Which is the oldest text on surgery?
Sushruta Samhita was one of the ancient and popular treatises of Ayurveda and especially deals with surgery. Sushrut Samhita is the oldest surgical textbook. which is available till today date and the Allopathic medicine system follow some basic rule from Sushruta Samhita.
Who wrote Sushruta Samhita?
Originally Acharya Sushruta composed the text
Sushruta Samhita and later on, Nagarjuna redacted it.
Originally it contains 120 chapters and was distributed in 5 divisions as under.
- Sushrut Sutra Sthana 46 chapters
- Sushrut Nidana Sthana 16 chapters
- Sushrut Sareera Sthana 10 chapters
- Sushrut Chikitsa Sthana 40 chapters
- Sushrut Kalpa Sthana 8 chapters
Sushrut Utara Tantra 66 chapters
So basically Sushrut Samhita has total of 186 Chapters. The sixth and the last division, Uitara Tantra is believed to be an addition to the original text by the redactor, Nagarjuna.
Superficial Details of Each Division of Sushrut Samhita
Sushrut Samhita Sutra Sthana (46 chapters) Covers the fundamental principles of Ayurveda. Preliminary preparations for surgery, various types of surgical instruments, Kshara, Agni, Jalouka, Cauterization, collection, and preservation of medicinal herbs, administration of emetics and purgatives, and various types of liquid and solid food substances have been discussed.
Sushrut Samhita Nidana Sthana – contains 16 chapters and deals with etiology, signs & symptoms, and the pathogenesis of various disorders like Vataroga, Ashmari, Arshas, Bhagandara, Tumors, Fractures, Minor ailments, etc.
Sushrut Samhita Sareera Sthana – contains 10 chapters and deals with embryology and anatomy.
Sushrut Samhita Chikitsa Sthana (40 chapters) – deals with principles of treatment and Panchakarma techniques.
Sushrut Samhita Kalpa Sthana -8 chapters deal with toxicology.
Sushrut Samhita Utara Tantra (66 chapters) – covers the other subjects, which were not discussed in the earlier divisions.
Theory Explain by Acharya Sushruta
- Susruta Samhita formulates the theory of cosmic evolution, which is a close parallel to that of Sankhya.
- Embryonic conception-Susruta clearly stated that the fertilization will take place by the union of spermatozoa and ova, but it is not sufficient for the creation of life. Then intervention of a superior agent is necessary.
- Humoral theory-The Humoral theory of Ayurveda was dealt with by Susruta in great detail and depth, in three different aspects such as physiological, pathological, and therapeutic.
- Susruta explains the various aspects of sleep and also dreams.
- Time is self-existent and is responsible for the creation as well as the dissolution of things. He states that life and death are also functions of time.
- Susruta explained that the fetus takes a recognizable shape in the 2nd month of pregnancy. An aspherical shape indicates male, an elongated shape indicates female and a tumor-like shape indicates a hermaphrodite creature to be born.
- The physiological process of blood circulation has been explained in detail.
- The formation of urine and urinary calculi is explained in a lucid way.
- The origin of diseases and their classification is mentioned as Adhyatmika, Adhibhoutika, and Adhidaivika.
- Similar to Charaka, Acharya Susruta also explained a number of diseases, their diagnosis, symptoms, and treatment.
- Susruta considers Madhumeha as the most serious of all infections of the urinary tract.
Susruta dealt with poisons and antidotes in the entire Kalpa Sthana.
Special Surgical Work of Sushrut Samhita
- Surgical procedures have been explained in a systematic way viz. pre-operative, operative, and postoperative measures.
- It is declared that practical training is essential for even those who are well versed in theory.
- Excisions are to be practiced on fruits & Vegetables like Alabu.
- Incisions on bladders and internal organs of dead animals, leather bags, etc.
- Scraping on animal skin covered with hair.
- Venesection on recently dead animals (or) stalks of water lily.
- Extraction on the pulp of Bilwa.
- Suturing on thick cloth or leather.
- Bandaging on full-sized human figures of clay.
- Preservation of the dead bodies was also explained.
- Special surgical methods like cauterization (thermal & chemical), bloodletting, venesection, etc. have been explained.
- Susruta Samhita described various types of grafting operations (plastic surgery) according to the nature of the deformity.
- Treatment for fractures and dislocations.
- Surgical treatment for piles and fistula.
- Surgery for cataracts and other ophthalmic conditions.
- Extraction of the tooth.
- The training and duties of physicians, surgeons, nurses, etc. have been explained in detail.
Commentators and Commentaries on Susruta Samhita
- Jeijata – N.A.
- Gayadas – Nyaya Chandrika
- Brahma Deva Tippani
- Bhaskaracharya (or) Bhaskara Bhatt Panjika.
- Chakrapani – Bhanumati
- Dalhana – Nibandha Sangraha.
- Harana Chandra Chakravarti Susrutardha Sandipani.
Where is Sushruta Samhita now?
One of the oldest palm-leaf manuscripts of Sushruta Samhita has been discovered in Nepal. It is preserved at the Kaiser Library, Nepal as manuscript KL–699, with its digital copy archived by Nepal-German Manuscript Preservation Project (NGMCP C 80/7).
Commentators and Commentaries on Susruta Samhita
1. Jeijata – N.A.
As per the available references ‘Jejjata’ was the first scholar who wrote a commentary on Susruta Samhita.