Ayurveda Surgical Procedures

Besides Herbs and medicines Ayurveda is pioneer in the field of Surgery and it is evident from detailed description of various surgical and parasurgical procedures found in the famous classical Samhita composed by Acharya Shushurata thousands of years ago.

Sushruta, one of the earliest surgeons of the recorded history (600 B.C.) is believed to be the first individual to describe plastic surgery. Sushruta who lived nearly 150 years before Hippocrates vividly described the basic principles of plastic surgery in his famous ancient treatise 'Sushruta Samhita' in 600 B.C. 'Sushruta Samhita'(Sushruta's compendium) which is one of the oldest treatise dealing with surgery in the world indicates that he was probably the first surgeon to perform plastic surgical operations. This paper presents a historical window into various contributions of Sushruta to plastic surgery and allied fields which were described in 'Sushruta Samhita' more than 2500 years ago.

The Sushruta's contribution in the field of Plastic Surgery can be enumerated as follows

Rhinoplasty (Cheek)

Classification of mutilated ear lobe defects and techniques for repair of torn ear lobes (15 different types of otoplasties)

• Cheek flap for reconstruction of absent ear lobe.
• Repair of accidental lip injuries and congenital cleft lip.
• Piercing children's ear lobe with a needle or awl.
• Use of suture materials of bark, tendon, hair and silk.
• Needles of bronze or bone (circular, two finger-breadths wide and straight, triangular bodied, three finger - breadths wide)
• Classification of burns into four degrees and explaining the effect of heat stroke, frostbite, and lightening injuries.
• Fourteen types of bandaging capable of covering almost all the regions of the body and different methods of dressings with various medicaments.
• Use of wine to dull the pain of surgical incisions.
• Described 20 varieties of sharp instruments *(sastra) and 101 types of blunt instruments (yantra) and their handling techniques.
• Systematic dissection of cadavers.
• Advocated the practice of mock operations on inanimate objects such as watermelons, clay plots and reeds.
• Use of leeches to keep wounds free of blood clots.
• A code of ethics for teachers as well as students.
• *"should have an edge so fine that it should divide the hairs on the skin."

The Sushruta's contributions to allied fields are:-

• Surgical demonstration of techniques of making incisions, probing, extraction of foreign bodies, alkali and thermal cauterization, tooth extraction, excisions, trocars for draining abscess draining hydrocele and ascitic fluid.
• Described removal of the prostate gland, urethral stricture dilatation, vesiculolithotomy, hernia surgery, caesarian section, management of haemorrhoids, fistulae, laparotomy and management of intestinal obstruction, perforated intestines, accidental perforation of the abdomen with protrusion of omentum.
• Classified details of the six types of dislocations, twelve varieties of fractures and classification of the bones and their reaction to the injuries.
• Principles of fracture management, viz., traction, manipulation, appositions and stabilization including some measures of rehabilitation and fitting of prosthetics.
• Classification of eye diseases (76) with signs, symptoms, prognosis, medical/surgical interventions and cataract surgery.
• Description of method of stitching the intestines by using ant-heads as stitching material.
• First to deal with embryology and sequential development of the structures of the fetus.
• Dissection and study of anatomy of human body.
• Introduction of wine to dull the pain of surgical incisions.
• Enumeration of 1120 illnesses and recommended diagnosis by inspection, palpation and auscultation.

Sushruta took surgery in medieval India to admirable heights and that era was later regarded as The Golden Age of Surgery in ancient India .Because of his numerous seminal contributions to the science and art of surgery in India, he is regarded as the 'Father of Indian Surgery' and the 'Father of Indian Plastic Surgery'.