Hippocrates is often credited with having contributed to the evolution of modern rational medicine.
Sushruta is the man who equally deserves that honour.
Although modern medicine and surgery look westward for their ideas, methods and technology, in ancient times, India was the fountain-head of advancement in several spheres including in the realm of Medicine and Surgery.
Credited with having written the most comprehensive medical treatise of his times, Sushruta is known today as the father of Indian surgery. The original text of the treatise, the Sushruta Samhita is dated to the late centuries BCE.
In it, Sushruta systematised scattered knowledge of surgical techniques and allied subjects like obstetrics, gynaecology, paediatrics, geriatrics and so on. His treatise describes in great detail, facets of anatomy, physiology, diagnoses, pathology, pharmacology and more. Each of these subjects is further classified and explained scientifically.
Sushruta is said to be the first person to have advocated dissection of the human body to understand human anatomy. In a section of the treatise called Shareera Sthana he describes Angarachana or Anatomy and propounds that a thorough knowledge of Anatomy was necessary to perform surgery.
Seen in the light of the times in which he lived when touching a dead body was considered polluting and society imposed several injunctions against it, the feat is indeed remarkable.
Sushruta conducted various kinds of surgery from amputation to nose reconstruction. The section on Surgery describes eight types of surgical procedures. Namely excision, incision, scraping, puncturing, blood-letting, probing, extraction and suturing. Pre and post operative measures are also described in vivid detail.
Rhinoplasty or nose reconstruction is one of the surgeries elucidated in the text. The nose is reconstructed by using the flap of skin cut from the patient’s cheek. This principle is exactly what present day plastic surgeons name as pedicile grafting. Hence, Sushruta is also often known as the father of plastic surgery.
Sushruta is said to be the first person to have evolved a sound method of training for his students in surgical skills stressing the importance of observation and practical experience in the art of surgery. In order to attain proficiency in surgical methods, Sushruta would have his students practice incision on the urinary bladder of dead animals filled with mud or materials of different density.
The tools required for surgery are also described in great detail in Sushruta Samhita. It describes hundreds of surgical instruments such as tongs, forceps, scalpels, catheters, syringes, speculums , needles, saws, probes, scissors etc.
Modern day Keyhole (laparoscopic) Surgery techniques connect in many ways with the surgical methods advocated by Sushruta and symbolize a leap in the ability of the human mind to imagine, create, and progress; while being evolved from ancient beginnings.
Keyhole approach (Laparoscopic approach) is a method of surgery that is minimally invasive with miniature incisions. Each incision having a size of one to three rice grains. Sushruta too experimented with different methods of surgery and techniques of incision. Sushruta’s methods demanded a thorough understanding of Anatomy. Keyhole procedures too require surgical teams that are skilled and experienced to handle the magnified anatomy that present themselves on a TV screen in keyhole methods.
The Sushruta Samhita is relevant and holds practical value even today over 2000 years after it was first written. This holds true despite major advances in medical and surgical knowledge and methods. That in itself speaks volumes about the genius that was Sushruta.
Centuries after he is gone, Sushruta continues to remain an inspiration to us and a source of great pride to the Indian medical fraternity, indeed to all Indians.
Take Care.
