In the pre-Aryan times, the
Indian sub-continent was inhabited by the short and dark skinned 'Dravidian'
Race. They were conquered by the taller and lighter skinned "Aryans", who
came from the regions of Caucasus and Iran. They brought with them the
Vedas, a term which embraces the worlds' first documented body of writings,
the origin of which is ascribed to Divine Revelation. It forms the base for
the Indian Brahmanical system of religious belief. This sacred canon is
divided into four collections:
1) The Rig-Veda (lore of
praise, hymns and education)
2) The Sama-Veda (lore of
tunes, chants and social science)
3) The Yajur-Veda (lore of
prayer and sacrament formulas)
4) The Atharva-Veda (lore
of the Atharvans, a high order of priests and business).
The term Ayurveda (meaning,
'knowledge of life'), was given to the ancient Indian system of medicine,
and it is believed to be a part of the Atharva-Veda. Ayurveda is an oldest
science in the world. This ancient Indian system of medicine had been
treatise into two volumes of the Chakra Samihita (Medicine) and Sushruta
Samihita (Surgery).
The Sushruta Samhita is
believed to be the work of a single author, and is nearly three thousand
years old, earlier than even the mahakavyas or the great Hindu epics of the
Ramayana and Mahabharata. Lord Dhanwantari (Sushruta's Preceptor), the
father figure of Indian surgery and also the king of Kashi (Benaras), a city
in northern India, was to Indian Medicine, what Aesculapus was to Greek
Medicine.
Ancient
India is the cradle of plastic surgery
'Sushrutra' as his name
indicates, means - 'Su - well, and Shruta - informed' - that is, 'a well
informed or learned person'. One of the sons of "Lord Vishwamitra" and the
student of "Lord Dhanwantari" overcame the Herculean task of documenting the
existing practice of the art and the science of contemporary surgery, which
till such time was being propagated by the spoken words down the ages
through disciples. As reported that there was a school of ancient Indian
medicine in Kashi (Benaras) around 1000 BC or even earlier. Sushruta (said
to have lived during the 4th and 5th century BC), was the world's First
Plastic Surgeon, who performed various Operations like rhinoplasty, removal
of bladder stones, aspiration for ascitis and hydrocele, removal metallic
splinters with magnets, used sutures made of cotton, hemp, leather, horse -
hair or animal sinews. He conducted cataract and many other eye operations
as well as caesarian sections, treated fractures and performed osteoplasty.
Sushruta had dissected
human bodies and described the bones, muscles and internal organs in
considerable detail. He had a fair knowledge of human anatomy and his
descriptions of reconstruction of mutilated parts is very apt, and include
those of the lips and nose. He also had defined the existence of Tumour and
its metastasis growth. He has designed many sharp as well as blunt
instruments such as those seen in the accompanying figures.
He was the first ever
surgeon to advocate physiotherapy for pre and post operative care.
Sushruta described the
reconstruction of the nose using the tissues from the cheek. It is true even
today that the cheek will not afford reconstruction of the entire nose. This
must have made the post Sushruta period surgeons to reconstruct the nose
using the forehead flap, which is now popular the world over as Indian
Rhinoplasty technique for the reconstruction of the nose. Sushruta
reconstructed the damaged lips by mobilizing the adjacent tissues almost in
a similar manner.
"Indian
methode” of nose reconstruction - 2500 y. old
He also had full concept of
surgical asepsis and did advocate paring of Nails at least twice a week.
The importance of practical
training is stressed by Sushruta. He insists that even if one understands
what he studies, he ought to talk about it much and converse on it with his
colleagues and experts or else his study will be a labour in vain like the
load of a sandal wood on a mule; for the mule can appreciate the weight of
the load alone, and not the fragrance of the sandalwood.
This is
also true in Indian philosophy. It has always invited logical discussion and
criticism and remained invincible. Sushruta himself offered his treatise for
the scrutiny by the learned colleagues and even described as many as 32
criteria on how to assess his own as well as other treatise.
According
to Sushruta there is no end to learning and one must understand the value of
the related sciences. Definition of cancer as described by Sushruta:
A big
globular fixed mass of tissue that causes mild pain and progresses slowly
but never suppurates: is called as tumour by wise men.
If a tumour
reappears at the same site (local) or in nearby area (regional) it is called
recurrent tumour. If two tumours at different places appear simultaneously
or in a sequence, they are called secondary (metastatic) tumour. Both these
types are incurable.
Dr. Ashok
Gupta, MD
Suite 16, Laud
Mansion, 21, M. KarveRd.
Mumbai,
Maharashtra 400004, India
Tel: ++91 222
388 8963
e-mail:
aesthakg@bom5.vsnl.net.in
Sushrutas surgical
instruments - 500 y. BC
