Sushruta was an Indian physician, who wrote one of the world’s earliest works on medicine and surgery and is therefore regarded as the ‘Father of Indian Medicine’ and ‘Father of Plastic Surgery.’
During the 6th century BCE, an Indian physician named Sushruta – widely regarded as the ‘Father of Indian Medicine’ and ‘Father of Plastic Surgery’ – wrote one of the world’s earliest works on medicine and surgery.
Sushruta lived in the ancient city of Kashi, now known as Varanasi or Banaras in the northern part of India.
Sushruta Samhita
Sushruta is known for his pioneering operations and techniques and for his influential treatise ‘Sushruta Samhita’ or Compendium of Sushruta, the main source of knowledge about surgery in ancient India.
Written in Sanskrit, the Sushruta Samhita dates back to the times before Christ and is one of the earliest works in the field of medicine. It forms the foundations of the ancient Hindu form of medicine known as Ayurveda and is highly regarded as one of the ‘Great Trilogy of Ayurvedic Medicine.’
The Sushruta Samhita documented the etiology of more than 1,100 diseases, the use of hundreds of medicinal plants, and instructions for performing scores of surgical procedures – including three types of skin grafts and reconstruction of the nose.
The influential nature of the Sushruta Samhita is supported not only by anatomical knowledge and surgical procedural descriptions contained within its pages but also by the creative approaches that still hold true today.
Skin grafts entail transplanting pieces of skin from one part of the body to another. Today, surgeons use skin grafts to restore areas that have lost protective layers of tissue due to trauma, infection, burns, as well as to restore areas where surgical intervention has created a loss of skin, as can happen with melanoma removal. Some grafts include blood vessels and muscle, such as in reconstructive breast surgery.
Origin of Rhinoplasty
Rhinoplasty, colloquially known as the ‘nose job,’ is a surgery performed to achieve two results:
- To improve the breathing function of the nose
- To improve the cosmetic look of the nose
Sushruta’s treatise provides the first written record of a forehead flap rhinoplasty, a technique still used today to reconstruct a nose. He used a flap of skin from the forehead, called a pedicle, to form a new nose.
The nose in Indian society has remained a symbol of dignity and respect throughout antiquity. In ancient times, amputation of the nose was frequently done as a punishment for criminals, war prisoners or people indulged in adultery.
The practice of Rhinoplasty slowly started as a result of the need to reconstruct the external nose and later developed to full-fledged science.
Other contributions by Sushruta
1. Besides trauma involving general surgery, Sushruta gave an in-depth account of the treatment of 12 varieties of fracture and six types of dislocation. This continues to spellbind orthopedic surgeons even today.
2. He mentioned the principles of traction, manipulation, apposition, stabilization, and postoperative physiotherapy.
3. Sushruta also prescribed measures to induce growth of lost hair and removal of unwanted hair.
4. He implored surgeons to achieve perfect healing which is characterized by the absence of any elevation, induration, swelling mass, and the return of normal coloring.
Plastic surgery in ancient India
Plastic surgery and dental surgery were practiced in India even in ancient times. Students were properly trained on models and were expected to study for at least six years before starting their training. Before beginning the training, the students were required to take a solemn oath. Sushruta taught his surgical skills to his students on various experimental models.
Incision on vegetables such as watermelon and cucumber, probing on worm-eaten woods are some instances of his experimental teachings. He was one of the first people in human history to suggest that a student of surgery should learn about the human body and its organs by dissecting a dead body.
According to Sushruta, “Anyone, who wishes to acquire a thorough knowledge of anatomy, must prepare a dead body and carefully observe and examine all its parts.”
The method of study was to submerge the body in water and allow it to decompose followed by an examination of the decomposing body at intervals to study structures, layer by layer, as they got exposed following decomposition.
The most important point to note here is that the dissection was performed without a knife.
Golden age of surgery
Sushruta Samhita remained preserved for many centuries exclusively in the Sanskrit language. In the eighth century AD, Sushruta Samhita was translated into Arabic as ‘Kitab Shah Shun al -Hindi’ and ‘Kitab-I-Susurud.’
The first European translation of Sushruta Samhita was published by Hessler in Latin and in German by Muller in the early 19th century; the complete English literature was done by Kaviraj Kunja Lal Bhishagratna in the three volumes in 1907 in Calcutta.
Sushruta took surgery in medieval India to admirable heights and that era was later regarded as the ‘Golden Age of Surgery’ in ancient India. The genius of Sushruta prompted eminent surgeon Allen Whipple to declare, “All in all, Sushruta must be considered the greatest surgeon of the pre-medieval period.”
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Prasanta Patnaik