Maharishi Shushruta, a great sage, is commonly considered as the son of wise Visvamitra (According to the scholar’s, he was not the Visvamitra of the Vedic period). The father of the Sushruta Samhita was the first person who had classified the surgical operations and explained the plastic surgery as well as its tools in his book of 120 chapters in five parts. He had described around eight special operations for surgery, such as the cutting, piercing, opening, scratching, inserting, and stitching. Maharishi Shushruta had worked as both, the practitioner and the teacher of surgery. His contribution towards the Indian traditional medicine and the ancient cultural heritage of India will always be a precious.
After his great writing, he had become very famed personality and his writing was first translated into the Arabic language (as a Kitab-i-Susrud in the 8th cen CE). Consequently, it got translated into the Latin and English languages. Maharishi Shushruta had become a worldwide legend and famous in many areas like doing surgery of the eye, amputations of the limbs and handling various complications after childbirth. His redaction text, the Sushruta Samhita consists of 184 chapters and explanation of 1120 illnesses, detail about 700 medicinal plants, a detailed study on Anatomy, 64 research from mineral sources and 57 research based on the animal sources. Sushruta Samhita is the key reference book for all the ayurvedic surgeons.
The Sushruta samhita has two parts, first one is known as the Purva-tantra (have five sections) and the second one is known as the Uttara-tantra. These two parts together cover all the other specialties such as the medicine, geriatrics, pediatrics, ear diseases, diseases of the nose, throat, eye, aphrodisiacs, toxicology, and psychiatry. Hence, The Sushruta samhita is an encyclopaedia of the medical learning for doctors with special importance on the Salya and Salakya. There are five books of the Purvatantra having 120 chapters are Sutra sthana, Sarira sthana, Nidana sthana, Chikitsa sthana and Kalpa sthana. The Agnivesatantra is commonly known better as the Charaka Samhita. One of the five books, the Nidana-sthana provides the knowledge of aetiology to the medical students.
Having knowledge about the aetiology, signs symptoms of various significant surgical diseases and their ailments, was not easy before the Sushruta samhita. The following has been described in detail in the Sarira sthana, the rudiments of embryology as well as the anatomy of the human body in conjunction with the instructions for venesection, essentials of obstetrics, positioning of the patient according to each vein, safety of the vital structures and may more. The Chikitsa sthana contains the principles of managing various surgical conditions including the obstetrical emergencies, geriatrics and aphrodisiacs.
The Kalpa sthana is generally known as the Visa tantra which describes the nature of poisons as well as the management. Hence, the Purvatantra holds four branches of Ayurveda. And the Uttaratantra holds the other four specialties that are Salakya, Kayacikitsa, Kaumarabhfefefrtya and Bhutavidya. The Uttaratantra is entirely known as the Aupadravika (have description of many complications of surgical procedures like hiccough, fever, krmi-roga, pandu, dysentery, cough, kamala, etc. The Salakyatantra has description of the various diseases of eye, ear, nose and head.
Maharishi Shushruta has described in his writings that the hemorrhage can be easily arrested by the apposition of cutting edges with the stitches, through the cauterization with chemicals or heat and application of styptic decoction etc. According to the Shushruta, the wound is an ultimate abrasion of the underlying pathological structure which starts with the inflammation. He says that the ulcer is totally unclean in the first stage, so it is called as the dusta vrana. And by only suitable management it changes to a clean wound, known as suddha vrana. The healing attempt is called as ruhyamana vrana and after complete healing it is known as the rudha vrana.
He was the pioneer of anesthesia and has promoted the proper use of wine with incense of cannabis for the anesthesia purpose. The use of henbane and Sammohini and Sanjivani was started in the later period. He had explained the eight types of surgical procedures such as the excision, incision, scraping, puncturing, probing, sravana, apposition, stitching. He had developed the variety of experimental modules for practicing surgical procedures. Incision and excision can be practiced on the vegetables or on the leather bags filled with mud of different densities. He had also classified the bones along with their reaction to injuries. He had described the six types of dislocation of joints and twelve varieties of fractures of the shaft together with the principles of fracture treatment such as traction, manipulation, appositions and stabilization.
Sushruta discussed the surgical conditions of ano-rectal region and provided all the methods of managing both haemorrhoids and fistulae. Sushruta was well known about the urinary stones, varieties of stones, signs symptoms, method of removal, operational complications as well as the anatomy of urinary bladder. Apart from all above, he had described the surgery of intestinal obstruction, perforated intestines, abdomen accidental injuries which involves the protrusion of omentum. His main contribution was towards the field of Plastic and Cataract surgery.
Plastic surgery
He had described all the basic principles of plastic surgery by offering a suitable physiotherapy before operation. The technique of the release of skin in order to cover all the small defects, rotation of the flaps to heal the partial loss and the pedicle flaps to cover the entire loss of skin from an area are well described by him. He has given various other methods together with the rotation graft, sliding graft, pedicle graft, rhinoplasty, labioplasty in his Samahita.
Legacy
The Bower manuscript which was founded in a Buddhist monastery in Chinese mentions the name of Susrutha as one of the 10 sages from Himalayas. It is reported that the first Indian rhinoplasty was performed by the local Vaidya of Koomhar caste using skin of the forehead. It is considered that he was the descendants of Brahma’s son and he performed his rhinoplasty in front of two British surgeons. Joseph Constantine Carpue was another who was able to perform the Indian rhinoplasty.
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