Digital Rare Book:
Sushruta Samhita - A Scientific Synopsis
By Priyadaranjan Ray, Hirendranath Gupta and Mira Roy
Published by The Indian National Science Academy, Delhi - 1980

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Susruta was believed to have been born in the Eastern part of India near Bihar. Known as the father of Indian surgery, Susruta was the first to practise rhinoplasty in India. When he lived has long been a controversial subject among many medical historians. Susruta's famous work, the Susruta Samhita, has not survived and its only existence is in the form of revisions and copies (Ruthkow, 1961). Late Vedic hymns ascribed to Susruta suggested that he must have flourished during the latter part of the Vedic age, which would place him around 1000 BCE.

Susruta's Samhita emphasized surgical matters, including the use of specific instruments and types of operations. It is in his work that one finds significant anatomical considerations of the ancient Hindu. There is also compelling evidence suggesting that the knowledge of human anatomy was revealed by both inspection of the surface of the human body and through human dissection, as he believed that students aspiring to be surgeons should acquire a good knowledge of the structure of the human body (Hoernle, 1907; Keswani, 1970) (Fig. 1). Interestingly, in neither the writings of Susruta or of Charaka is there any indication that animal dissection was practised. Their anatomical knowledge, therefore, appears to have been gleaned from human dissection. Moreover, their writings show a considerable familiarity with the bones of the human body (Banerjee, 2006; Hoernle, 1907).

The advancement of surgery during ancient Indian medical history is significant when considering the obstacles that deterred the study of anatomy. According to Hindu tenets, the human body is sacred in death. Hindu law (Shastras) states that no body may be violated by the knife and that persons older than 2 years of age must be cremated in their original condition (Ruthkow, 1961). Susruta was, however, able to bypass this decree and achieve his remarkable knowledge of human anatomy by using a brush-type broom, which scrapped off skin and flesh without the dissector having to actually touch the corpse.

Susruta's description of anatomical specimens included over 300 bones, as well as types of joints, ligaments and muscles from various parts of the body (Hoernle, 1907). Critics suggest that Susruta's overestimate of the number of bones contained in the human body may be due to the large number of child cadavers he observed (i.e. it is very possible that Susruta accounted for individual parts of bones that had not yet fused.) Despite his erroneous accounts of the skeleton, Susruta offered an in-depth understanding of bones, muscles, joints and vessels that far exceeded the knowledge of the time (Persaud, 1997).

The Susruta Samhita

Arguably the oldest surgical textbook is the Susruta Samhita. The literal translation of this Susruta is ‘that which is well heard’ or ‘one who has thoroughly learned by hearing’ (Chari, 2003). The first translation of this book from Sanskrit was the Arabic translation of the late 8th century. It was later translated into Latin, German and English (Mukhopadhaya, 1929). The most recent English translation was by Kaviraj Bhishagharatan, published in 1910; a later edition was released in 1963 (Bhishagratna, 1963). The Susruta Samhita is divided into two parts, the Purva-tantra and the Uttara-tantra. The Purva-tantra is subdivided into five books, the Sutrasthana, Nidana, Sarirasthana, Chikitasathanam and the Kalpastham, totalling 120 chapters, collectively (Mukhopadhaya, 1929). At the approximate time of the Susruta Samhita, the healing arts were divided into five parts, which included the Rogaharas (physicians), Shaylyaharas (surgeons), Vishaharas (poison healers), Krityaharas (demon doctors), and Bhisagatharvans (magic doctors) (Chari, 2003).

The Sutrasthana deals with basic medical science and pharmacology; Nidana, addresses disease processes; Chikitsasthanam is the bulk of the text, 34 chapters on surgical procedures and post-operative management; and the Kalpasthanam is composed of eight chapters on toxicology.

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