Trividha karma in surgical parlance- a conceptual study
Journal name: Ayushdhara
Original article title: Trividha karma in surgical parlance- a conceptual study
AYUSHDHARA is an international peer-reviewed journal. It focuses on research in Ayurveda, Yoga, Unani, Siddha, Homeopathy, Allopathy, and Pharmaceutical Sciences.
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Gupta Pooja*
Associate Professor, Jammu Institute of Ayurveda and Research, Nardani Jammu
Gupta Arjun
Assistant Professor, Babe ke Ayurveda College, Daudhar, Moga
Bharti Neeru
Assistant Professor, Jammu Institute of Ayurveda and Research, Nardani Jammu
Hiteshi
PG Scholar, Jammu Institute of Ayurveda and Research, Nardani Jammu
Ayushdhara:
(A peer-reviewed, bi-monthly open-access journal)
Full text available for: Trividha karma in surgical parlance- a conceptual study
Year: 2019
Copyright (license): CC BY-NC-SA 4.0
Download the PDF file of the original publication
Summary of article contents:
Introduction
Ayurveda, a traditional Indian medical system, encompasses a range of treatment modalities, including surgical interventions termed "Shastra Chikitsa." Among the key principles highlighted in Ayurvedic surgery is the concept of "Trividha Karma," which translates to the three stages of surgical practice: Purva Karma (pre-operative care), Pradhana Karma (operative procedure), and Paschat Karma (post-operative care), as described by Acharya Sushruta, a foundational figure in this medical discipline. Enhanced by sound scientific principles, this framework emphasizes meticulous preparation and patient care throughout the surgical process.
Purva Karma: The Importance of Pre-Operative Care
Purva Karma, or pre-operative procedure, involves comprehensive preparation of the patient and environment before surgery. This stage incorporates elements such as patient history taking, physical examination, sterilization, and dietary considerations to minimize complications. Specific rituals, like "Raksha Karma," involve chanting mantras aimed at ensuring the patient's well-being and successful surgery. Additionally, Ayurvedic texts prescribe various cleansing techniques, including the "Upkarmas," which prepare the body for the surgical procedure. These preparations, while sometimes viewed as obsolete by modern practitioners, underscore a deep ethical commitment to patient welfare and emphasize the importance of thorough assessment and preparation to enhance surgical outcomes.
Pradhana Karma: The Operative Procedures
Pradhana Karma represents the core surgical interventions and includes the eight principal surgical techniques ("Ashtavidhha Shastra Karma") that every surgeon should master. These techniques encompass a range of procedures such as excision (Chedana), incision (Bhedhana), and suturing (Seevana), which are relevant for various conditions including abscesses and tumors. Each procedure is associated with specific indications that guide the surgeon in determining the appropriate method of intervention. Sushruta's insights into surgical techniques demonstrate his thorough understanding of not only the physical aspects of surgery but also the importance of form and direction in making incisions to promote effective healing.
Conclusion
In conclusion, the principles established by Acharya Sushruta in the realm of Trividha Karma highlight the integral relationship between pre-operative, operative, and post-operative care in ensuring surgical success. By emphasizing comprehensive patient preparation, skilled execution of surgical techniques, and diligent post-operative care, Ayurveda offers a holistic framework that aims to minimize complications and enhance recovery. These timeless principles underscore the significance of meticulous planning and compassionate patient care in the practice of surgery, reinforcing the enduring relevance of Ayurveda in contemporary medical practices.
FAQ section (important questions/answers):
What are the components of Trividha Karma in Ayurveda?
Trividha Karma consists of three components: Purva Karma (pre-operative procedures), Pradhana Karma (main operative procedure), and Paschat Karma (post-operative care), which together ensure effective surgical treatment.
What is the significance of Purva Karma in surgery?
Purva Karma includes patient preparation, sterilization, and ethical rituals that enhance the likelihood of a successful surgery by ensuring the patient is ready both physically and psychologically.
How does Paschat Karma contribute to patient recovery?
Paschat Karma focuses on post-operative care, such as dressing changes, monitoring wound healing, and dietary recommendations, all of which are crucial for a smooth and speedy recovery.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Trividha karma in surgical parlance- a conceptual study”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Karma (Karman):
In the context of Ayurvedic surgery, 'Karma' refers to the operational procedure. It signifies the actions taken during different phases of surgery, such as pre-operative, operative, and post-operative tasks, collectively termed as Trividha Karma.
2) Ayurveda (Ayus-veda):
Ayurveda is the ancient Indian medical science, considered a subdivision of the Atharveda. It encompasses traditional knowledge and practices, including various forms of treatment and surgical procedures as described by ancient texts like the Sushruta Samhita.
3) Purvakarma (Purvakarman, Purva-karman):
Purva-karma, or pre-operative procedure, in Ayurveda includes the preparation of the patient, sterilization, anesthesia, and other preliminary measures essential for surgery. This phase ensures that the patient is optimally prepared for the surgical intervention.
4) Purva:
Purva is a term meaning 'before' or 'pre'. In the context of Ayurvedic surgery, it refers to the pre-operative phase, known as Purva-karma, which involves preparing the patient for the surgery that follows.
5) Pradhana-karma:
Pradhana-karma refers to the main operative procedure in Ayurvedic surgery. It includes critical surgical tasks like Ashtavidha ShastraKarma (eight surgical procedures) that are essential for performing the surgery effectively.
6) Pradhana:
Pradhana means 'main' or 'chief'. In Ayurvedic surgical parlance, it denotes the primary operative phase, Pradhana-karma, which involves performing the central surgical activities essential for treating the patient.
7) Vrana:
Vrana refers to wounds. In Ayurvedic surgery, pre-operative and post-operative care related to Vrana includes specific cleansing measures and preparations such as Upkarmas to improve healing.
8) Disease:
In Ayurveda, diseases are conditions treated either through medicinal therapy or surgical interventions like Shastra chikitsa. Different types of diseases require tailored Purva-karma, Pradhana-karma, and Paschat-karma for effective treatment.
9) Lekhana:
Lekhana is a surgical procedure meaning 'scraping.' It is one of the Ashtavidha ShastraKarma techniques, with indications including conditions like Adhijiwika (uvulitis) and Mandal Kushta (patchy dermatitis).
10) Raksha (Raksa):
Raksha Karma involves chanting mantras for the patient's prosperity and welfare. Though considered outdated today, it reflects the ethical values and deep concern of the surgeon towards the patient's well-being.
11) Gupta:
[see source text or glossary: Gupta]
12) Paschat-karma:
Paschat-karma refers to post-operative care in Ayurveda. It involves steps taken after surgery, such as dressing wounds, changing bandages, and dietary recommendations to ensure proper healing and recovery.
13) Vedhana:
Vedhana means puncturing in Ayurvedic surgical procedures. Indications for Vedhana include puncturing veins for bloodletting or other conditions like Jalodra (ascites) and hydrocele.
14) Esana (Eshana):
Eshana, meaning 'probing,' is a surgical procedure used for detecting and treating conditions like Naadee Vrana (sinus) and Salya anaveshana (detection of foreign bodies)
15) Pooja:
[see source text or glossary: Pooja]
16) Diet:
Diet before and after surgery is crucial in Ayurvedic practice. Pre-operative diet involves light food, while post-operative care may include foods like unpolished rice and bitter gourd to help in recovery.
17) Vagbhata:
Acharya Vagbhata is one of the ancient scholars who contributed to Ayurvedic texts. He emphasized the pre-operative procedure, including practices like Raksha Karma for the well-being of the patient.
18) Vidradhi:
Vidradhi refers to abscesses. Surgical procedures like Bhedhana (incision) and Visravana (draining) are indicated for treating various types of abscesses, except certain conditions as specified in Ayurvedic texts.
19) Shastra (Sastra):
[see source text or glossary: Sastra]
20) Ashmari (Asmari):
Ashmari refers to urinary calculi or stones. Ayurvedic surgery involves procedures for diagnosis and removal, with guidelines similar to modern practices regarding pre-operative fasting and care.
21) Mantra (Mamtra):
Mantras are sacred chants used in Raksha Karma, an ancient Ayurvedic ritual performed by the surgeon to invoke prosperity and success for the patient, demonstrating the spiritual aspect of healing.
22) Indian:
[see source text or glossary: Indian]
23) Arshas (Arsa, Arsas, Arsha):
Arshas, or piles, are treated in Ayurveda through surgical procedures like Chedana (excision). These techniques are part of the traditional practices ensuring effective treatment of such conditions.
24) Blood:
In Ayurvedic surgery, procedures like Rakta Mokshana (bloodletting) and Siras Vedhana (puncturing veins) are practiced to treat various conditions, reflecting age-old medical understandings of blood-related therapies.
25) Pain:
Post-operative pain in Ayurveda is managed using methods like applying lukewarm ghee mixed with Mulethi, reflecting the ancient principles of natural healing and pain management.
26) Ghi (Ghee):
Ghee, often mixed with medicinal herbs like Mulethi, is used in Ayurveda for post-operative care to relieve pain and promote healing, emphasizing natural remedies in patient care.
27) Antra Vriddhi:
[see source text or glossary: Antra Vriddhi]
28) Blood letting:
Blood letting, or Rakta Mokshana in Ayurveda, is performed through techniques like Siras Vedhana to treat conditions like ascites and hydrocele, reflecting its significance in ancient surgical practices.
29) Bitter gourd:
Bitter gourd is recommended in post-operative care as an essential part of the Ayurvedic diet, believed to aid recovery and promote better health after surgical procedures.
30) Sushruta-samhita (Susruta-samhita):
The Sushruta Samhita, written by Sushruta, is a foundational text in Ayurveda detailing surgical techniques, procedures like Trividha Karma, and other medical practices originating around 500 B.C.
31) Agantujavrana (Agantuja-vrana):
[see source text or glossary: Agantuja-vrana]
32) Antravriddhi (Antravrddhi, Antra-vriddhi, Amtravriddhi):
[see source text or glossary: Antra-vriddhi]
33) Blood-letting:
Blood-letting, known as Rakta Mokshana, is an ancient Ayurvedic procedure practiced to balance bodily humors and treat specific conditions, showing the role of therapeutic blood removal.
34) Mudhagarbha (Mudha-garbha):
Mudhagarbha refers to abnormal presentation of the fetus. In Ayurveda, surgical interventions are conducted in such cases with precautions like pre-operative fasting for effective treatment.
35) Bhagandara (Bhagamdara):
Bhagandara, or fistula-in-ano, is treated in Ayurveda using surgical techniques like Chedana (excision). Detailed protocols for the procedure and post-operative care are provided in Ayurvedic texts.
36) Apatarpana:
Apatarpana, or Langhana (fasting), is one of the preparatory steps in Ayurvedic pre-operative care, believed to purify the body and improve the chances of successful surgical outcomes.
37) Ashtavidha (Astavidha, Ashtan-vidha):
Ashtavidha ShastraKarma refers to the eight surgical procedures outlined by Acharya Sushruta, which are fundamental to Ayurvedic surgical practice, encompassing techniques like excision, incision, and scraping.
38) Prosperity:
Prosperity is invoked for patients in Ayurveda through practices like Raksha Karma, which involves chanting mantras to ensure the patient's welfare and successful surgical outcomes.
39) Discussion:
The discussion section of the provided text compares Ayurvedic surgical practices with modern techniques, highlighting the systematic and scientific approach of ancient Ayurvedic principles in surgery.
40) Science (Scientific):
Ayurvedic surgery is based on scientific principles, as evidenced by Sushruta's systematic approach to procedures like Trividha Karma, aseptic techniques, and detailed pre-operative and post-operative care.
41) Mukharoga (Mukha-roga):
[see source text or glossary: Mukharoga]
42) Parisheka (Pariseka):
Parisheka is one of the pre-operative cleansing measures in Ayurveda, involving washing or pouring liquids on inflamed areas to prepare the surgical site and facilitate better healing.
43) Vimlapana:
Vimlapana involves softening the Vrana shotha (swelling) as part of pre-operative care in Ayurveda, aimed at enhancing surgical readiness and promoting faster recovery.
44) Abhyanga (Abhyamga):
Abhyanga, or body massage, is one of the preparatory steps in Ayurvedic surgery, believed to improve circulation and relaxation, contributing to overall better surgical outcomes.
45) Mokshana (Moksana):
[see source text or glossary: Mokshana]
46) Agantuja (Agantu-ja):
[see source text or glossary: Agantuja]
47) Manthana (Mamthana):
[see source text or glossary: Manthana]
48) Language:
[see source text or glossary: Language]
49) Sanskrit:
Sanskrit is the ancient language in which foundational Ayurvedic texts like the Sushruta Samhita were written. Its exclusivity made these texts initially inaccessible to broader medical sciences.
50) Langhana (Lamghana):
Langhana, or fasting, is a preparatory step in Ayurveda before surgery. It is believed to help purify the body and enhance the efficacy of the surgical and post-operative processes.
51) Samhita:
Samhita refers to classical collections of Ayurvedic medical literature. The Sushruta Samhita is a key text detailing surgical principles and procedures like Trividha Karma, compiled by Sushruta.
52) Chedana:
Chedana means excision in Ayurvedic surgery. It is one of the Ashtavidha ShastraKarma procedures used to treat conditions like Bhagandara (fistula-in-ano) and Arshas (piles).
53) Bhedana:
Bhedana, meaning incision, is another essential surgical procedure in Ayurveda. It is used to treat various abscesses and other conditions, following precise guidelines for incision techniques.
54) Snehana:
Snehana refers to the practice of oil massage, part of the preparatory measures in Ayurvedic pre-operative care. It is believed to soften tissues and facilitate smoother surgery and recovery.
55) Jangala (Jamgala):
[see source text or glossary: Jangala]
56) Grahana:
[see source text or glossary: Grahana]
57) Upanaha:
Upanaha, meaning poultices, is one of the preparatory steps in Ayurvedic surgical care, used to treat inflamed areas pre-operatively to aid in better surgical outcomes and faster healing.
58) Vriddhi (Vrddhi):
[see source text or glossary: Vriddhi]
59) Sharkara (Sarkara):
[see source text or glossary: Sarkara]
60) Leprosy:
[see source text or glossary: Leprosy]
61) Dahana:
[see source text or glossary: Dahana]
62) Modaka:
Modaka, including radish and carrot, is part of the recommended post-operative diet in Ayurveda, believed to promote healing and provide necessary nutrients after surgery.
63) Shotha (Sotha):
[see source text or glossary: Shotha]
64) Garbha:
[see source text or glossary: Garbha]
65) Madhya:
Madhya, referring to substances like alcohol, is to be avoided in post-operative care according to Ayurveda as such substances can deteriorate health and delay wound healing.
66) Sthana:
[see source text or glossary: Sthana]
67) Vamana:
Vamana, or emesis, is one of the cleansing measures in Ayurvedic pre-operative care. It helps purify the body and is part of the broader Purva karma procedures for better surgical outcomes.
68) Arbuda:
[see source text or glossary: Arbuda]
69) Kritya (Krtya):
[see source text or glossary: Kritya]
70) Vilepi:
Vilepi is a type of food recommended in the post-operative diet in Ayurveda, known for its light yet nutritious quality, enhancing recovery and healing after surgical procedures.
71) Mandal:
[see source text or glossary: Mandal]
72) Bitter:
[see source text or glossary: Bitter]
73) Temple:
[see source text or glossary: Temple]
74) Summer:
[see source text or glossary: Summer]
75) Carman (Carma):
[see source text or glossary: Charma]
[Note: The above list is limited to 75. Total glossary definitions available: 101]
Other Science Concepts:
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Pradhana-karma, Paschat-karma, Purvakarma, Shastrachikitsa, Wound healing, Clinical diagnosis, Patient management, Acharya Sushruta, Aseptic precaution, Surgical Procedure, Post-operative care, Trividha Karma, History taking, Raksha Karma, Surgical conditions, Pre-operative care, Pre-operative diet, Ashtaviddha Shastra Karma.