Wednesday 3 August 2011

Sushruta and Sushruta Samhita

Hindu sages and seers have paid as much attention to the life here and now as to the one hereafter. It is towards such an end that they developed secular sciences like medicine “Shariram Adyam Khalu Dharma Sadhanam’ which means that ‘for the practice of our Dharma, the first priority is a healthy body’.
Since our body is a precious gift of God and since we achieve whatever we want only through it, to keep it in a fit and healthy condition has been considered the primary duty of every human being. The Science of Ayurveda or the Science of Health and Longevity aims exactly at this.
Of the several standard treatises on the subject of medicine and health sciences written in ancient India, the Charaka Samhita of Charaka and Sushruta Samhita of Sushruta have carved out for themselves a special place in the field of medicine and health sciences.
     Whereas Charaka Samhita’is a work on medicine, Sushruta Samhita is predominately a treatise on surgery.
We are familiar with the name Hippocrates, referred to as ‘The Father of Medicine.’ He was a noted physician in ancient Greece who lived by about 425 B.C.
He is celebrated for having saved several Greek cities from the ravages of plague nearly five centuries before Christ. Even today, physicians on entering the noble profession of medicine,  take an oath known as ‘Hippocratic Oath’, vowing to live with the same spirit of selfless service and purity of purpose as Hippocrates did.
Predating him by more than a century, our own Sushruta, Crest Jewel of Indian medicine and Surgery, a contemporary of the Buddha, imparted a similar exhortation to his students on their entering the practice of medicine and surgery.
In his exhortation, Sushruta emphasised that knowledge was not an individual monopoly and that remuneration was secondary to service.
According to Sushruta, doctors should serve the patient with the motto “Service to man is service to God’
Sushruta is supposed to have lived somewhere between 1000 and 600 B.C. and is considered the oldest medical authority in India. He wrote a wonderful medical treatise called as Sushruta Samhita —a monumental work, which besides acquainting us with his ideas on medical methods and surgical operations, demonstrates to the entire world how India was ahead of the whole world in medical knowledge.
The Samhita deals exhaustively with eight branches of medical knowledge such as
2.Treatment of the diseases of the eye, ears,  throat  and  teeth.                           
3. Therapeutics,    
4. Psychiatry and psychotherapy                            
5. Pediatrics           
6. Toxicology and treatment of poison                 
7. Therapy for longevity and rejuvenation, and
8. Therapy for increasing virility.
But the text is known more for its extensive chapter on Surgery.  Some of the operations deal with ophthalmic couching, cutting for stone, removal of arrows and splinters, suturing, examination of dead bodies for atopsy and finally Caesarean operations.
There are descriptions of 700 medicines, 3,000 surgical instruments and several disease processes with their symptoms and treatment –both medical and surgical.
Sushruta says “Only the union of medicine and surgery constitutes a complete doctor. The doctor who lacks knowledge of one of those branches is like a bird with only one wing”. It has now been acknowledged that Sushruta Samhita was the first medical treatise that influenced the practice of medicine all over the world.
As it was not possible to perform some of the meticulous operations without the use of general anesthesia, Sushruta deals with them in his Treatise. A reference to the use of such anesthesia is available in a Sanskrit composition called ‘Bhoja Prabandham’ written by Sanskrit Pandit Ballala in the 12th Century A.D.
In this poetic work, the poet describes an operation on King Bhoja where a tumour of the brain was removed by drilling a hole in the skull.
In the description of the operation, a drug known as ‘‘Sammohini’ as prescribed by Sushruta was used to make him insensitive.
After the operation, another drug by name ‘Sanjeevini’ was used to revive him back to consciousness. The knowledge of such drugs has been, unfortunately, lost in antiquity.
 The meticulous aseptic and antiseptic principles of surgery, described by Sushruta, were discovered in Europe in the late 19th century by Lord Lister [1817-1912]. 
In fact, it was Joseph Lister who, for the first time, demonstrated antiseptic surgery in 1890. Further, while Sushruta laid emphasis on absolute cleanliness while performing an operation, the Western doctors did not care much for cleanliness. It is learnt that the wearing of clean clothes by the surgeon was accepted in Europe only in the late 19th century. Before that, surgeons used to wear the same old dirty gown throughout as a mark of seniority and experience.
For treating epidemics like plague, Sushruta adopted the principle of ‘Sound therapy’—a specialisation to which the Western countries woke up recently.
The 3rd Chapter of ‘Sushrutha Samhita’ called Kalpa Sthana deals with what could be called as ‘Instrumental or sound therapy’. Sushrutha found out that the sound waves emanating from a musical instrument could be used to act as a vehicle or a medium to carry with it the medicine required for the patient. The 15th shloka of this chapter says:
“Vadyasya shabdena hi   yanti nasham
Vishani ghoranyapi Yaani   Santhi”
meaning that ‘the sound released out of the musical instrument relieves the community of the poisonous effect of an epidemic’.
Those days when an epidemic like plague broke out, it would be impossible for a doctor to attend to all the patients individually.
Under such circumstances, an instrumental therapy was resorted to. After smearing a drum with a layer of the paste of the medicine to be given as treatment, the drum would be kept on the tower of a temple and the beating of the drum would start. With this, the sound waves created would act as a vehicle to carry the medicine in micro form.
 The patient staying in the medicine-enriched atmosphere would inhale it and thus receive the treatment.
Thus, Sushruta combined the effects of both sound therapy and aero therapy for restoring health, nearly 2,600 years ago. This restoration of health by the attuning of sound vibrations first in the environment and then within the body, is now scientifically established
 It may look unbelievable  that Sushruta was the first plastic surgeon in the world who conducted plastic surgery more than 2,500 years ago. Plastic surgery, as the name implies, does not involve any plastics as generally understood.
The word ‘plastics’ in plastic surgery derives its name from the Greek word ‘plastiko’ which means ‘to build up; or ‘take form’. Sushrutha specialised in building up noses—now called ‘rhinoplasty’ (Rhino means nostril or nose in Greek).
In those days of flashing swords in a battle, soldiers lost their noses easily. Such soldiers would go to Sushrutha for treatment, when he took strips of flesh from other parts of the body and mend their noses. Occasionally, a man would go to him, one who needed not a nose but a lip. Sushrutha would fashion a new lip for him.
Such surgery was not available anywhere in the world even for centuries later except in India.
In the War of 1792 between the Britishers and Tippu Sultan, Tippu’s soldiers captured a Maratha cart driver by name Cowasjee working in the British army and cut off his nose and arm. A year later, a native vaidya from Pune (a potter by profession) reconstructed Cowasjee’s nose in the presence of two English doctors, Thomas Cruso and James Hindlay of Bombay Presidency. An illustrated account of this surgical marvel, described as ‘not uncommon in India and has been in practice from time immemorial’ appeared in the Madras Government Gazette.
A London based magazine ‘The Gentleman’ reproduced this article in its issue dated October 1794 The surgical process corresponds to that mentioned in the medical treatise ‘Sushrutha Samhita’. It is this article that aroused the interest of surgeons all over the world.
Sushruta Samhita is the oldest medical work that clearly describes plastic surgery of the nose, ear and the lip.
An Indian physician in Baghdad during the reign of Abbasid Caliph (786 A.D – 809 A.D.) translated Sushruta Samhita into Arabic. Persian physician al-Razi [860-925] quotes the Arabic translation of Sushruta Samhita as an authority on surgery.
It is tragic that the West has always termed our religion and philosophy as mystical, not understanding their basic rationality.
The whole underlying philosophy of medicine is neither mystical nor unpractical. All activities are for the betterment of mankind and they are all adorations of God.
Medicine is specially so, since it brings direct relief both to the healer and the healed, if done with the spirit of service which is fundamental to all religions.
Article by : B.M.N.Murthy
Source: Bhavan's Journal 15 May 2011
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