We tend to think of surgery as a high-tech modern science, but the fact is that surgery has a history dating back more than 5000 years. In the 5th century BC, a celebrated Ayurvedic physician and surgeon, Sushruta, was blazing a path which would be trod by surgeons in the centuries to come. He lived, taught and practiced his art on the banks of the River Ganga in India. Many of Sushruta’s contributions to medicine and surgery preceded similar discoveries in the Western world. He had a deep knowledge of anatomy, etiology, embryology, digestion, metabolism, genetics and immunity. Much of what we know about this inventive surgeon is contained in a series of volumes he authored, which are collectively known as the Susrutha Samhita. It may seem incredible, but Sushruta conducted complicated surgeries like cesareans, cataract, artificial limbs, fractures, urinary stones and even plastic surgery and brain surgery! He is considered to be the father of Plastic Surgery and Cosmetic Surgery since his technique for repairing the disfigured nose with a flap of skin from the forehead is practiced almost unchanged in technique to this day. Usage of anesthesia was well known in ancient India, and Sushruta was the first to prescribe the use of wine with incense of cannabis for anaesthesia. Sushruta was also perhaps the first surgeon in the world to describe different types of surgical instruments including endoscopes. In addition, he was the first surgeon to teach by performing operations on inanimate objects such as watermelons, clay plots and reeds- the forerunner of the modern practice of surgical workshops.
Sushruta’s Magnum Opus
The Susrutha Samhita contains the first known description of several operations, including the uniting of bowel, the removal of the prostate gland, the removal of cataract lenses and the draining of abscesses. In this awe-inspiring work, he describes over 120 surgical instruments, 300 surgical procedures and classifies human surgery in 8 categories. These include cutting, probing, scratching, piercing, inserting, excision, puncturing and stitching. The details about 650 drugs of animal, plant, and mineral origin are included in his work. Many of the complicated procedures for dissolving, macerating, extracting, and combusting a variety of solid, squashy, and liquids used for treatment, remain part of modern Ayurvedic pharmacological practice. In the book’s 184 chapters, 1,120 medical conditions, including injuries and illnesses relating to ageing and mental illness, are listed. Specialties like medicine, pediatrics, geriatrics, diseases of the ear, nose, throat and eye, toxicology, aphrodisiacs and psychiatry are dealt with in detail.
Sushruta devotes a complete volume of his experience to ophthalmologic diseases. In particular, Sushruta describes what may have been the first extra capsular cataract surgery using a sharply pointed instrument with a handle fashioned into a trough. Sushruta’s coverage of toxicology goes into great detail regarding symptoms, first-aid measures, and long-term treatment, as well as classification of poisons and methods of poisoning.
Sushruta was both a practitioner and a teacher of surgery. A surgeon and philosopher, he is one of the leading lights of Ayurveda, the holistic system of healing that is rooted in India and flourishes all over the world. Kerala in South India has nurtured this system of healing in its purest form, and lamp of that Sushruta lit still glows in all its brightness in this sunny state that is called God’s Own Country.