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Indian achievements in surgery

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Indian achievements in surgery

Do you know that the first Caesarean section in human history was performed in India 2,344 years ago? Such is the lamentable state of ignorance about our glorious heritage that the moment you mention the marvellous achievements of ancient Hindus in surgery, peoples’ first reaction is that of scandalous disbelief. Most people dismiss it as rhetorical propaganda of typical Hindu Right Wingers. That is why, for their satisfaction, I shall start this article with a quote from none other than the Columbia University Irving Medical Center. No one can accuse them of being inclined towards the Hindu Right Wing or Hindu Cultural Nationalism. They are, in fact, associated with the Presbyterian Church! It is due to their intellectual integrity and fairness that they have showered encomiums upon Hindu surgery.   

The book is available on Amazon

What Columbia University Says of Sushrut’s Surgical Techniques

In ‘History of Medicine: Ancient Indian Nose Jobs & the Origins of Plastic Surgery’, they write: “During the 6th  Century BCE, an Indian physician named Sushruta – widely regarded in India as the ‘father of surgery’ – wrote one of the world’s earliest works on medicine and surgery. 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…Skin grafts entail transplanting pieces of skin from one part of the body to another. Sushruta’s treatise provides the first written record of a forehead flap rhinoplasty, a technique still used today, which a full-thickness piece of skin from the forehead is used to reconstruct a nose…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…Amazingly, these techniques are all explained in the Sushruta Samhita.

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History of Surgery by Ancient Hindus

For maintaining scientific rigour I shall not make any reference to Hindu mythological accounts here. However, just one historical account would suffice. A popular misconception is that the Caesarean section (that is, the surgical delivery of a baby through a cut made in the mother’s abdomen and uterus) started in the West in ancient Rome. In the 16th century, a surgeon by the name James Guillimeau speculated that the Roman emperor Julius Caesar was “ripped out of his mother’s wombe” (sic). The story has stuck in popular imagination since then. Fact is, as Dr. Donald Todman points out in his paper ‘A History of Caesarean Section: From Ancient World to the Modern Era’, this is unlikely considering his mother Aurelia Cotta lived for many years afterwards, which would have been extremely unlikely after such an operation in Ancient Rome with no concept of antisepsis having been discovered.

S. Lurie in his paper ‘The Changing Motives of Caesarean Section: From the Ancient World to the Twenty-First Century” in the Archives of Gynaecology and Obstetrics (2005) and Nigel Keith Maybury in his book ‘Surgery: An Unfamiliar History’ (2022) categorically maintain that the earliest recorded birth by Caesarean section was that of the second Mauryan emperor Bindusar (320-273 BC).

According to the Buddhist texts Mahavansh and Mahavansh Tikka and the Jain text Parishishta-Parvan, it so happened that somehow or the other, Durdhara, his mother and the wife of Chandragupta Maurya, came on the verge of dying just seven days before her expected date of delivery. Legend is that she was either poisoned by enemies or had ingested some toxic substance by mistake. In any case, the matter was brought to the notice of Chanakya, the great polymath and the Mahamatya (prime minister) of Chandragupta. It is believed that being skilled in surgery himself, he instantly performed an emergency Caesarean section on the dying woman and managed to save the heir to the Empire. The hurried procedure probably left a mark on the forehead of the infant due to injury by some instrument, apparently a forceps, which is, at times, used in Caesarean sections even now. It was because of that mark (Bindu), that he was named Bindusar.  

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Sushrut, Not Just a Pioneer but a Giant in Surgery

Most people, including doctors, regard Hippocrates of the Hippocratic Oath fame (a Greek physician during 460-370 BC) as the ‘Father of Medicine’. The tragedy of Indian education is that most people do not know that centuries before him (sometime between the 6th century BC to 10th century BC) thrived a genius called Sushrut in Kashi where he practiced and taught numerous disciples. Legend is that he was taught either by Dhanwantari, the god of medicine himself, or Divodas, the king of Kashi, who is believed to have been a reputed physician. However, the fact that the details furnished by him are so minute that it leaves no doubt that they could have been written only by someone who had practiced the science himself and performed innumerable surgeries. He has not just reproduced some revealed knowledge.

He describes at great length, starting from general surgical techniques of making incisions, probing, extracting of foreign bodies, alkali and thermal cauterisation, tooth extraction, excision, the use of trocars to drain abscess, hydrocele and ascitic fluid (that is, fluid collecting in the spaces within the abdomen), and methods to stitch the intestines using ant-heads as stitching material, to more complex procedures including removal of the prostate gland, dilatation of the urethral stricture, vesicolithotomy (surgical removal of bladder stones), hernia surgery, Caesarean section, management of hemorrhoids, fistulae, laparotomy (a surgical incision into the abdominal cavity, for diagnosis or in preparation for major surgery) and the management of intestinal obstruction, perforated intestine and accidental perforation of the abdomen with protrusion of omentum (an apron-like structure of adipose tissue located in front of abdominal organs).

He also discusses management of dislocations and fractures, classification of the bones and their reaction to injury and traction, manipulation, apposition (parts of the body being in close contact) and stabilisation, including rehabilitation and the fitting of prosthetics.

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Sushrut Samhita, the Great Treatise of Surgery and Medicine

His treatise Sushrut Samhita was got translated into Arabic as early as 8th century. It was translated into Latin in 1844 by F. Hessler and in English by A.F.R. Hoernle in 1883. In India, Kaviraj Kunj Lal Bhishajratna translated it in English in 1907 in Calcutta. Subsequently, we have had more translations. It describes in great detail the examination, diagnosis, treatment and prognosis of numerous ailments, as well as procedures of plastic surgery, including cosmetic surgery and rhinoplasty (surgery that changes the shape of the nose).

This work is not just about surgery. It is divided into five principal parts:

1. Sutrasthan: 46 chapters dealing with basic principles of medical sciences and pharmacology;

2. Nidan: 16 chapters dealing with pathological concepts;

3. Shareersthan: 10 chapters on human anatomy;

4. Chikitsasthan: 34 chapters on medical and surgical managements; and

5. Kalpasthan: 8 chapters on toxicology.

In all, he discusses 1120 illnesses, 700 medicinal plants, 64 preparations from mineral sources and 57 preparations based on animal sources.

The First Plastic Surgeon of the World

His most startling discovery is about rhinoplasty. K. Bath (Department of Surgery, Harlem Hospital, New York) et al have shown in their paper that his technique of repairing the disfigured nose with a flap of skin from the forehead has remained unchanged till date. To honour him, the pedicled (a pedicle is a stem or stalk of tissue that connects parts of the body to each other) forehead flap is called the Indian flap. He has also described lobuloplasty (earlobe repair surgery) and otoplasty (a cosmetic procedure used to change the position, shape, or size of the ear using permanent sutures).

G. Mukhopadhyay has shown in his comprehensive work ‘The Surgical Instruments of the Hindus, With a Comparative Study of the Surgical Instruments of Greek, Roman, Arab and the Modern European Surgeons’ that Sushrut has described some 120 surgical instruments, catheters, and irrigating syringes and given details of their manufacture (including the metal to be used and the measurements) and maintenance (cleaning by caustics and alkalis) also.

Jeevak, Yet another Great Surgeon

Lest someone get an impression that Sushrut was Hindus’ only great surgeon, I must inform that we had many others and Sushrut was no historical fluke. Jeevak, the physician and surgeon finds mention in numerous Sanskrit, Pali, Tibetan and even Chinese texts. He is believed to be the son or grandson of Bimbisar, the king of Magadh (the father of Ajatshatru) apparently from his liaison with some courtesan. He used to treat mainly the aristocracy and is said to have treated Gautam Buddha himself. Some of his famous innovations include the surgery for fistula in ano (a tunnel that develops between the inside of the anus and the outside skin around the anus), surgical treatment of a volvulus (bowel obstruction resulting from a loop of intestine twisting upon itself), as well as surgery for hydrocele. For brevity, I am obliged to omit mentioning other great surgeons here.

How Hindus Were Made To Forget the Greatness of Their Ancestors

Sushrut’s genius can be gauged from the fact that millennia before anyone in the rest of the world even thought of it, he understood and recommended the use of wine for lessening the pain of the patient during surgery and emphasized antisepsis of the operation room by fumigating it with fumes of mustard, butter and salt.

Dr. Frank McDowell, himself a legendary plastic surgeon, in his book ‘The Source Book of Plastic Surgery’ pays tributes to Sushrut thus, “Through all of Sushruta’s flowery language, incantations and irrelevancies, there shines the unmistakable picture of a great surgeon. Undaunted by his failures, unimpressed by his successes, he sought the truth unceasingly and passed it on to those who followed. He attacked disease and deformity definitively, with reasoned and logical methods. When the path did not exist, he made one.”

Also Read: Hindus made the best steel and swords in the world

Friends, lament the fact that you have to hear such glowing words about Hindu geniuses from Western scholars. Such words should rather have been shouted from every rooftop in India; taught in schools and colleges and commemorated by the people. Yet, if you have remained ignorant of our glorious heritage, it is because of one man; Nehru who moulded Indian education to suit his personal biases and notions. A man for whom it is claimed that he was extremely well-read in numerous fields, it cannot be argued that he was unaware of the English translations of the Sushrut Samhita in 1883 and 1907. It was nothing but his hatred of the Hindu heritage that made him banish the monumental Hindu heritage from the collective mind of the Indian people.

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Dr N C Asthana IPS (Retd)
Dr N C Asthana IPS (Retd)
Dr. N. C. Asthana, IPS (Retd) is a former DGP of Kerala and ADG BSF/CRPF. Of the 51 books that he has authored, 20 are on terrorism, counter-terrorism, defense, strategic studies, military science, and internal security, etc. They have been reviewed at very high levels in the world and are regularly cited for authority in the research works at some of the most prestigious professional institutions of the world such as the US Army Command & General Staff College and Frunze Military Academy, Russia. The views expressed are his own.

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