Surgery in Ancient India
Pre-Christian India Contributed Much to Modern Surgical Knowledge
Nov 16, 2009 Sanjiva Wijesinha
There are several possible explanations for the paucity of knowledge in the west about the ancient Indian contributions to our present day medical knowledge.
Sanskrit and Medicine
Firstly, Sanskrit, the language in which most of the early Indian medical texts was written is difficult to master - and very few scholars with a knowledge of Sanskrit as well as medicine were available to translate these early written works into western languages.
Another reason is the one that was given by Johnston-Saint (1) in his Sir George Birdwood Memorial Lecture, delivered before the Indian Section of the Royal Society of Arts in 1929:
"Our system of classical education had already given us an apparent beginning for all the arts and sciences. A disproportionate part of our education was devoted to ancient Rome and Greece where we learned all about Apollo and Aesculapius and in Greek history we came to Hippocrates. Here we had got a founder of medicine already for us, and that there might have been anyone before him, few of us were disposed to inquire."
Susruta Samhita
Sometime between 800 and 600 years before the birth of Christ, the surgeon Susruta lived in India - practising and teaching the art of surgery at the University of Varanasi (Benares), located on the banks of the river Ganges in north eastern India . He is acknowledge today as the author of the Susruta Samhita, a monumental treatise on surgery that clearly described operations like cataract surgery, laparotomy (abdominal surgery), plastic repair of the nose, bladder stone removal and repair of urethral stricture .
The Samhita appears to be the earliest known written work detailing the systematic teaching of surgery. It was first translated into Arabic in the 8th century - and later into European languages. The best available English translation is that by Kaviraj Bhishagharatna - originally published in 1910 with a later edition in 1963.
Branches of Medicine
The Samhita is divided into into six sections that covering all the branches of medicine - including toxicology, hygiene, midwifery, ophthalmology, psychosomatic ailments and materiamedica.
Susruta (nor surprisingly!) deemed surgery to be the foremost branch of medicine, stating: "Surgery has the advantage, by means of surgical instruments and appliances, of producing instantaneous effects. Hence, it is the highest in value of all the medical tantras . It is eternal and a source of infinite piety, imports fame and opens the gates of Heaven to its votaries. It prolongs the duration of human existence on earth and helps men in successfully fulfilling their missions and earning a decent competence in life."
Ancient Surgical Instruments
Susruta in his textbook provided detailed descriptions of the manufacture and maintenance of about 125 surgical instruments - including 28 varieties of catheters, sounds and irrigating syringes - providing precise measurements and recommending what metals should be used in their manufactuire and what caustics and alkalis should be used to clean them after use. Some of these bear an amazing resemblance to surgical instruments in use in the present era.
Rhinoplasty
The detailed description of the operation of Rhinoplasty (nasal reconstruction) in the Samhita written over a millenium ago is strikingly precise and comprehensive. Plastic surgeons even today describe the pedicled forehead flap used for plastic surgical repair of the nose as the Indian flap.
References:
Johnston-Saint P. An outline of the history of medicine in India. Indian Med Rec. 1929;49:289.
Bhishagratna KL. An English translation of The Sushruta Samhita. Varanasi: Chowkhamba Sanskrit Series Office; 1963
Raju VK. Susruta of ancient India. Indian J Ophthalmol 2003;51:119-22
Das S. Urology in ancient india. Indian J Urol. 2007 Jan–Mar; 23(1): 2–5
Surgical Instruments described by Susruta
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