Surgery in Ancient India: Introduction (Part One)
THE CONCEPT OF SURGERY IN VEDIC SAṂHITĀS
Article Credit : Dr. Priti Sinha
PART ONE : Introduction
Synopsis: Surgery in ancient India article is divided into three parts. The first part in the following article, covers the different medical branches during Vedic times like surgery, general medicine, ENT and others. It also covers the etymology and importance of medicine in surgery . This section of the article also talks about the different modalities used for surgery, like incision, puncture, stitching etc.
In modern times, surgery has transformed from a last resort measure into an arguably the most important medical treatments. The shift can be explained by surgery’s technical effectiveness and its safety. This advanced ensemble of interdependent technologies and knowledge has been widely in practice since the ancient times.
Veda is one of the most ancient literature available. In the light of the linguistic specialities and deliverable objects, the Ṛgveda is considered older than the Yajurveda, Sāmaveda and Atharvaveda. Almost every aspect of life is described in the Vedas, from seeds of thoughts on language, spirituality, kãvya, history, geography, mathematics, chemistry, to law and science and much more.
A very advanced and developed form of medical science is also found in the Vedas. To name a few, references of naturo-therapy, fire therapy, water therapy, hymn / sound therapy, socio-psycho therapy, botanical medical therapy and surgery, sunbeam therapy etc can be seen.
The need and diseases were a bit different from the modern times for performing Surgery in ancient India. Due to wars, cuts from weapons, pulling out metals or objects left in the body, suturing, re-construction of cut body parts, transplantation etc required proficient surgeons with great knowledge and skill. We have tried to present these references in the light of modern medical practices for better understanding.
Seeing the vastness and details of the subject, the article is divided into Three Parts
- Introduction: Introduction to medical sciences and it’s various sub-specialties. We start with a brief Introduction of the meaning, importance and branches of Surgery in ancient times.
- Types of Surgery: The second part in the series contains reference of various Types of Surgery and medical modalities, that were used for treatment in Vedic times. Eg.: Plastic surgery, Reimplantation, Transplantation, Obstetrics etc.
- References: The third and final part includes the surgical references and procedures in the Samhitãs : Ṛksaṃhitā, Yajuṣsanhita, Sāmsanhita, Atharvasanhitā.
Even though according to Mantrabrāhmaṇayorvedanāmadheyam, the word ‘Veda’ contains four parts : saṃhitā, brāhmaṇ, āraṇyaka and upaniṣad, this series discusses the citations about śalyacikitsā (surgery) available in the Samhitãs only.
MEDICAL BRANCHES IN VEDIC TIMES (1500-500 BCE)
According to Āyurveda , there are eight different branches of medical sciences :
- Śalyacikitsā (Surgery),
- Kāyacikitsā (General Medicine),
- Śālākyacikitsā (Ear, Nose & Throat Surgery and Ophthalmology),
- Bhūtavidyā (Treatment of super natural diseases),
- Kaumārabhṛtya or Bālacikitsā (Paediatrics),
- Agadatantra or Viṣatantra (toxicology),
- Rasāyanatantra (Rejuvenation) and
- Vājīkaraṇatantra (Virilificatica)
Tadyathā-śalyaṃ, śālākyaṃ, kāyacikitsā, bhūtavidyā,
kaumārabhṛtyam, agadatantraṃ, rasāyānatantraṃ, vājīkaraṇatantramiti
Suśrutasaṃhitā, sūtrasthāna 1-7
The most popular and main branches were: General Medicine and Surgery. All the other six branches are mostly included in the above. In this series, we will be concentrating on Surgery only.
SURGERY IN ANCIENT INDIA
Surgery involves cutting into the body (incision) to explore or remove tissue while the patient is under anesthesia. A surgery can be for curative purpose, diagnostic (staging) process or as a preventive measure. Surgeries are also performed to relieve pain or repair deformities and abnormalities, like in re-constructive surgery. The latest trend in surgery is more for body transformation than treatment pruposes, as in cosmetic and plactic surgery.
Surgery in ancient India was considered as the first and primary branch of medical science in Āyurveda. Ancient surgeon and scholar Suśruta concluded that surgery was the most reliable amongst the eight branches of medical sciences. It not only included all the qualities of the other branches, but also addressed the problem faster and delivered immediate relief. Use of surgical instruments, like alkali and fire etc are mentioned in the scriptures.
aṣṭāṣvapi cāyurvedatantreṣvetadevādhikamabhimataṃ āśukriyākaraṇādyantr-aśastrakṣārāgnipraṇidhānāt sarvatantrasāmānyacca.
Suśrutasaṃhitā Sūtrasthāna 1.18
Surgery was considered to be the eternal and munificent of virtue, paradise, fame, longevity and subsistence.
tadidaṃ śāśvataṃ puṇyaṃ svargyam yaśasyamāyuṣyaṃ vṛttikaraṃ ceti.
Suśrutasaṃhitā Sūtrasthāna 1.19
The word Śalya (pronounced as : Shallya) is derived from the root śal hiṃsāyām with the addition of suffix yat. The etymological meaning of Śalyacikitsā (pronounced as : Shallya Chikitsaa) is the process to remove the root cause of pain or suffering which came from outside or itself came to existence internally, with the help of surgical instruments.
The disease is treated through surgery, transplantation, fire or alkaline therapy, blood drainage etc. According to Suśruta, surgery is used to remove stone, iron, pus, discharge, secretions, embolus etc and to treat ulcers.
tatra śalyaṃ nāma vividhatṛṇakāṣṭhapāṣāṇapānśulohaloṣṭāsthibālan-akhapūyasrāvaduṣṭavraṇān-targarbhaśalyoddharaṇārthaṃ yantraśastrakṣārāgnipraṇidhānavraṇaviniścayārthaṃca
Suśrutasaṃhitā Sūtrasthāna 1.8 p3
Surgery and medicine go hand in hand. Per ancient text, a surgeon was expected to be well versed in general medicine along with expertise in surgery, to successfully understand and address the problem. While citing the importance of theoretical and practical knowledge in both surgery and medicine, Suśruta concluded, that a surgeon lacking in proficiency in either medicine or surgery, is like a bird trying to fly with a single wing.
ubhāvetāvanipuṇāvasamarthāu svakarmaṇi /
ardhavedadharāvetāvekapakṣāviva dvijau //
Suśrutasaṃhitā Sūtrasthāna 3.50
The surgery is decided after consideration of the patterns of diseases. The diseases are of four kinds: adventitious diseases, physical diseases, mental diseases and common diseases. Surgery has due importance in the treatment of adventitious diseases.
te caturvidhā āgantavaḥ śārīrāh, mānasāh, svābhāvikāśceti
So, it can be concluded with the help of these discussions on surgery in Vedic texts that treatment of diseases were carried out through various methods of surgery like incision and concision, planting, using fire and alkalis and blood purification. Examples of all these methods are available in the Vedic sanhitās.
Eight methods of surgery are described respectively in Suśrurtasaṃhitā.
(ka) pāṭanaṃ vyadhanaṃ caiva chedanaṃ lepanaṃ tathā/
proñchanaṃ sīvanaṃ caiva ṣaḍvidhaṃ śastraarma//
Suśrutasaṃhitā Cikitsāsthāna 1.8. p381
1) CHEDANA : The intention of incision or Chedana is to cut it away from the body. It is mostly used in case of piles and fissures.
2) BHEDANA or DĀRANA : Bhedana is intended to incise pimples and abscess.
3) LEKHANA : Lekhana means incision with a small edged surgical instrument.
4) VEDHANA : Vedhana is used to treat venepuncture (phlebotomy), retention of urine and hydropsy etc.
5) EṢANA : Eṣaṇa means investigation of blood vessels and wounds with a spoke.
6) ĀHARANA : Āharaṇa means to drag something out.
7) VISRĀVAṆA : Visrāvaṇa means to drain the blood and pus.
8) SĪVANA : The meaning of Sīvana is to stitch.
The precise treatment via surgery appear to be decided after considering the severity of the disease. Besides these, the diseases were treated with the help of prayers towards the deities, use of external medicines and incantations in need.
The methods of treatments are far more enriched and advanced in Atharvaveda in comparison to other Vedas. Āyurveda is considered to be the upaveda of the Atharvaveda because of the numerous descriptions on diseases, medicines and treatments in it.
Continued in Part Two: Types of Surgery
Unprecedented growth is seen in twentieth century in the field of modern surgery. The dimensions of surgery are also changing very fast in the twenty first century bringing in Robotic surgery, Remote surgery etc. If the methods of Surgery in ancient India are reviewed in context of the modern surgery, the concept of super specialized branches were present during the ancient times as well.
Disclaimer : The practices and methods elaborated in the articles are not in any way suggestive to be used by or on anyone. It is just a source of information strictly for knowledge purposes only.
- RELATED ARTICLES
- Surgery in Ancient India: Introduction (Part One)
- Surgery in Ancient India: Types of Surgery (Part Two)
- Suśruta: The Father of Surgery and Plastic Surgery
- Reproductive Endocrinology during Mahabharata