Maharishi Sushruta is regarded as the renowned academician of Indian Medical Science and founding father of surgery. Along with his co-workers, about 2600 years ago, he directed and managed several complicated surgeries like artificial limbs, fractures, caesareans, cataracts, urinary stones and mainly plastic surgery. Sushruta wrote about all the surgical procedures in a book called Shalya Tantra. Shalya Tantra was subsequently renamed Sushruta Samhita. The book has a detailed account of the ancient medical science of India, widely known as the Ayurveda. Hence, the author of Sushruta Samhita in the Sanskrit language is Maharishi Sushruta. He mentioned all the surgical methods with precision and curative efficacy in the book. His substantial discoveries have become an essential constituent of Indian medicine.
Maharishi Sushruta, the prominent scholar, is the son of wise Visvamitra. Maharishi Sushruta was the first to categorise the surgical operations and define plastic surgery and its tools in his book Sushruta Samhita with 120 chapters in five parts. The book explains eight special operations for surgery: excision, incision, scraping, puncturing, probing, Sravana, apposition, and stitching. Maharishi Sushruta had worked both as a practitioner and educator of surgery. His significant contribution towards Indian Traditional Medicine and ancient cultural legacy will always be valued.
Following his exceptional book, he became a well-known personality. His book was first translated into the Arabic language as Kitab-i-Susrud in the 8th CE. Later on, it was also transcribed into Latin and English languages. Maharishi Sushruta became famous worldwide because of his exceptional talent and skill. He was known for amputating limbs, eye surgery, and managing different complications after childbirth. His revised text Sushruta Samhita includes 184 lessons and an elaborate account of 1120 illnesses, a comprehensive description of about 700 remedial plants, a detailed study on anatomy, 64 explorations from mineral sources, 57 investigations from animal sources. Ayurvedic surgeons regard Sushruta Samhita as the fundamental source for all their work.
Sushruta Samrat is divided into two portions. The first portion is Purva-tantra, which has five sections, and the second one is known as Uttara-tantra. These parts collectively report all specialities like medicine, geriatrics, paediatrics, ear diseases, nose, throat and eye diseases, aphrodisiacs, toxicology, and psychiatry, as a result. Sushruta Samrat is the treasury of medical training and education for doctors with significance on the Salya and Salakya. Purva Tantra is divided into five books with 120 units. The books are Sutra sthana, Sarira sthana, Nidana sthana, Chikitsa sthana and Kalpa sthana. The Agnivesatantra is commonly known as the Charaka Samhita. The Nidana sthana, one of the five books of Purva Tantra, imparts knowledge about aetiology to medical students.
Before Sushruta Samhita, it wasn’t easy to understand the aetiology, signs and symptoms of various significant surgical diseases and their ailments. The rudiments of embryology and the anatomy of the human body in conjunction with the directives for venesection, obstetrics prerequisites, patient positioning according to each vein, the safety of the vital structures, and many more aspects are mentioned in detail the Sarira sthana. In addition, the Chikitsa sthana states the principles of managing various surgical conditions like obstetrical emergencies, geriatrics and aphrodisiacs.
The Kalpa sthana, familiar as Visa tantra, chronicles the nature of poisons and their handling. Above are the disciplines of Ayurveda as per Purvatantra. Uttaratantra addresses other specialities that are Salakya, Kayacikitsa, Kaumarabhfefefrtya and Bhutavidya. Aupadravika is another name for Uttaratantra, and it gives details about numerous complex surgical procedures like dysentery, cough, Kamala, krmi-roga, hiccough, fever, Pandu so on. Several diseases of the eye, ear, nose and head are explained in the Salakyatantra.
Maharishi Sushruta expressed in his writings that the haemorrhage can be stopped by the opposition of cutting edges with the stitches, through the cauterisation with chemicals or heat and application of styptic decoction etc. Sushruta claims that the wound is an ultimate abrasion of the underlying pathological structure that begins with inflammation. He states that the ulcer is entirely unclean in the first phase, called Dusta Vrana. It further changes into a clean wound known as Suddha Vrana with the help of proper care. The healing attempt is called Ruhyamana Vrana. After the healing happens wound is known as Rudha Vrana.
He was the discoverer and the innovator of anaesthesia. He encouraged the proper use of wine with the incense of cannabis for anaesthesia. In due course, the usage of Henbane, Sammohini and Sanjivani also began. He created multiple experimental modules for practising surgical methods. For example, he recommended practising incision and excision on vegetables or the leather bags filled with the mud of various densities. He categorised bones as per their reaction to different injuries. He specified six kinds of dislocation of joints and twelve varieties of shaft fractures and the concepts and essentials of fracture treatment such as traction, manipulation, appositions and stabilisation.
He conferred about the surgical circumstances of the anorectal region and gave all the techniques to handle both haemorrhoids and fistulae. In addition, Sushruta had in-depth knowledge about the urinary stones, varieties of stones, signs and symptoms, removal method, operational complications, and the urinary bladder’s anatomy. He also explained the surgery of intestinal obstruction, perforated intestines, abdomen accidental injuries which involve the protrusion of the omentum. His key role was in the discipline of Plastic and Cataract surgery.
He stated all the fundamentals of plastic surgery and also suggested physiotherapy before operation. He specified the technique of the release of skin to cover all the minor defects, rotation of the flaps to heal the partial loss, the pedicle flaps to cover the complete loss of skin from an area and many other procedures. In his book, he has also explained techniques with rotation graft, sliding graft, pedicle graft, rhinoplasty, labioplasty.
Sushruta is mentioned as one of the ten sages of the Himalayas in the Bower manuscript discovered in a Buddhist monastery in China. It is believed that the first Indian rhinoplasty was carried out by the local Vaidya of the Koomhar caste using the skin of the forehead. The local Vaidya executed the rhinoplasty on the heir of Brahma’s son in two British surgeons. Another being who was capable of doing Indian rhinoplasty was Joseph Constantine Carpue.