIASPORA OF ANCIENT INDIAN MEDICAL THE DIASPORA OF ANCIENT INDIAN MEDICAL KNOWLEDGEKNOWLEDGE


An Arab Surgeon Performing the ancient An Arab Surgeon Performing the ancient cataract cataract Operation called COUCHING first described byOperation called COUCHING first described bySUSHRUTHA.SUSHRUTHA.


““Medicine can now be regarded as Medicine can now be regarded as the oldest of the Indian sciences, the oldest of the Indian sciences, and have been proved to be the and have been proved to be the

science in which Indians specialized science in which Indians specialized first”.first”.

Julius Jolly Julius Jolly as quoted in ‘Indian Medicine’ by C.G.KASHIKARas quoted in ‘Indian Medicine’ by C.G.KASHIKAR


““INDIAN SURGERY INDIAN SURGERY REMAINED AHEAD OF EUROPEAN REMAINED AHEAD OF EUROPEAN UNTIL THE 18UNTIL THE 18THTH CENTURY,WHEN CENTURY,WHEN THE SURGEONS OF THE EAST THE SURGEONS OF THE EAST INDIA COMPANY WERE NOT INDIA COMPANY WERE NOT ASHAMED TO LEARN THE ART OF ASHAMED TO LEARN THE ART OF RHINOPLASTY FROM THE RHINOPLASTY FROM THE INDIANS”.INDIANS”.

A.L.BASHAM A.L.BASHAM

(The wonder that was India, 1971)(The wonder that was India, 1971)


SUSHRUTHA SAMHITASUSHRUTHA SAMHITA

Sushrutha divided 1120 diseases into natural Sushrutha divided 1120 diseases into natural and supernatural.and supernatural.

He taught palpation and auscultation of heart, He taught palpation and auscultation of heart, lungs, and womb; and advocated the use of lungs, and womb; and advocated the use of special senses. special senses.

He was the pioneer of most teaching He was the pioneer of most teaching techniques in experimental and clinical techniques in experimental and clinical surgery.surgery.


CONCLUSIONCONCLUSION

To Sushrutha, belongs the honor of To Sushrutha, belongs the honor of being called “the FATHER OF being called “the FATHER OF

SURGERY” and the ‘PATRON OF A SURGERY” and the ‘PATRON OF A SURGEON IN TRAINING’,SURGEON IN TRAINING’,

as he was the first before all to as he was the first before all to emphasize on practical training in emphasize on practical training in experimental and clinical surgery.experimental and clinical surgery.

a tribute to ancient indian surgery

Health & Medicine

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sushrutha samhitateaching

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singhal india

pair of nerves

surgeon of ancient india