Sushruta Samhita, volume 1: Sutrasthana

by Kaviraj Kunja Lal Bhishagratna | 1907 | 148,756 words

This current book, the Sutra-sthana (english translation), is the first part of this voluminous medical work. It contains a large summary of the knowledge envelopig the medical aspects of Ayurveda. Descriptions of diseases, various diets and drugs, the duties of a surgeon, surgical procedures, medical training; these are only some of the numerous s...

Chapter I - Origin of Ayurveda

Well, we[1] shall now describe the origin of the Science of Medicine, as disclosed by the holy Dhanvantari to his disciple Sushruta. (Vedotpatti-adhyaya).

Once upon a time, when the holy Dhanvantari, the greatest of the mighty celestials, incarnated in the form of Divodasa, the king of Kasi, was blissfully seated, in his hermitage, surrounded by a concourse of holy Rishis; Aupadhenava, Vaitarana, Aurabhra, Paushkalavata, Karavirya, Gopura-rakshita, Sushruta and others addressed him as follows:—

“O Sire, it grieves us much to find men, though otherwise well befriended by their kin and relations, falling a prey to diseases, mental, physical, traumatic, or natural, and piteously wailing in agony like utterly friendless creatures on earth; and we supplicate thee, O Lord, to illumine our minds with the truths of the Eternal Ayurveda (Medical Science) so that we may faithfully discharge the duties allotted to us in life, and alleviate the sufferings of humanity at large. Bliss in this life and hereafter, is in the gift of this eternal Ayurveda, and for this, O Lord, we have made bold to approach thee as thy humble disciples.”

To them, thus replied the holy Dhanvantari:—

“Welcome to all of you to this blissful hermitage. All of you are worthy of the honour of true pupilship or tutelage.”

The Ayurveda

(which forms the subject of our present discourse), originally formed one of the subsections of the Atharva Veda; and even before the creation of mankind, the self-begotten Brahma strung it together into a hundred thousand couplets (Shlokas), divided into a thousand chapters. But then he thought of the small duration of human life on earth, and the failing character of human memory, and found it prudent to divide the whole of the Ayurveda into eight different branches such as, the Salya-Tantra, the Salakya-Tantra, the Kaya-Chikitsa, the Bhuta-Vidya, the Kaumar-Bhritya, the Agada-Tantra, the Rasayana-Tantrani and the Vajīkarana-Tantra. Now about the characteristic features of each of these branches of the Science of the Ayurveda

The Salya-Tantra:—[2]

The scope of this branch of Medical Science is to remote from an ulcer; any extraneous substance such as, fragments of hay, particles of stone, dust, iron or bone; splinters, nails, hair, clotted blood, or condensed pus (as the case may be, or to draw out of the uterus a dead fetus, or to bring about safe parturitions in cases of false presentation, and to deal with the principle and mode of using and handling surgical instruments in general, and with the application of fire (cautery) and alkaline (caustic) substances, together with the diagnosis and treatment of ulcers.

The Shalakya-Tantra:—[3]

Embraces as its object the treatment of those diseases which are restricted to the upward (lit:—region above the clavicles) fissures or cavities of the body, such as the ears, the eyes, the cavity of the mouth, the nostrils, etc.

The Kaya-Chikitsa (General diseases):—[4]

Treats of diseases, which, instead of being simply restricted to any, specific organ, or to any particular part of the body, affect the entire system, as Fever, Dysentery, Haemoptysis, Insanity, Hysteria, Leprosy, unnatural discharges from the urethra, etc.

The Bhuta-Vidya (Demoniacal diseases):—

Lays down incantations and modes of exorcising evil spirits and making offerings to the gods, demons, Gandharvas, Yakshas, Rakshas, etc. for cures of diseases originating from their malignant influences.

The Kaumara-Bhritya (Management of children):—

Deals with the nursing and healthy bringing up of infants, with purification and bettering of mothers’ milk, found deficient in any of its characteristic traits, and also with cures for diseases peculiar to infant life and due to the use of vitiated mother’s milk or to the influences of malignant stars and spirits.

The Agada-Tantra (Toxicology):—

Deals with bites from snakes, spiders and venomous worms, and their characteristic symptoms and antidotes. It has also for its object the elimination of poison whether animal, vegetable, or chemical (resulting from incompatible combinations) from the system of a man, overwhelmed with its effects.

The Rasayana-Tantra (Science of Rejuvenation):—

Has for its specific object the prolongation of human life, and the invigoration of memory and the vital organs of man. It deals with recipes which enable a man to retain his manhood or youthful vigour up to a good old age, and which generally serve to make the human system invulnerable to disease and decay.

The Vajīkarana-Tantra (Science of Aphrodisiacs)—

Treats of measures by which the semen of a man naturally scanty or deficient in quality becomes shorn of its defects; or is purified, if deranged by the vitiated humours of the body (such as wind, etc.); or is invigorated and increased in quantity (if pure and healthy); or acquires its healthy and normal consistence (if thinned and enfeebled by indiscretions of youth). [In short, it deals with things which increase the pleasures of youth and make a man doubly endearing to a woman].

Thus the entire science of the Ayurveda is classified into the eight preceding branches. Now tell me, which of them is to be taught and to which of you? Said the disciples:—“Instruct us all, O Lord, in the science of surgery (Shalva) and let that be the chief subject of our study.” To which replied the holy Dhanvantari:—“Be it so.” Then the disciples again said:—“We are all of one mind in the matter, O Lord, that Sushruta shall be our spokesman and ask you questions conformably to the general trend of our purpose. All of us will attentively hear what you will be pleased to discourse to Sushruta, [and that will save you the trouble of teaching us individually]”. To which replied the venerable sage—“Be it so. Now listen, Sushruta, my dear child. The object or utility of the science which forms the subject of our present discussion, may be grouped under two distinct sub-heads such as (1) the cure of diseased persons, and (2) the preservation of health in those who are not afflicted with any sort of bodily distempers.”

The etymological meaning of the term “Ayurveda” may be interpreted to denote either a science in the knowledge of which life exists, or which helps a man to enjoy a longer duration of life.

The primary position of surgery:—

[As regards time and importance among the other allied branches of the Science of Medicine]. Hear me discourse on the Science of Surgery (Shalya-Tantra) which is the oldest of all the other branches of the Science of Medicine (Ayurveda) and is further corroborated by the four classes of testimonies, viz., Perception, Inference, Analogy and Scriptural Truths (agamas). The primary position of this branch of the ayurveda, (as regards its time or origin), may be inferred from the fact that Surgery lends her aid materially towards the healing up of traumatic ulcers.[5] The second reason for such an inference may be deduced from the replacement of the severed head of Yajna. It is told that the god Rudra, severed the head of the God of Sacrifice (Yajna).

Whereupon the gods approached the celestial Ashvins, and addressed them as follows:—

“You twins, O lords, who are to be the greatest of us all, connect the head of Yajna with his decapitated trunk.”

To them, replied the divine Ashvins:—

“We shall do, O lords, as you command us to do.”

Then the celestials propitiated the god Indra in order that a portion of the oblations offered in the course of a sacrifice, might be allotted to those heavenly twins. The Ashvins reunited the severed head of Yajna to his body as prayed for. [Hence this branch of the ayurveda (Shalyanga) is the oldest of all its subdivisions].

The primary importance of the Shalya:—

All hold this Tantra to be the most important of all the other branches of the????????? instantaneous actions cab???????? of such appliances as, surgical operations, external applications of alkalis, cauterisation, etc., and secondly inasmuch as it contains all that can be found in the other branches of the science of medicine as well, with the superior advantage of producing instantaneous effects by means of surgical instruments and appliances. Hence it is the highest in value of all the medical Tantras. It is eternal and a source of infinite piety, imparts fame and opens the gates of Heaven to its votaries, prolongs the duration of human existence on earth, and helps men in successfully fulfilling their missions, and earning a decent competence, in life.

Gradual extension of the Ayurvedic Knowledge:—

Bramha (Brahma?) was the first to inculcate the principles of the holy ayurveda. Prajapati learned the science from him. The Ashvins learned it from Prajapati and imparted the knowledge to Indra, who has favoured me (Dhanvantari) with an entire knowledge thereof. I, for the good of mankind, am ready to impart it to those ===== on earth.

The King of Kas???? of account?f himself i??:—

?m the supreme and original god???? form of Dhanvantari. It is I who warde???? disease and decay from the celestials. Fo????? was an inmate of the region of heaven, now I a????carnated on earth with the view to teach the Science of Surgery with all its allied branches of study to men.

In the present science (ayurveda), the Purusha (self-conscious organic individual) is described as the resultant of the combination of the soul and the five primary material principles. All medical acts such as, surgical operations, administration of medicinal remedies and applications of alkaline substances, or cauterisation, etc.), are restricted to the Purusha alone.[6]

Why is it so? The answer is, simply because the created world is composed of two distinct classes, such as the mobile and the immobile.[7] These two classes, in their turn, are further sub-divided for the purposes of the science of medicine into the two orders, agneya (hot) and Saumya (cool). Hence the world is composed of five material principles, though characterised by the twofold virtues, agneya (hot) and Saumya (cool).[8]

Further classification of the mobile and the immobile:—

The animated world may be divided into four subdivisions, such as the Svedaja (born of sweat or heat and moisture i.e. abiogenous), the Andaja (egg-born or oviparous), the Udbhijja (vegetable) and the Jarayuja (placental or viviparous). The Purusha or the subjective personality (man) is the greatest of them all, because all other forms of life are made to minister to his wants on Earth.

Disease:—its Definition:—

The Purusha (man) is the receptacle of any. particular disease, and that which proves a source of torment or pain to him, is denominated as a disease.[9] There are four different types of disease such as, Traumatic or of extraneous origin (agantuka), Bodily (Sharira), Mental (Manasa) and Natural (Svabhavika). A disease due to an extraneous blow or hurt is called agantuka. Diseases due to irregularities in food or drink, or incidental to a deranged state of the blood, or of the bodily humours acting either singly or in concert, are called Sharira. Excessive anger, grief, fear, joy, despondency, envy, misery, pride, greed, lust, desire, malice, etc. are

other fundamental material principles, it is not improper to classify all under the head of hot or cold, a third factor being non-existent. Hence the world (jagat) is possessed of the twofold virtues, hot and cold. included within the category of mental (Manasa) distempers; whereas hunger, thirst, decrepitude, imbecility, death, sleep, etc. are called the natural (Svabhavika) derangements of the body. The Mind and the Body are the seats of the abovesaid distempers according as they are restricted to either of them, or affect both of them in unison.[10]

Samshodhana (Cleansing), and Samshamana (Pacification of the deranged or agitated bodily humours giving rise to the disease), and the regimen of diet and conduct are the four factors which should be duly employed in order to successfully cope with a disease.[11]

Food is the principal factor which materially contributes to the strength, complexion and vitality (Ojah) of animated beings. Food consists of six different tastes (Rasa) [which cannot exist independently of the substances] in which they are inherent. These substances which are called the Oshadhis may be divided into two classes such as the mobile and the immobile. The immobile Oshadhis in their turn, admit of being grouped under four sub-heads such as, the Vanaspatis, the Vrikshas, the Virudhas and the Oshadhis proper.

Those trees which bear fruit without blossoming are called the Vanaspatis such as, the Plaksha and the Oudumvura. Those that bear both fruits and flowers are called the Vrikshas. Shrubs and creepers that trail on the ground are called Virudhas, whereas those plants which die with the ripening of their fruits, are called Oshadhis proper (such as cereals;.

The mobile Oshadhis or animals' are divided into four classes such as the viviparous, the oviparous, the sweat-begotten, and those that are born of decomposed vegetable matter. Man and other mammals belong to the first group; birds, snakes, and reptiles belong to the second; ants, worms, etc. belong to the third; while frogs and Indragopas belong to the fourth. For medicinal purposes, bark, leaves, flowers, fruits, roots, bulbs, the expressed juice, and milky or resinous secretions of plants, etc.[12] are obtained from the vegetable world. The skin, nails, wool, blood, flesh, fat, marrow, bones, are procured from the animal world.

Metals and minerals such as gold, silver, gems, and Manahshila (Realgar), as well as pearls, clay and Kapalas (bones), etc. should be included in the list of the earthy substances.[13]

Gale, windfall, sunshine, shade, moonshine, darkness, heat, cold, rain, day, night, fortnight, month, seasons, and solstices, etc. should be deemed as the works of eternal time, which, by virtue of their natural effects, contribute to the accumulation, augmentation, pacification or diminution of the deranged bodily humours (such as, wind, etc..

Authoritative verses on the subject:—

Physicians should look upon these four factors of (food, conduct, earth and time), as the accumulators, aggravators and pacifiers of the deranged bodily humours and of the diseases resulting therefrom in man. Diseases due to causes which are extraneous to the body may affect the mind or the body. When it would affect the body in the shape of any traumatic disease (such as an inflammation due to a blow or a sword cut), it should be treated medicinally like the rest of the physical maladies, while the remedy should consist in the enjoyment of pleasurable sounds, touch, sights, taste or smell where the mind would be found to be the seat of the distemper.

Thus I have briefly dealt with the Purusha, Disease, Medicine, Appliances and the Specific Time. The term Purusha should be interpreted to include within its meaning the combination of its five material components, and all things resulting therefrom, such as the limbs and members of the body, as well as the skin, the flesh, the blood, the veins and the nerves, etc. The term Disease signifies all distempers incidental to the several or combined actions of the three deranged bodily humours and blood. The term Medicine signifies drugs and their virtues, tastes, potency, inherent efficacy (Prabhava) and reactionary properties (Vipaka). Appliances (kriya) denotes such processes as, surgical operations, injections, emulsive measures, lubrications, etc. The term Time signifies all opportune moments for medical appliances.

Authoritative verses on the subject:—

The primary principle of the Science of medicine has thus been briefly stated and will be fully dealt with in the following one hundred and twenty chapters distributed among the five main sub-divisions or Sthanas of the present work. These hundred and twenty chapters will be found to be elaborately discussed according to the specific import or significance of their denominations under the sub-heads of Sutra-Sthana (Definitive Aphorisms or Fundamental principles), Nidana (Etiology), Sharira-Sthana (Anatomy and Physiology), Chikitsa-Sthana (Therapeutics) and Kalpa-Sthana (Toxicology). Subjects other than the preceding ones will be discussed in the closing chapters of the book by way of an Appendix (Uttara-Tantra).

Authoritative verse on the subject:—

The man who reads this Eternal Science of Medicine (Ayurveda-Shastram) discoursed by the self-origined Brahma and propagated by the King of Kasi, becomes noted for his piety, is honoured by the kings on earth, and attains to the region of Indra (the lord of the celestials) after death.


Thus ends the first chapter of the Sutra-Sthana in the Sushruta Samhita which deals with the origin of the Ayurveda.

Footnotes and references:


The present work which originally formed the subject of a discourse by the holy sage Dhanvantari to his disciple Sushruta, has been compiled in its present form by the venerable Nagarjuna, and is accordingly designated as the Sushruta Samhita.


Any foreign matter, lodged in a human organism and proving painful to it, is called a Shalya.


The name is derived from the Sanskrit term Shalaka, a probe or a rod, the use and application of the instrument being primarily included within the scope of this branch of the Ayurveda.


The term Kaya literally signifies the vital heat or fire which runs through the entire system, and hence the Kaya-chikitsa deals with diseases which may gradually invade the root-principles of a living human organism.


????????????nd sword-cuts had to be dressed and??????? the gods and the demons, long before????????? idipathic maladies such as, fever, etc.;?????????? was demanded of her towards the healing???????? branch of the Ayurveda is the oldest of all????? ng art.


It may be questioned why they should be confined to the Purusha? Such a query may be successfully met by the statement that the Purusha alone is the receptacle of health and disease in contradistinction to the Self or Ego.


The vegetable world belongs to the latter category, while animals, possessed of locomotion, belong to the former.


It may be argued here, since everything in the universe is composed of the five fundamental material principles [of earth, water, fire (heat), air and sky (ether)], it is not competent to assert that the universe is possessed of the twofold attributes Agneya (heated or fiery) and Saumya (cool or watery), alone. But since fire (heat) or water (cold) predominates in all things in the universe in juxtaposition with the primary virtues of the


A disease may be defined as something which afflicts the Purusha (self-conscious personality), or those things or incidents which combine to afflict the Purusha are usually interpreted to connote that meaning.


The Self or the Jīvatma of a person is above all human concerns and, as such, can never be affected by any disease.


Cleansing (Samshodhana) is of two kinds, viz. External and Internal. External purification consists in employing such measures as surgical operations, cauterisation of the affected part or organ, external use of alkaline preparations and medicated plasters, the internal one including such measures as exhibition of purgatives and emetics, application of intestinal enemas (Asthapana) and blood-letting. Diet comprises four different factors such as, food, drink, lambative, etc., which, for the purposes of the Ayurveda, are again grouped under three different heads, such as the pacifier of the deranged bodily humours (Dosha-prashamana), therapeutical (Vyadhi-prashamana) and health-giving (Svastha-Vrittikara). Acara (conduct) appertains to three different factors, such as the body, the speech, and the mental acts. The abovesaid measures, duly employed, are potent enough to combat all sorts of bodily distempers, if the special exigencies of each case are carefully taken into consideration.


The use of oil expressed out of drugs and seeds, as well as of their ashes or alkaline preparations are likewise indicated.


Oxide of Iron, sand, yellow sulphurate of arsenic (Orpiment), salt, Gairika (ferruginous earth), Rasanjana (antimony) should be regarded as appertaining to the class of earthy substances.

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