Sushruta

The sixth century BCE Indian surgeon Sushruta is renowned for his innovative procedures and methods, as well as for penning the important Sushruta Samhita, which served as the primary source of surgical knowledge in prehistoric India.

Shalya tantra, or surgical science, was all encompassing to Sushruta. His revolutionary procedures include rhinoplasty, which involves rebuilding or repairing the nose, and lithotomy, which involves making a surgical incision into a hollow organ like the bladder to remove calculi or stones. Along with developing several original and useful methods, he also studied the structure of the human body by dissecting it.

Toxicology, pediatrics, pharmacology, and other areas of the ancient Indian medical system known as Ayurveda are also covered in detail in the Sushruta Samhita.

Sushruta the Physician

Sushruta's life is largely unknown because his writings are devoted to the practical application of medical knowledge rather than providing insight into his personal background or identity. Since "Sushruta" is an adjective that means "renowned," not even his birth name is known. Although it appears improbable given that Charaka either lived right before him or was a contemporary, he is typically dated to the 7th or 6th century BCE. However, he may have lived and worked as early as 1000 BCE. He has been identified as the son of the sage Visvamitra, Sushruta, as described in the Mahabharata, although most scholars reject this connection.

His profession of medicine in the vicinity of present-day Varanasi (Benares), near the banks of the Ganges River in northern India, is all that is known for sure about him. He was revered as a great healer and wise man, and it was believed that the gods had bestowed upon him his abilities. Legend has it that the sage Dhanvantari received his medical knowledge from the gods, and that he subsequently passed it on to his disciple Divodasa, who in turn gave it to Sushruta.

Even while it wasn't as sophisticated as what Sushruta performed, surgery was already well-established in India at the time of his teachings. Above all, he invented the practice of cosmetic surgery. He also made substantial contributions to the development of various surgical methods, such as the use of an ant's head to stitch sutures.

Prior to an operation, patients were advised to consume large amounts of wine as it was employed as an anesthetic. The surgery would start with the surgeon sitting on a stool with instruments on a nearby table, and the patient, once inebriated to the point of insensibility, strapped to a low-lying wooden table to prevent movement. The wine was used to induce slumber or put patients into a stupor during surgeries like rhinoplasty, which led to the invention of an anesthetic that combined alcohol and cannabis incense.

Given the lengthy history of rhinotomies or the amputation of the nose as a form of punishment, rhinoplasty was a particularly significant breakthrough in India. Amputation was a common practice for women accused of adultery, even if they were found not guilty. Convicted criminals would often have their noses severed to identify them as untrustworthy. An individual who was so branded was forced to bear the stigma for the remainder of their life. Therefore, the promise of restoration and normalcy was provided by reconstructive surgery.

Many followers of Sushruta became known as Saushrutas, and they had to study for six years before they could start receiving practical surgical instruction.

Similar to the later Hippocratic Oath from Greece, which is being said by doctors today, they took an oath at the start of their studies promising to dedicate themselves to healing and to do no harm to others. Following their acceptance by Sushruta, the trainees would practice cutting on vegetables or dead animals to perfect the depth and length of an incision before receiving instruction in surgical techniques. Students were given the opportunity to operate on patients after they had demonstrated their abilities with soft or decaying wood, plants, or animal corpses and had closely watched real surgeries take place.

Anatomy was just one of the several medical arts subjects in which their master instructed their students. Doctors could operate on the dead to learn more about how to treat the living because there was no longer a ban on corpse dissection, as there had been in Europe for centuries.

In order to examine the layers of skin, musculature, and ultimately the arrangement of internal organs and skeleton, Sushruta advises putting the corpse in a cage (to keep animals out) and submerging it in cold water, such as a flowing river or stream. Then, one should monitor the corpse's decomposition over time. The doctor might discover a lot about how each part of the body works and how to help a patient have a healthy life as the body breaks down and softens.

The Samhita Sushruta

In addition to covering 1,120 diseases, injuries, and conditions and their treatments, the Sushruta Samhita devotes chapter after chapter to surgical techniques, listing over 300 surgical procedures and 120 surgical instruments. It also goes into great detail about over 700 medicinal herbs and their uses, tastes, and efficacy. Some academics (like Vigliani and Eaton) have argued that surgery was only used as a last option since the ancients preferred to investigate alternative healing modalities rather than make incisions into people's bodies.

While some of their claims may be true, it does not apply to Sushruta. Sushruta believed that, in some cases, surgery was the best way to relieve suffering rather than a last option.

Throughout the book, a condition is described in several chapters, along with a suggested course of therapy that includes step-by-step instructions on how a doctor should conduct a particular surgery. The Sushruta Samhita differs from the previous Charaka Samhita precisely because of these details: Charaka established medical knowledge and practice, but Sushruta created surgical methods, and so founded the field known as Salya-tantra, or "surgical science."

These methods were applied to numerous situations, such as caesarian section delivery, prostate removal, tooth extraction, cataract removal, treatment of wounds and internal bleeding, and plastic surgery rebuilding of the nose and cheek, among many others. In addition, he invented prosthetic limbs, described and treated illnesses of the eyes and ears, administered eye and ear drops, founded the school of embryology, and expanded our understanding of human anatomy through dissection.

This is not to imply that he disregarded the value of believing in higher powers; rather, it is to say that his understanding of how the body functioned allowed him to heal without turning to the superstitious explanation of illness or the use of charms or amulets in healing. In order to treat a patient and ensure their best possible health, a doctor must be aware of and utilize all facets of the human condition, as his observations throughout the book demonstrate.

His Research and Findings

With regard to the structure, amount, shape, and size of the organs, tissues, blood vessels, nerves, bones, and joints, Sushruta was able to record every little detail because of her understanding of anatomy. The following is a list of some of Sushruta's works:

Cheek Rhinoplasty

By the time of Sushruta, surgery was well-established in India but in a less sophisticated form than what he performed. He made great contributions to the development of various surgical methods (such as sewing sutures with an ant's head) and, most famously, created the field of cosmetic surgery. His book provides guidance to other surgeons on precisely how to perform rhinoplasty, or the reconstruction of the nose, which is his area of expertise.

You should first use a leaf to estimate the area of the nose that will be covered. Next, a little pedicle should be kept attached to the cheek while a piece of skin the necessary size is removed from the face's live skin and flipped back to cover the nose. Using a knife, make a raw incision on the nasal stump at the area where the skin is going to be connected.

The doctor should next put the skin over the nose and quickly sew the two pieces together, maintaining the skin's proper elevation by placing two tubes of Aranda (the castor-oil plant) in the nostrils'location to give the new nose the right form.

After the skin has been appropriately adjusted, a powder made of licorice, red sandalwood, and barberry plant should be sprinkled over it. Lastly, a cotton cloth should be placed over it, and fresh sesame oil should be administered frequently.

If the nose is too long or too short, the middle of the flap should be separated, and an attempt should be made to lengthen or shorten it once the skin has reconnected and granulated.

• The four-degree burn classification system and its explanation of the consequences of heatstroke, frostbite, and lightning injuries.
• Promoted the use of simulated operations on inanimate items, including reeds, clay plots, and watermelons.
• A code of ethics that applies to both educators and learners.
• Categorization of ocular disorders encompassing indications, manifestations, prognosis, therapeutic and surgical measures, and cataract extraction.
• Wine is used to reduce discomfort from surgical incisions.
• Twelve different forms of fractures, six different dislocation types, and a classification of the bones and how they respond to traumas are all explained in detail.
• Developed the field of aesthetic surgery.
• His expertise and experience span the fields of medicine, obstetrics, gynecology, plastic surgery, and dentistry.
• Susruta also recommended methods to encourage the growth of hair that has been lost and to get rid of undesirable hair.
• He begged surgeons to attain perfect healing, which is defined as the return of normal coloring, induration, swelling mass, and absence of any elevation.

Analyzing a Human Cadaver

Sushruta was a fervent supporter of dissecting human corpses as a necessary step towards learning medicine and surgery. It is clear from his record in Sarira Sthana that he had carefully considered the anatomy and function of the human body. There is no indication in his papers that animal dissection was the source of his anatomy knowledge.

Despite religious prohibitions, they learned them from extensive human dissection. Hindu beliefs hold that the human body is holy even after death.

According to Hindu law (Shastras), a deceased person's body cannot be penetrated by a knife, and if the individual is older than two, their remains must be burned in their exact, undamaged state at the time of death. Exactly how Sushruta managed to get around this ruling is unclear.

Cosmetic Surgery

Susruta establishes the fundamentals of plastic surgery by recommending appropriate physical therapy prior to the procedure and outlining several approaches for various kinds of defects, such as:

1. Skin release for minor defects.
2. Flap rotation to compensate for partial loss.
3. Pedicle flaps for total skin loss from an area.

He has discussed a number of techniques, such as pedicle grafting, rotation grafting, and sliding grafting. More information has been provided about nasal repair, also known as rhinoplasty, which has withstood the test of time and is referred to in cosmetic surgery manuals as the Indian technique of rhinoplasty.

And lastly, he has also given labioplasty some thought. All of the fundamentals of plastic surgery accuracy, precision, economy, hemostasis, and perfection-are, in essence, heavily considered in Susruta's publications on the subject.

Salyantra, or surgical science, encompasses all procedures intended to eliminate causes of physical or psychological suffering. Susruta defined health as a state of both physical and mental well-being brought about and maintained by adequate hygienic practices, proper elimination of waste products, a good diet, and a harmonious relationship between the body and the mind.

Susruta cautions against using surgical maneuvers improperly since they might cause complications if done carelessly, out of greed for money, or ignorance of the disease's progression. Conversely, a diligent surgeon takes the patient's overall condition into account. As illnesses that are separated from their patients are abstractions from reality. Any surgical maneuver is a carefully thought-out, stepwise program that is then carried out. Rehabilitation and the elimination of complications were part of the Pascatkarman program.

The Top 13 Fascinating Details About Sushruta

• Sushruta used alcoholic beverages like wine and henbane to produce anesthesia for a successful surgical procedure.
• In Tibetan literature, Susruta was also regarded as a medical authority.
• The Sushruta Samhita also made its way outside of India to other continents.
• In addition to trauma needing general surgery, Sushruta provided a detailed description of the management of six different kinds of dislocations and 12 different forms of fractures. Orthopedic surgeons are still enthralled with this nowadays.
• He discussed the fundamentals of postoperative physical therapy, traction, manipulation, apposition, and stabilization.
• All four castes, including the Shudras, were admitted as pupils at Shusruta Schools.
• The Sutrasthanam, Nidhanasthan, Sharesrasthanam, Chikitsasthanam, Kalpasthanam, and Uttaratantrum are the six main portions of the Sushruta Samhita.
• Those who acquired the skill of surgery, or Shalya tantra, were all granted the title of "Dhanwantari" and went on to become surgeons.
• "Dhanwantareeya" refers to the Dhanwantri, or old surgeons, tradition.
• When it came to instruction, preaching, and practice, the Shalya Tantra was given first attention.
• Susruta identified 76 distinct types of ocular disorders.
• Because Susruta valued pragmatism, he required his pupils to practice eating vegetables.
• Vishvamitra belonged to a clan known by the name Susruta.

Conclusion

The ancient Indian Surgeon Sushruta is regarded as a source of medical innovation and insight that has endured for millennia. His foundational work, the Sushruta Samhita, continues to be a mainstay of Ayurvedic surgery and medicine. Sushruta has made a lasting impact on the history of medicine with his detailed observations, complex surgical methods, and deep comprehension of the human anatomy.

Modern medical procedures and research are still influenced by his emphasis on ethics, accuracy, and holistic healing. With its enduring heritage of human inventiveness and therapeutic devotion, Sushruta's teachings offer a poignant reminder of the enormous influence that traditional wisdom may have on forming our knowledge of and attitude toward healthcare.