Sushruta is considered one of the earliest surgeons in recorded history and has been the first individual to describe plastic surgery in his famous ancient treatise ‘Sushruta Samhita’. He is said to have lived nearly 150 years before Hippocrates, and his renowned compendium written in 600 B.C. spells out surgical procedures in minutest detail. He is also credited to be the first surgeon to perform plastic surgery!
Many believe plastic surgery to be a new specialty. However its origins are ascertained to have existed over 4000 years back in India. The Vedas compiled in Sanskrit language between 3000 and 1000 B.C. comprise of the oldest sacred books of the Hindu religion. Of the four Vedas – ‘Sushruta Samhita’ is a part of Atharvaveda. The treatise describes ancient Indian tradition of surgery and remains a most brilliant compilation in Indian medical literature.
The treatise contains detailed descriptions of teachings and practice elucidated by this great ancient surgeon said to have been practicing in Varanasi. It also provides surgical knowledge that is of relevance to this day. As a pioneer in the field of surgery, Sushruta expounds prolifically on the healing arts that were grounded on physiology and medicine. He studied human anatomy with the help of dead bodies! Much as in medical colleges today.
The Samhita specifically describes methods for selecting and preserving dead bodies to be studied. Cadavers of elderly or severely diseased were not taken up for purposes of study. Bodies needed to be perfectly clean and were preserved with barks. They were placed in cages, hidden carefully in the river for currents to soften them. After seven days they were retrieved, cleaned with brushes for inner and outer body parts to be seen clearly.
Over 1100 diseases are mentioned in this ancient tome including 26 types of fevers, 8 kinds of jaundice and 20 different urinary disorders. There are 760 plants inclusive of roots, bark, juice, resin, flowers etc. that are described in detail for treatments. These also include common household remedies like cinnamon, sesame, peppers, cardamom, ginger and more. Additionally the treatise offers descriptions of 101 instruments used in surgery.
Sushruta’s greatest contributions were in the fields of plastic surgery and removal of cataracts. In a time when cutting of nose or ears was a common punishment, restoration of these parts and even limbs lost in wars was a common medical practice. There are detailed and accurate step-by-step descriptions of such operations. Strikingly these are the very steps followed by modern surgeons doing plastic surgery even today.
Serious procedures were undertaken like drawing fetuses out of wombs, repairing damaged rectums and removing stones from bladders. Surgical techniques included incisions, probing, extraction of foreign bodies, cauterization, tooth extraction, excisions, draining abscess, draining hydrocele, removal of prostate gland, urethral stricture dilatation, hernia surgery, management of haemorrhoids, fistulae, intestinal obstruction, perforated intestines, and accidental perforation of abdomen. Students were given knowledge of relevant branches of medicine to attain proficiency in allied subjects.
Sushruta Samhita remains an important text on medicine that is also a foundational text for Ayurveda. This seminal text was translated to Arabic as Kitab-i-Susrud in the 8th century. The Arabic translation was received in Europe by the end of the medieval period when Renaissance Italy became familiar with the techniques of Sushruta Samhita. Among other translations since then, more recently in 1999, P. V. Sharma undertook an English translation of this ancient Indian medical treatise.