Sushruta samitha
SUSHRUTA SAMITHA
The Sushruta Samhita is a Sanskrit text on surgery, attributed to Sushruta, (6th century BCE), the "father of Surgery". The original manuscript has not survived, and only "copies of copies and revisions of revisions" exist. The Bower Manuscript holds some of the most important information related to the early Ayurvedic documents.
The text as preserved dates to the 3rd or 4th century . Amongst the eight divisions of medical knowledge, surgery was considered the most important branch. The text was translated into Arabic in the 8th century. However, Richard Salomon states that the earliest confirmed specimens of India's earliest written script, the Brāhmī script, are rock-cut inscriptions called the Edicts of Ashoka and are dated to the 3rd century BC; any excavated evidence for writing in India that may predate these Edicts (such as graffiti on pottery shards from Sri Lanka that may date to the 4th century BC are controversial and their dating ambiguous.
Contents
KALPAS
CONTENTS
PLASTIC SURGERY ETC..
PLASTIC SURGERY
SushrutaS basic principles of plastic surgery by advocating a proper physiotherapy before the operation and describes various methods or different types of defects, release of the skin for covering small defects, rotation of the flaps to make up for the partial loss and pedicle flaps for covering complete loss of skin from an area. He has mentioned various methods including sliding graft, rotation graft and pedicle graft. Nasal repair or rhinoplasty has been described in greater detail, which to this day has stood the test of time and is mentioned as the Indian method of rhinoplasty in the books of plastic surgery. Lastly, labioplasty too has received his attention. In short, all the principles of plastic surgery, viz., accuracy, precision, economy, haemostasis and perfection find an important place in Sushruta's writings on this subject.
Surgical science – Salyantantra – embraces all processes aiming at the removal of factors responsible for producing pain or misery to the body or mind. Health is, according to Sushruta, a state of physical and mental well-being brought about and preserved by the maintenance of humours, good nutrition, proper elimination of waste products and a pleasant harmony of the body and the mind.
Sushruta warns that improper intervention with surgical manoeuvre due either to ignorance of the progress of the disease-process, greed for money or lack of judgement, lead only to complications. A conscientious surgeon, on the other hand, considers his patient as a whole. For diseases divorced from patients are abstractions from reality. Any surgical manoeuvre is a phased programme planned well and then executed. The pascatkarman included the rehabilitation and removal of complications.
CONTENTS
The Sushrutasamhita is in two parts, the Purva-tantra in five sections and the Uttara-tantra. Those two parts together encompass, apart from Salya and Salakya, the other specialities like medicine, pediatrics, geriatrics, diseases of the ear, nose, throat and eye, toxicology, aphrodisiacs and psychiatry. Thus the whole Samhita, devoted as it is to the science of surgery, does not fail to include the salient portions of other disciplines too. In fact, Sushruta emphasises in his text that unless one possesses enough knowledge of relevant sister branches of learning, one cannot attain proficiency in one's own subject of study. The Samhita is thus an encyclopaedia of medical learning with special emphasis on Salya and Salakya. Sutra-sthana, Nidana-sthana, Sarira-sthana, Kalpa-sthana and Chikitsa-sthana are the five books of the Purvatantra containing one hundred and twenty chapters. Incidentally, the Agnivesatantra known better as the Charaksamhita and the Astangahrdaya of Vagbhata also contain one hundred and twenty chapters in all. The Nidana-sthana gives the student the knowledge of aetiology, signs and symptoms of important surgical diseases and those ailments, which have a bearing on surgery. The rudiments of embryology and anatomy of human body along with instructions for venesection (cutting of veins), the positioning of the patient for each vein, and protection of vital structures (marma) are dealt with in the Sarira-sthana. This also includes the essentials of obstetrics. Principles of management of surgical conditions including obstetrical emergencies are contained in the Chikitsa-sthana, which also includes a few chapters on geriatrics and aphrodisiacs. The Kalpa-sthana is mainly Visa-tantra, dealing with the nature of poisons and their management. Thus the Purva-tantra embraces four branches of Ayurveda. The Uttara-tantra, contains the remaining four specialities, namely Salakya, Kaumarabhrtya, Kayacikitsa and Bhutavidya.
KALPAS
The ancient thoughts on medicine and surgery were perhaps confined to texts called Kalpas, small monographs. Early Indian medical literature was full of such monographs or handbooks. Agnivesa gave shape to such knowledge by gathering, pruning, enlarging and emphasising important aspects into text-books of medicine as early as 1200 B.C. The ancient Indian medical practitioners were divided into two classes: the Salya-chikitsakas (surgeons) and the Kaya-chikitsakas (physicians). Surgery had not yet been incorporated into the encyclopaedic tradition as represented by the Agnivesatantra. It was through the efforts of Sushruta that surgery achieved a leading position in general medical training.
Sushruta Samhita is the translation of what he learnt at the feet of his preceptor Divodasa Dhanvantari. We have seen that along with Sushruta, Aupadhenava, Vaitarana and others too had their instruction from Divodasa and each in his turn prepared a treatise on Salyatantra. The present Samhita itself reveals that there existed many such works on surgery and the one belonging to Aupadhenava, Aurabhra, Pauskalavata and Sushruta were the source books for the rest of the treatises. Amongst these compositions, only the Sushrutasamhita is extant, and apart from the redactions by Nagarjuna, Candrata and the commentators, it has remained the only treatise for two of the eight branches of Ayurveda, namely Salya and Salakya.