When you think of surgery, you think of cutting edge technology, of gleaming antiseptic theatres and state of the art equipment. However, the fact is that surgery is a science that was practiced even thousands of years ago. Ayurveda, the world’s oldest system of medicine, is the pioneer of surgery. Ayurveda is basically a health science that emphasizes the prevention and management of disease through a fundamental understanding of the principles of creation. In Kerala, where Ayurveda took root more than five thousand years ago, ayurvedic physicians or vaidyars will explain to you that whatever the disorder, Ayurveda has numerous techniques for proper diagnosis and treatment, in one of its eight branches. Of these eight branches, it is Shalya Chikitsa that specializes in surgery. The principles of Shalya Chiktsa were first spelled out by the great Ayurvedic physician, Susruta, thousands years ago in his work, the “Susruta Samhita”. Susruta, whose name is synonymous with surgery in Ayurveda, makes it clear that Shalya Chikitsa is the best alternative when other procedures and medicines fail.
Shalya Chikitsa- A Scientific Approach
Even in ancient times, Shaya Chikitsa was taught scientifically. Dissection of dead bodies was an important part of the learning process, and an exhaustive range of surgical methods was taught. Pre-operative procedures, as well surgical techniques like excision, incision, scraping, puncturing, extracting, draining, and suturing were all dealt with. Post operative procedures, the body’s vital points or marmas, anesthesia, the different types of bandages and dressings, as well as the instruments to be used, have all been discussed in detail in the Susruta Samhita. The instruments were made mainly of stone, wood, branches, leaves and other natural materials. Creepers were often used for ligatures. Bloodletting and leech treatment are also a part of Shalya Chikitsa.
Susruta Samhita gives a detailed explanation of the conditions that call for Shalya Chikitsa. According to Ayurveda, Shalya Chikitsa is carried out only when the conventional forms of treatment do not produce results or are not applicable. Intestinal obstructions, tumours, internal and external injuries, fractures and complications during pregnancy and delivery all may need surgical intervention. Susruta was the very first surgeon to develop cosmetic surgery in Ayurveda. Rhinoplasty and auroplasty- the repair of nose and ear traumas- were carried out even in those days, and Susruta also did eye surgeries which are similar to those being done by modern surgeons. Certain diseases which normally respond well to non-invasive treatment may also require Shalya Chikitsa. The legendary sage-physician of ancient times, Charaka recommended Shaya Chikitsa in certain cases like hemorrhoids, and abdominal lumps.
The long years of foreign rule in India put a brake to the progress of Shalya Chikitsa . Moreover, in earlier days, the lack of properly sterile conditions was a challenge faced by Ayurvedic surgeons. In addition, the instruments that were used were rather primitive, which made the procedures rather painful. However, we must always remember that Shalya Chikitsa was at one time immensely popular not only because it gave fast relief, but also because it was effective when conventional treatments were not. This was especially true when it came to abcesses and cysts, enlarged lymph nodes, prolapsed rectum, stones, retention of urine and breast diseases. Shalya Chikitsa remains to this day the last option available to save a patient’s life, and Ayurvedic surgeons insist, as their counterparts in Western medicine do, that it can be done only after getting the consent of a patient’s well wishers and family.