The Saga of Ancient Indian Medicine - Its Wisdom & Brilliance

It might come as news to the thousands of health industry employees in India that the first ever surgeries were being performed in India around the time Gautama Buddha was taking his first steps towards enlightenment.  And yes, we are talking of a time predating Hippocrates, the Father of Western Medicine, by hundreds of years.  

The Atharva Veda is the earliest document in India that contains allusions to medical subjects, although they are of a somewhat primitive nature, and largely permeated by magic and sorcery.

Archaeological digs, however, confirm that the most comprehensive technical and medical knowledge existed and was applied successfully in the old Indian empires dating back to 4,000 B.C.  By the medieval period, the Indian subcontinent had developed a number of medicinal preparations and surgical procedures for the treatment of various ailments.

Ayurveda, the traditional Hindu system of medicine, was divided into eight volumes:

1. Kaya Chikitsa (Internal Medicine)

2. Kaumarabhrtya (Pediatrics)

3. Rasayanatantra (Geriatrics)

4. Shalya Chikitsa (Surgery)

5. Shalakyatantra (ENT, Dentistry, Ophthalmology)

6. Agadatantra (Toxicology)

7. Bhutavidya (Psychiatry/exorcism)

8. Vajikaranatantra (Sexual problems)

Surgical science was called shalya-tantra (shalya referring to the broken parts of an arrow and other sharp weapons and tantra referring to the application of cosmic sciences in performing ritual acts of body, speech or mind).  The commonest and most dangerous of foreign objects causing wounds and requiring surgical treatment were quite obviously the instruments of war, and experienced surgeons were in great demand. Among the many distinguished names in ancient Hindu medicine, those of Susruta, Charaka, Atreya and Yajnavalkya stand out.  Both Susruta and Charaka are authors of compendiums on medicine and surgery and their combined works are considered the most authoritative on the subject.

Susruta was generally believed to have resided at the court of the Gupta kings at Pataliputra during the ‘Golden Age’ of Hindu culture.  Some accounts depict him as living as far back as 400 BC, although there is no consensus among historians on this point.  The ancient Indian medical practitioners were divided into two classes: the Salya-Chikitsakas (surgeons) and the Kaya-Chikitsakas (physicians), but it was only through the efforts of Susruta that surgery achieved a leading position in general medical training.

Susruta attempted to arrange systematically the experiences of older surgeons and to collect scattered facts about medicine into a workable series of lectures or manuscripts. The result was the Susruta samhita

comprising several hundred texts on medicine, written more in poetry than prose form.  Though this work is mainly devoted to surgery, it also includes chapters on medicine, pathology, anatomy, midwifery, biology, ophthalmology, hygiene, and a little psychology and understanding of what would today be called the “bedside manner.”

Susruta begins his samhita with an allegorical description of the beginning of medical teaching, but he quickly gets into some very practical suggestions about how a medical student should be selected, how he should be initiated, and the oath he should take (quite similar to the Hippocratic Oath).  

He also sets forth quite plainly the qualifications of a physician about to enter practice and rules of personal and professional conduct that are singularly parallel to those of today.

Contained in the text are surgical techniques of making incisions, probing, extraction of foreign bodies, tooth extraction, cauterization, excisions, and trocars for draining abscess, hydrocele and ascitic fluid; the removal of urinary stones and the prostate gland, urethral stricture dilatation, hernia surgery, caesarian section; management of haemorrhoids and fistulae, laparotomy and management of intestinal obstruction; perforated intestines, and accidental perforation of the abdomen with protrusion of omentum; plastic surgery; the principles of fracture management, including traction, manipulation and stabilization; and even measures of rehabilitation and prosthetics.

In the above illustration, surgical training is being provided to pupils by having them operate on fruits, gourds, watermelons, cucumbers, etc.

Susruta has also included a list of blunt and sharp instruments and added that a surgeon, by his own experience and intelligence, may invent and add new instruments to facilitate the surgical procedures. 

He apparently used the heads of giant ants to effectively staple a wound over intestine while performing surgery for perforations.

The live creatures were affixed to the edges of the wound, which they clamped shut with their pincers. The physician then cut the insects' bodies off, leaving the jaws in place.

The samhitas of Charaka and Susruta were translated into Persian and Arabic around about 800 AD, and since Arabic medicine became the chief authority for European medicine down to the 17th century, Indian ideas undoubtedly have indirectly entered modern Western medicine. It is also a less known but interesting fact that British physicians learned the art of rhinoplasty from Indian surgeons in the days of the East India Company. 

So the next time someone talks to you  about the ‘backwardness’ of medicine, science or technology in India, just remind them about  Susruta, and about all other ancient Indian doctors, their wisdom & brilliance in treating their patients using vastly advanced medical technology that was  unheard of in other parts of the ancient world.

And yes, it is also up to us to take India back to its heydays in Science & Technology

Happy Independence Day!