Medical and Surgical Treatment methods as outlined in Susrutha Samhita
(A fundamental Ayurveda Treatise)

AYURVEDA AS THE FORERUNNER OF MODERN MEDICAL SCIENCE

S.N.SRIRAMADESIKAN
Formerly Honorary Special Officer,
Ayurveda Translation Wing,
Department of Indian Medicine & Homeopathy,
Government of Tamil Nadu.

(It is well known that Pandit S.N. Sriramadesikan was appointed as Special Officer (Ayurveda Translation Wing) by the Government of Tamilnadu. In that capacity he had translated the first Ayurveda Treatise Charaka Samhita and Susrutha Samhita from Sanskrit to Tamil and this was published by the Government of Tamilnadu).

The term “Ayurveda” denotes the fact that it deals with life and living long, free from any illness. Its chief aim is to cure illness and in the case of healthy persons, to preserve that state. Charaka, Susruta and other Acharyas of Ayurveda declare this to be an Upaveda to the Atharvaveda, because of the close connection between the two.

It is familiar to us that Vedas refer to illnesses cured by Mantra, Tantra, Yagna and Devapujas etc., But the Atharva Veda speaks also of illness, the medicinal herbs to be used for curing them and the ways to be adopted for the same. We can realise from this that the system of Ayurveda had begun even in the early Vedic period. Scholars know that the influence of Ayurveda is to be seen in other Vedas as well.

FOREIGNERS ACCLAIM INDIANS AS PIONEERS OF SCIENCE

While observing certain surgical treatment methods in Susrutha Samhitha, it is felt that Susrutha had become renowned as pioneer in the Scientific medical world for the fantastic achievement made today. A Britisher named Twhaple in his book entitle “The Story of the Wound Repair’, has acclaimed, by mentioning that “Susrutha was a pioneer in anaesthesia also”. Yet another Britisher named Weber in his book has mentioned that “our modern surgeons have been able to borrow from them (Indians) the operations of rhinoplasty in plastic surgery”. It is explained vividly in the 16th chapter of the Suthra-Sthaanam in Susrutha Samhitha that for the Plastic Surgery of the ear and the nose, flesh from the cheeks had to be used for the transplantation of the same. The same opinion has been given by Hirsenberg, a Britisher, in his remark “The whole plastic surgery in Europe had taken its new flight, when these cunning devices of Indian workmen became known to us. The transplanting of the skin flaps is also essentially an Indian method”.

Foreigners like Hornele have praised Sustrutha with astonishment for having explained in Anatomy, the method of preserving the Corpse to the extent of tracing very minute nerves etc., while dissecting the same.

(Sustrutha Samhitha – Sareera Sthaana – Chapter 5).

Even Foreign experts like Keith, Mcdonald and others have explained that Indian are capable of critical / investigation of all the organs of the body, namely Anatomy.

Susrutha Has Sown the Seed For Medical Science

Susrutha has enunciated in his work about the miraculous achievements like the abortion (Medical termination of Pregnancy through surgery), delivery of the child through Caesarean Operation during critical child birth etc., (15th Chapter of the Chikitsa Sthaanam in Susrutha Samhita). The method of contraception through Vasectomy is clearly seen in the part of Atharvaveda, a part of which is Ayurveda. The method of preventing pregnancy during coitus has been explained in Aaraniya Upanisad. Alleviating pain through traeatment during abortion and the ways of begetting a male or female child as per the wish have been mentioned in the second part of Sareera Sthaana in Susrutha Samhita. Surgery should be avoided in 107 vital parts essential to life which are otherwise called the secret zones. Susrtha, while mentioning in his work, that utmost caution must be exercised during treatment, if surgery can’t be avoided, has also described about 120 instruments used in surgical operation.

The information given by Ramayana about the transplantation of goat’s testicle for the restoration of male virility to Indra who lost his testicle due to a curse by Gowthama, is almost like reminding the persent modern medical system, wherein animal parts are transplanted.

Anatomy As Enunciated By Susrutha

Susrutha in his Chikitsa Sthaana explains the method of performing surgery in about 200 parts /organs of the body, just like the performance of surgery by the modern medical practitioners in the present time. He elaborately explains in Sareera Sthanna the important organs and the sub-divisions of the body implying that it is necessary to know extensively about the organs before performing surgery on them. This description of the body is known as ‘Anatomy’ in the present times. Susrutha remains a guide to modern medical system from 2000 years ago by enunciating the description of human organs termed as Anatomy which is being written and talked about by the modern medical practitioners in a big way.

Similarly a medical practitioner should understand the foetal development, Since medical practice starts from there and continues upto the treatment of the developed organs by keeping this in mind, Susrutha, in his Sareera-Sthaana has mentioned about weekly and monthly development of the foetus by stages. The modern medical practitioners call only this as ‘Gyneacology’. Hence is it not befitting to say that only Susrutha was the guide for the explanation of the foetal development, namely, Gynaecology, which is advanced today in the modern medicine.

Anatomy

A surgeon must be well-versed in Anatomical science before he is able to identify the bones and various parts of the human body including that of the skin. This science is called SALYA TANTRA.

Hence, if the doctor has to take out a nail from the patient’s body, he should have through knowledge of the parts of the body, in the first instance.

To acquire full knowledge of anatomy, he should possess a corpse and cleanse it by proper methods. Then he should dissect the body and examine each part. Observation and scientific knowledge alone will help to learn the anatomy of the human body.

While acquiring a corpse the following points are to be observed: The person who died should not be too old ie. a man who should be less than 100 years old; he should have died of a natural death; he should not have died due to poison nor due to prolonged disease.

From the acquired body, the excrements and entrails must be removed. Then, the body should be covered with any of the followings; Hay munja grass, Dharba (kusa) grass, hemp rolls. Then the body should be rolled and kept in the secured place of a cage. Then it should be palced in a hidden place on the banks of the running brook.

After seven days, the body should be taken out and scrapped off slowly with the Whisk made up of any of the following; grass roots, kusa blade split, young shoots of bamboo or hay. After washing, one can observe the skin, nerves and the external and internal organs of the body.

PLASTIC SURGERY-RHINOPLASTY

Treatment for the severed nose. We must collect the leaf of a creeper to the size of severed nose and place it in the cheek portion nearer to the nose. Then we must cut the flesh along with the skin so that it may hang upward.

Then the served nose should be incised to look proper and normal. And the incised tissue should be grafted from the upward portion.

After the proper fixation of the tissue, place two equal sized sticks upright under the skin portion, in such a way that the two nostrils are able to get respiration.

There upon the grafted part should be sprayed with the powders of red sandalwood liquonce [ Yestimaddy, Rasanjanam ertraltum berberis] all pulverised together.

Then cover the portion with pure white cotton, which should be drenched frequently with gingelly oil. The patient should be asked to swallow ghee. After the ghee is digested, the oil should washed out, by giving the purgative.

The severed portion of the nose would have been adhered by this time. After healing, a portion adhered to the cheek should again be cut into half.

In the Healed nose, the tissue should be grown properly. Otherwise suitable treatment should be given to reduce the excess grown or add for the lesser growth.

(Susrutha Samhithai Suthrasthan Chapter 16 Sloka 27-32)

Tippu Sultan Sponsored Plastic Surgery

In 1792, war broke out between Tippu sultan and Britishers. In that battle, a British coachman by name Govarge, and four soldiers happened to have their noses cut.

They had their noses refixed by Ayurveda treatment by an Indian medical expert of Maharashtra in Pune.

The British doctors Mr. Domas, Mr. Cruso, Mr. Jhames and Mr. Pindlay had seen this kind of treatment, and understood its all aspects.

After return to England, the British doctors had implemented this kind of Plastic Surgery.

This news was published with photos in “The Madras Gazette” and in the London based magazine “Gentleman” 1794.

Surgery for Cataract

Important Treatment

The damaged portion of cataract of the eye should be made to sweat by applying LAVANIGA powder. The Cataract is raised portion with folds. Where shrinking is noticed, such portion should be held by the sharp hook called PADISAM. Then the eye ball should be moved to the extreme side. The doctor should sit opposite to the patient and lift the cataract gently with the instrument MUSUNDI. No haste is to be shown as otherwise the cataract portion may be damaged.

A needle with thread inserted should be pierced in MAMSANGURAM and by the thread it should be raised.

During surgery, the eye-lids should be open, and for this purpose an instrument call SAMDAMSAM can be used.

Then the broad and raised cataract portion should be brought from the eye to the side of nose.

One fourth of the cataract should be left and the remaining three-fourths portion should be cut by the instrument MANDALAGRAM.

If one fourth is not left and the full portion is cut, the eye portion in the nasal are will also be cut, blood may ooze out in plenty. Later a hole may form and caus pain due to the injury.

If more than one fourth of the cataract is left untouched, cataract will again be formed and close the eye balls. Therefore correct portion should be cut and thus the cataract removed.

The Lavaniga powder should be applied to raise the cataract and it should be held by the instrument “Padisam” as Musundi” while the joint portion between white portion of the eye-ball and the eye-lid should be cut and removed by “Mandalagra”

(Susrutha Samhithai Uthrasthanam Chapter 15-17 Sloka 1.10)

Caesarian Operation

On no account, surgical operation should be done to remove the child which is alive in the mother’s womb, as it will endanger, the life of the child and its mother.

It is good to resort to surgical operation, if te mother is feeling unbearable pain. The pregnant lady should be saved by any way.

In case, where surgical method is necessary to extract the dead child from the womb, the mother should be consoled and encouraged with hopes for her survival, so that she may get moral strength.

The instrument called MANDALAGRA and ANGULISASTRA should break the head of the dead child. The broken parts of the head, legs, bones should then be removed.

With the instrument of SANKU, the chest or shoulder part should be held and then the entire body should be removed.

If the head portion of the dead child is not broken, it should be drawn out by pulling it at the cheeks or eye sockets.

The hands of the dead child should be cut off and the swollen belly like a stuffed leather bag should be cut open and the intestines be removed. The severed foetus should be taken out.

The parts below the hip of the dead child should be broken. Also the bones of the Thigh (Jagana Kapala) should be cut of its easy withdrawal from the womb.

The Knowledgeable doctor who is well-versed in anatomy, should take a careful decision in such critical circumstances. Knowing the proper, meticulous and systematic procedures.

(Susrutha Samhithai Chikitsasthanam Chapter 15 Sloka 1.15)

Brahmi (Vallari) Which Empowers Memory

First the person’s body should be cleansed by methods like vomiting etc., then he should take liquid diet such as peya, vilebi Kanji Gruel Porridge as per Samsarjana method.

Then he should enter the house and conduct “HOMA” (worshipping of fire God) chanting “Sambadha” Hymns and he should drink Brahmi juice.

After the digestion of the medicine, he can take, if the bdoy accepts porridge called “Yavahu” without salt, in the midday by adding milk to it.

Such person, who takes the above medicine for seven days, may get the power of intelligence and the radiant body.

If the same person takes the medicine for further seven days he will get memory power and also acquire skill of composing poems.

If the same person continues to take for the third time, he will be able to repeat hundred words without any mistake, on hearing the same.

If the medicine is taken for twenty one days, sorrow and poverty will vanish. All artistic talents will come to memory. Words once heard can be repeated verbatim, at any time. Such a power of knowledge will be acquired.

Persons will live long for a period of hundred years with such honours.

(Susrutha Samhitha Chikitsasthanam Chapter 28 Sloka 5)

Charaka’s Prescription Of Snake Venom As Medicine

It is said that the physicians who could not prevent a patient suffering from dropsy/flatulence, also known as big belly, becoming severe despite serious treatment methods, should explain the situation to the patient’s relatives and use cobra’s venom as medicine for the same. The Venom of the annoyed cobra, which would have been emitted while bitting some fruit should be given for consumption of the patient/ Ayurveda enunciates that the snake venom can be used for the chronic diseases like billous and anal disorders, as well as leucodarma and cure of eye diseases due to paralytic attack. By following only this, the modern medical practitioners are using the snake venom as medicine for chronic diseases. Hence, it is believed today that the ancient Indian sages alone were the guide for the use of snake venom as medicine.

(Charaka Samhitha Chikitsasthanam Chapter 13)

Removal of stone from the urinary bladder

A Physician should resort to surgical treatment only in the cases where the (decoctions) potions, medicated milk, alkahlie, clarified butter and uttara vasti (urethral syringe) of the drugs etc., would prove ineffective. Even in the hands of experienced surgeon, the operation in theses cases do not bring success. Lithotomic operation is hardly recommended. If the death of the patient is certain without surgical operation and the result from the operation is also not certain, in such cases the surgeon should perform the operation only with the tacit approval of the patient.

The patient should be softened by the application of oily (Oleaginous) substance, the patient’s body should be cleaned with emeties, purgatives, the patient’s weight should be reduced, the patient then he fomented after being anointed with oily unchuants. The patient should be allowed to par take a meal, prayers, offering and prophylactice charms should be offered. The instruments such as yantra, tantra, salaka etc., and the surgical accessories required in the case, should be arranged in the order laid down in the agropaharaneeya chapter(Sutra sthaana) Chapter V) the surgeon should encourage the patient and solace with hopes and confidence. A person of strong physique and unagitated mind should first be made to sit on a table as high as the knee joint. The patient should then be made to sit facing east. The upper portion of the hip resting on the lap of strong man, the patient should be allowed to lie down in a supine position. His hip portion should rest on an elevated cloth cushion. Then the elbows and knee joints should be bound with strong rope to the cloth cushion. Then the elbows and knee joints should be bound with strong rope or cloth bandage. Then apply oil on the umbilical region and rub it well. The region should be pressed with the elbow so as to prevent the stone descending down the umbilical region. The surgeon should then introduce into the rectum, the second and third fingers of the left hand, duly anointed with oil, and with the nails well pared. Then the fingers should be carried upwards so as to bring the tumor like stone between the rectum and the penis taking care that the bladder remains contracted.

The operation should not be proceeded with nor an attempt be made to extract stone (Salya) in a case where the stone on being handled, the patient is found to drop down motionless (i.e. faint) with the head bent down and eyes fixed in a vacant stare like that of a dead man; and in this case, the extraction will lead to the death of the patient. The operation should only be continued in the absence of such an occurrence. An incision should then be made on the left side of the “Seevanee” a nerve of the raphae perineum at a distance of a barely corn and sufficient width to allow the progress of the stone. Utmost care must be taken in extracting the stone so that it may not break into pieces nor leave any broken particle behind (i.e. inside the urinary bladder) however small it may be it would grow larger again. Hence the entire stone should be extracted with the help of an agravaktra yantra (a kind of foreceps, the points of which are not too sharp).

In a woman the uterus is adjacent to the urinary bladder; hence incision should not be made deeply and cut open to take out the stone. Otherwise by deep incision urine inducing ulcer will result. Any hurt to the urethra will be immediately attended to with the same result even in a male patient. In extracting the stone and incision is made or any fissure occurs for some reason or the other, the fissure do not join then the incision made ulcer is incurable.

Chikitsastana Chapter - 7