A tribute to Ancient Indian surgery

1. SURGICAL LEGACY OFSURGICAL LEGACY OF
SUSHRUTHA’S IN ANCIENT INDIA…SUSHRUTHA’S IN ANCIENT INDIA…
Dr.ANIL PANDEDr.ANIL PANDE
Neurosurgeon,VHS Hospital, Chennai, India.Neurosurgeon,VHS Hospital, Chennai, India.
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2. 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
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3. PAVED BATHROOM AND BRICKWALL PAVED BATHROOM AND BRICKWALL
MOHENJO-DARO (c.3300BC)MOHENJO-DARO (c.3300BC)
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4. SUSHRUTHA,SUSHRUTHA, SURGEON OF ANCIENT INDIA, PERFORMING SURGEON OF ANCIENT INDIA, PERFORMING
AN ARTIFICIAL EAR LOBE AN ARTIFICIAL EAR LOBE (BY ROBERT ATHOM).(BY ROBERT ATHOM).
A DESCENDENT OF VISWAMITHRA?A DESCENDENT OF VISWAMITHRA?
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5. WHEN DID HE LIVE ?WHEN DID HE LIVE ?
MENTIONED IN THE MENTIONED IN THE
MAHABHARATHA (1000 BC).MAHABHARATHA (1000 BC).
WESTERN SCHOLARS PLACE HIM WESTERN SCHOLARS PLACE HIM
22
ndnd
TO 4 TO 4
thth
CENTURY A.D. CENTURY A.D.
--- NOT ACCEPTED BY MANY.--- NOT ACCEPTED BY MANY.
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6. SUSHRUTHA SAMHITASUSHRUTHA SAMHITA
ORIGINSORIGINS
ATHARVA VEDAATHARVA VEDA
AYURVEDAAYURVEDA
(The fifth Veda) (The fifth Veda) CHARAKA CHARAKA
(Knowledge of life)(Knowledge of life) SUSHRUTHA SUSHRUTHA
VAGABHATAVAGABHATA
SS
AA
MM
HH
II
TT
AA
SS
VIRDDHA VIRDDHA
TRAYITRAYI
“TRIAD OF ANCIENTS” “TRIAD OF ANCIENTS”
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7. TRADITIONAL AYURVEDIC TRADITIONAL AYURVEDIC
GENEOLOGY GENEOLOGY
BRAMHABRAMHA
DAKSHAPRAJAPATIDAKSHAPRAJAPATI
ASHWINI KUMARSASHWINI KUMARS
INDRAINDRA

BHARADWAJA BHARADWAJA
ATREYAATREYA
AGNIVESHAAGNIVESHA
DHANAVANTRIDHANAVANTRI
DIVADOSADIVADOSA
SUSHRUTHASUSHRUTHA
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8. DHANVANTARIDHANVANTARI HOVERING ABOVE HOVERING ABOVE
VISHNU BAS – RELIEF FRAGMENT VISHNU BAS – RELIEF FRAGMENT
FROM ANGKOR WAT FROM ANGKOR WAT
MANUSCRIPT PAGE MANUSCRIPT PAGE
FROM ATHARVAVEDA FROM ATHARVAVEDA
TUBINGENTUBINGEN
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9. ““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”
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10. SUSHRUTHA SAMHITASUSHRUTHA SAMHITA
TEACHING 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 – 6
THTH
BC. BC.
Revised by Revised by
NAGARJUNA NAGARJUNA 2 2
ndnd
– 4 – 4
thth
century BCcentury BC
KITAB-I-SUSRURD 8KITAB-I-SUSRURD 8
thth
Century AD Century AD
(Mentioned by Rhazes as authority on (Mentioned by Rhazes as authority on
surgery)surgery)
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11. SUSHRUTHA SAMHITA INCORPORATES SUSHRUTHA SAMHITA INCORPORATES
IN IT ALL THE CLASSICAL 8 LIMBS OF IN IT ALL THE CLASSICAL 8 LIMBS OF
AYURVEDA.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)
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12. SUSHRUTHA SAMHITASUSHRUTHA SAMHITA
VRADDHA SUSHRUTHAVRADDHA SUSHRUTHA
120 120 ChaptersChapters
SSUTRA STHANAUTRA STHANA Fundamental principlesFundamental principles
NIDANANIDANA EtiologyEtiology
SARIRA STHANASARIRA STHANA Anatomy and PhysiologyAnatomy and Physiology
CIKITSA STHANACIKITSA STHANA Therapeutics Therapeutics
KALPA 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
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13. SUSHRUTHA SAMHITASUSHRUTHA SAMHITA
UTTARA TANTRAUTTARA TANTRA
An addendum An addendum
? Work of later authors and ? Work of later authors and
commentators.commentators.
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14. Sushrutha SamhitaSushrutha Samhita
SUTRA STHANASUTRA STHANA
THERE ARE FOUR DIFFERENT TYPES OF THERE ARE FOUR DIFFERENT TYPES OF
DISEASES.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.)
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15. 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.
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16. Rare mention about the Brain?!Rare mention about the Brain?!
SARIRA STHANASARIRA STHANA
In the fifth month the fetus is endowed with the mind and In the fifth month the fetus is endowed with the mind and
wakes up from the sleep of his subconscious existence.wakes up from the sleep of his 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 its In the seventh month all the limbs and members of its
body are markedly developed.body are markedly developed.
SANUKA says that probably the head of the fetus is the SANUKA says that probably the head of the fetus is the
first developed since head is the only organ that makes first developed since head is the only organ that makes
the functions of all other organs possible.the functions of all other organs possible.
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17. SHIROROGA --- Disorders of the HeadSHIROROGA --- Disorders of the Head
VATAVYADHI --- Disorders of “Vayu”VATAVYADHI --- Disorders of “Vayu”
AKSHEPAKAAKSHEPAKA C0NVULSIONSC0NVULSIONS
PAKSHAVADHAPAKSHAVADHA HEMIPLEGIAHEMIPLEGIA
ARDITAARDITA TOTAL PARALYSISTOTAL PARALYSIS
DANDA PATANKADANDA PATANKA ?PARKINSONS?PARKINSONS
MANYA STAMBHAMANYA STAMBHA STIFF NECKSTIFF NECK
JIHAVASTAMBHAJIHAVASTAMBHA PARALYSIS OF TONGUEPARALYSIS OF TONGUE
GRIDHARASIGRIDHARASI SCIATICASCIATICA
MURCHAMURCHA FAINTINGFAINTING
DHANUSH STAMBHADHANUSH STAMBHA TETANUSTETANUS
APASMARAAPASMARA EPILEPSYEPILEPSY
UNMADAUNMADA MADNESSMADNESS
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18. 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.
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19. # 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 which if # a pair of nerves inside the two nostrils which if
cut cause anosmia. cut cause anosmia.
# a pair of nerves below the end of the eyebrow # a pair of nerves below the end of the eyebrow
which if cut causes blindness.which if cut causes blindness.
-Keswani.N.H.-Keswani.N.H.
Medical Heritage of IndiaMedical Heritage of India
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20. ““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
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21. 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
SpeculaSpecula
ScalpelsScalpels
ScissorsScissors
SawsSaws
CauteriesCauteries
SyringesSyringes
NeedlesNeedles
TrocarsTrocars
CathetersCatheters
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SVASTIKA YANTRASSVASTIKA YANTRAS

22. SURGICAL INSTRUMENTS DESCRIBED SURGICAL INSTRUMENTS DESCRIBED
IN SUSHRUTHA SAMHITAIN SUSHRUTHA SAMHITA
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23. SURGERYSURGERY
Specific 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.
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24. Influence on the worldInfluence on the world
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 HARUN AL RASHID (786-809) kept
the torch of learning alive during the the torch of learning alive during the
dark ages. dark ages.
Indian Physicians were in charge of Indian Physicians were in charge of
their hospitals, and one Manak their hospitals, and one Manak
translated the SUSHRUTHA SAMITHA translated the SUSHRUTHA SAMITHA
into ARABICinto ARABIC (8(8
thth
century AD). century AD).
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25. HINDU MEDICINE WAS AN INDEPENDENT HINDU MEDICINE WAS AN INDEPENDENT
DEVELOPMENT; ARAB MEDICINE WAS DEVELOPMENT; ARAB MEDICINE WAS
FOUNDED ON TRANSLATION OF FOUNDED ON TRANSLATION OF
SANSKRIT TREATISE, AND EUROPEAN SANSKRIT TREATISE, AND EUROPEAN
MEDICINE DOWN TO THE SEVENTH MEDICINE DOWN TO THE SEVENTH
CENTURY WAS BASED UPON THE LATIN CENTURY 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)
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26. THE DIASPORA OF ANCIENT INDIAN MEDICAL KNOWLEDGETHE DIASPORA OF ANCIENT INDIAN MEDICAL KNOWLEDGE
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27. An Arab Surgeon Performing the ancient cataract An Arab Surgeon Performing the ancient cataract
Operation called COUCHING first described byOperation called COUCHING first described by
SUSHRUTHA.SUSHRUTHA.
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28. ““Medicine can now be regarded as the Medicine can now be regarded as the
oldest of the Indian sciences, and have oldest of the Indian sciences, and have
been proved to be the science in which been proved to be the science in which
Indians specialized first”.Indians specialized first”.
Julius Jolly Julius Jolly
as quoted in ‘Indian Medicine’ by C.G.KASHIKARas quoted in ‘Indian Medicine’ by C.G.KASHIKAR
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29. ““INDIAN SURGERY INDIAN SURGERY
REMAINED AHEAD OF EUROPEAN REMAINED AHEAD OF EUROPEAN
UNTIL THE 18UNTIL THE 18
THTH
CENTURY,WHEN THE CENTURY,WHEN THE
SURGEONS OF THE EAST INDIA SURGEONS OF THE EAST INDIA
COMPANY WERE NOT ASHAMED TO COMPANY WERE NOT ASHAMED TO
LEARN THE ART OF RHINOPLASTY LEARN THE ART OF RHINOPLASTY
FROM THE INDIANS”.FROM THE INDIANS”.
A.L.BASHAM A.L.BASHAM
(The wonder that was India, 1971)(The wonder that was India, 1971)
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30. SUSHRUTHA SAMHITASUSHRUTHA SAMHITA
Sushrutha divided 1120 diseases into natural and Sushrutha divided 1120 diseases into natural and
supernatural.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 techniques in He was the pioneer of most teaching techniques in
experimental and clinical surgery.experimental and clinical surgery.

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31. CONCLUSIONCONCLUSION
To Sushrutha, belongs the honor of To Sushrutha, belongs the honor of
being called “the FATHER OF SURGERY” being called “the FATHER OF SURGERY”
and the ‘PATRON OF A SURGEON IN and the ‘PATRON OF A SURGEON IN
TRAINING’,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.