Charaka Samhita and Sushruta Samhita

by Nayana Sharma | 2015 | 139,725 words

This page relates ‘Surgery: Pre-operative and Post-operative Care (Introduction)’ of the study on the Charaka Samhita and the Sushruta Samhita, both important and authentic Sanskrit texts belonging to Ayurveda: the ancient Indian science of medicine and nature. The text anaylsis its medical and social aspects, and various topics such as diseases and health-care, the physician, their training and specialisation, interaction with society, educational training, etc.

Surgery: Pre-operative and Post-operative Care (Introduction)

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“There are five duties of surgery: to remove what is superfluous, to restore what has been dislocated, to separate what has grown together, to reunite what has been divided, and to redress the defects of nature.”—Ambroise Paré^[1]

The words of the French surgeon Ambroise Paré (1510- 1590) can well be said to reflect the concerns of the surgeon in the Suśruta Saṃhitā. Surgery evolved as a distinct stream from medicine which is so well evident in our survey.

As medical historians have pointed out,

“Surgery and Medicine are inseparably fused today as inseparable parts of healing. Such, of course, has not always been the case. Indeed it was but a short time ago that this union took place. Over the millennia of recorded history, surgery and medicine have followed separate and largely independent evolutionary patterns, with brief and infrequent periods of convergence of the two streams.”^[2]

References to surgeries are rare in Vedic literature and appear more as a minor appendage in therapeutics. Some form of surgical intervention is encountered in respect of diseases like balaśa (swelling), apacīts (rash with pustules) and urological ailments. The treatment of balaśa (swellings)^[3] and apacīts^[4] (rash with pustules) in the Atharvaveda involved lancing while that of urine retention required the use of an arrow-like reed as a primitive catheter.^[5] The principal cure of broken bones and fractures was herbal drugs.^[6] However, by the time of the composition of the Suśruta Saṃhitā, surgery had progressed so far as to evolve as a specialised branch of Āyurveda. The terms, śalyavid [śalyavidaḥ]^[7] and śalyahartṛ [śalyahartrāḥ]^[8] in the Caraka Saṃhita refer to physicians with expertise in the use of sharp instruments and these specialists are identified as belonging to the school of Dhanvantari, that is, the Dhānvantariyas. Significantly, surgeons of this school refer to themselves as bhiṣak or vaidya and not by any other term indicating their keenness to be identified as members of the medical mainstream.

In this chapter we shall look at the perception of surgery in the Saṃhitās, the surgical diseases, the training of surgeons, the pre-operative and post-operative care involved in surgical procedures and the concept of infection.