{{Short description|Ancient Sanskrit medical compendium}} {{italic title}} {{Use dmy dates|date=September 2022}} {{Use Indian English|date=September 2022}} [[File:The Susruta-Samhita or Sahottara-Tantra (A Treatise on Ayurvedic Medicine) LACMA M.87.271a-g (1 of 8).jpg|thumb|250px|Palm leaves of the ''Sushruta Samhita'' or ''Sahottara-Tantra'' from [[Nepal]], stored at [[Los Angeles County Museum of Art]]. The text is dated 12th-13th century while the art is dated 18th-19th century.]] {{Hindu scriptures}} The '''''Sushruta Samhita''''' ({{langx|sa|सुश्रुतसंहिता|lit=Suśruta's Compendium}}, {{IAST3|Suśrutasaṃhitā}}) is an ancient [[Sanskrit]] text on [[medicine]] and one of the most important such treatises on this subject to survive from the ancient world. The ''Compendium of [[Sushruta|Suśruta]]'' is one of the foundational texts of [[Ayurveda]], alongside the ''[[Charaka Samhita|Charaka-Saṃhitā]]'', ''the [[Bhela Samhita|Bhela-Saṃhitā]]'', and the medical portions of the [[Bower Manuscript]].{{Sfn| Meulenbeld|1999|pp = 203–389 (Volume IA)}}{{Sfn|Rây|1980}} It is one of two foundational Hindu texts on the medical profession that have survived from ancient India.Wendy Doniger (2014), On Hinduism, Oxford University Press, {{ISBN|978-0199360079}}, page 79;
Sarah Boslaugh (2007), Encyclopedia of Epidemiology, Volume 1, SAGE Publications, {{ISBN|978-1412928168}}, page 547, '''Quote''': "The Hindu text known as Sushruta Samhita is possibly the earliest effort to classify diseases and injuries" The ''Suśrutasaṃhitā'' is of great historical importance because it includes historically unique chapters describing surgical training, instruments and procedures.{{Sfn|Rây|1980}}{{Sfn|Valiathan|2007}}{{pageneeded|date=November 2023}} The oldest surviving manuscript of the ''Suśrutasaṃhitā'' is MS Kathmandu KL 699, a [[palm-leaf manuscript]] preserved at the [[Kaiser library|Kaiser Library]], Nepal, dated to 878 AD.{{Cite book |last=Wujastyk |first=Dominik |url=https://books.ub.uni-heidelberg.de/index.php/xa/catalog/book/1203 |title=On the Plastic Surgery of the Ears and Nose |last2=Birch |first2=Jason |last3=Klebanov |first3=Andrey |last4=Parameswaran |first4=Madhu K. |last5=Rimal |first5=Madhusudan |last6=Chakraborty |first6=Deepro |last7=Bhatt |first7=Harshal |last8=Lele |first8=Vandana |last9=Mehta |first9=Paras |date=2023 |publisher=Heidelberg Asian Studies Publishing |doi=10.11588/hasp.1203}}{{cite journal|author= Kengo Harimoto| title= In search of the Oldest Nepalese Manuscript|journal= Rivista degli Studi Orientali| volume=84|year=2011|pages=85–88}} ==History== {{Quote box |width=26em | bgcolor=#FFE0BB |align=right |salign = right |quote='''Ancient qualifications of a Nurse''' That person alone is fit to nurse or to attend the bedside of a patient, who is cool-headed and pleasant in his demeanor, does not speak ill of any body, is strong and attentive to the requirements of the sick, and strictly and indefatigably follows the instructions of the physician. |source =—''Sushruta Samhita'' Book 1, Chapter XXXIV
Translator: Bhishagratna{{Sfn| Bhishagratna|1907|p=307}}}} ===Date=== The most detailed and extensive consideration of the date of the ''Suśrutasaṃhitā'' is that published by Meulenbeld in his ''History of Indian Medical Literature'' (1999–2002). Meulenbeld states that the ''Suśrutasaṃhitā'' is likely a work that includes several historical layers, whose composition may have begun in the last centuries BCE and was completed in its presently surviving form by another author who redacted its first five sections and added the long, final section, the "Uttaratantra."{{Sfn|Meulenbeld|1999|pp=203–389 (Volume IA)}} It is likely that the ''Suśruta-saṃhitā'' was known to the scholar {{ill|Dṛḍhabala|qid=Q107208659|display=true}} (fl. 300–500 CE), which gives the latest date for the version of the work that has survived into the modern era.{{Sfn|Meulenbeld|1999|pp=203–389 (Volume IA)}} In ''Suśrutasaṃhitā - A Scientific Synopsis'', the historians of Indian science Ray, Gupta and Roy noted the following view, which is broadly the same as Meulenbeld's:{{Cite book |last1=Ray |first1=Priyadaranjan |url=http://n2t.net/ark:/13960/t6066dz1s |title=Suśruta saṃhitā: (a scientific synopsis) |last2=Gupta |first2=Hirendra Nath |last3=Roy |first3=Mira |date=1980 |publisher=Indian National Science Academy |location=New Delhi |pages=4 |language=English |oclc=985517620}}
"The Chronology Committee of the National Institute of Sciences of India (Proceedings, 1952),{{Cite book |last=India |first=National Institute of Sciences of |url=https://books.google.com/books?id=wSg2AQAAIAAJ |title=Proceedings of the National Institute of Sciences of India |date=1952 |publisher=National Institute of Sciences of India |language=en}} was of the opinion that third to fourth centuries A. D. may be accepted as the date of the recension of the Suśruta Saṃhitā by Nāgārjuna, which formed the basis of Dallaṇa's commentary."
The above view remains the consensus amongst university scholars of the history of Indian medicine and Sanskrit literature. ==== Hoernle's view ==== The scholar [[Rudolf Hoernle]] (1841–1918) proposed in 1907 that because the author of the ''[[Satapatha Brahmana|Śatapathabrāhmaṇa]]'', a Vedic text from the mid-first-millennium BCE, was aware of [[Sushruta]]'s doctrines, Sushruta's work should be dated based on the composition date of ''Śatapathabrāhmaṇa''.{{Sfn|Hoernle |1907 |p = 8}} The composition date of the Brahmana was itself unclear, added Hoernle, but he estimated it to be about the sixth century BCE.{{Sfn|Hoernle |1907 |p = 8}} However, Hoernle's view was based on the unexamined assumption that the ideas about the human skeleton in the ''Suśrutasaṃhitā'' preceded those of the ''Brāhmaṇa.'' He seems never to have questioned this assumption. Hoernle's date of 600 BCE for the ''Suśrutasaṃhitā'' was challenged by intervening scholarship over the last century. This scholarship was summarized by Meulenbeld in his ''History of Indian Medical Literature''.{{Cite book |last=Meulenbeld |first=Gerrit Jan |url=http://worldcat.org/oclc/872371654 |title=A history of Indian medical literature. |date=2000 |isbn=90-6980-124-8 |volume=IA |location=Groningen |pages=361-363 |oclc=872371654}} Central to the problem of chronology is the fact that the ''Suśrutasaṃhitā'' was the work of several hands. The internal tradition recorded in manuscript colophons and by medieval commentators makes clear that an old version of the ''Suśrutasaṃhitā'' consisted of sections 1-5, with the sixth part having been added by a later author. However, the oldest extant manuscripts include the sixth section, called "The Later Book" (Skt. Uttara-tantra). Manuscript colophons refer to the whole work as "The Suśrutasaṃhitā together with the Uttara-tantra," reinforcing the idea that they are a combined work. Thus, it does not make sense to speak of "the date of Suśruta." Like "Hippocrates," the name "Suśruta" refers to the work of many authors working over several centuries. ==== Further views on chronology ==== As mentioned above, scores of scholars have proposed hypotheses on the formation and dating of the ''Suśrutasaṃhitā'', ranging from 2000 BCE to the sixth century CE. These views have been gathered and described by the medical historian Jan Meulenbeld.{{sfn|Meulenbeld|1999|pp=341–346}} ===Authorship=== {{anchor|Sushruta}} [[File:A statue of Sushruta at RACS, Melbourne.jpg|thumb|A statue of [[Sushruta]] (600 BCE) at [[Royal Australasian College of Surgeons]] (RACS) in [[Melbourne]], [[Australia]].]] ''Sushruta'' or ''Suśruta'' ([[Sanskrit]]: '''सुश्रुत''', [[IAST]]: {{IAST|Suśruta}}, {{lit|well heard}},{{Cite book|title = A Sanskrit-English Dictionary|last = Monier-Williams|first = Monier|publisher = Clarendon Press|year = 1899|location = Oxford|pages = 1237|url = http://www.sanskrit-lexicon.uni-koeln.de/cgi-bin/monier/serveimg.pl?file=/scans/MWScan/MWScanjpg/mw1237-suvarNya.jpg}} an adjective meaning "renowned"Monier-Williams, ''A Sanskrit Dictionary'' (1899).) is named in the text as the author, who is presented in later manuscripts and printed editions a narrating the teaching of his guru, Divodāsa.{{Cite book|title = An English Translation of the Sushruta Samhita, based on Original Sanskrit Text|last = Bhishagratna|first = Kunjalal|year = 1907|publisher=self-published|location = Calcutta|pages = 1|url = https://archive.org/stream/englishtranslati01susruoft|ref = bhishagratna}}{{Cite web|title=The Suśruta Project – The textual and cultural history of medicine in South Asia based on newly-discovered manuscript evidence|url=https://sushrutaproject.org/|access-date=2021-06-21|language=en-GB}} Early Buddhist [[Jataka tales|Jatakas]] mention a Divodāsa as a physician who lived and taught in ancient Kashi ([[Varanasi district|Varanasi]]). The earliest known mentions of the name Suśruta firmly associated with the tradition of the ''Suśrutasaṃhitā'' is in the ''[[Bower Manuscript]]'' (4th or 5th century CE), where Suśruta is listed as one of the ten sages residing in the Himalayas.{{Sfn|Kutumbian|2005|pp=XXXII-XXXIII}} After a review of all past scholarship on the identity of Suśruta, Meulenbeld concluded that:
As is obvious from the foregoing, it is rather generally assumed that we owe the main part of the Suśrutasaṃhitā or an earlier version of it to a historical person called Suśruta. This assumption, however, is not based on uncontrovertible evidence and may be illusory. The text of the Suśrutasaṃhitā does not warrant that the one who composed it was a Suśruta. The structure of the treatise shows without ambiguity that the author, who created a coherent whole out of earlier material, attributed the teachings incorporated in his work to Kāśirāja Divodāsa...{{sfn|Meulenbeld|1999|p=342 }}
===Religious affiliation=== The text has been called a Hindu text by many scholars.{{Sfn| Boslaugh|2007| p= 547, Quote: "The Hindu text known as Sushruta Samhita (600 AD) is possibly the earliest effort to classify diseases and injuries".}}{{Sfn|Schultheisz|1981| pp= 60-61, Quote: "(...) the Charaka Samhita and the Susruta Samhita, both being recensions of two ancient traditions of the Hindu medicine."}}{{Sfn|Loukas |2010 |p=646, Quote: 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."}} The text discusses surgery with the same terminology found in more ancient Hindu texts,{{Sfn|Hoernle |1907 |pp = 8, 109-111}}{{cite journal | last=Raveenthiran | first=Venkatachalam | title=Knowledge of ancient Hindu surgeons on Hirschsprung disease: evidence from Sushruta Samhita of circa 1200-600 bc | journal=Journal of Pediatric Surgery | volume=46 | issue=11 | year=2011 | pages=2204–2208 | doi=10.1016/j.jpedsurg.2011.07.007 | pmid=22075360 }} mentions Hindu gods such as [[Narayana]], [[Hari]], [[Brahma]], [[Rudra]], [[Indra]] and others in its chapters,{{Sfn| Bhishagratna|1911|p=156 etc}}{{Sfn| Bhishagratna|1907|pp=6-7, 395 etc}} refers to the scriptures of Hinduism namely the [[Vedas]],{{Sfn| Bhishagratna|1911|pp=157, 527, 531, 536 etc}}{{Sfn| Bhishagratna|1907|pp=181, 304-305, 366, lxiv-lxv etc}} and in some cases, recommends exercise, walking and "constant study of the Vedas" as part of the patient's treatment and recovery process.{{Sfn| Bhishagratna|1911|p=377 etc}} The text also uses terminology of [[Vaisheshika|Vaiśeṣika]], [[Samkhya]] and other schools of [[Hindu philosophy]].{{Sfn| Bhishagratna|1911|pp=113-121 etc}}{{Sfn| Bhishagratna|1916|pp=285, 381, 407, 409, 415 etc}}{{Sfn|Engler|2003|pp=416-463}} The ''Sushruta Samhita'' and ''Caraka Samhita'' have religious ideas throughout, states Steven Engler, who then concludes "Vedic elements are too central to be discounted as marginal".{{Sfn|Engler|2003|pp=416-463}} These ideas include the use of terms and same metaphors that are variously pervasive in Buddhist and Hindu scriptures – the Vedas, and the inclusion of theory of [[Karma]], self ([[Atman (Hinduism)|Atman]]) and [[Brahman]] (metaphysical reality) along the lines of those found in ancient Hindu and Buddhist texts.{{Sfn|Engler|2003|pp=416-463}} However, adds Engler, the text also includes another layer of ideas, where empirical rational ideas flourish in competition or cooperation with religious ideas.{{Sfn|Engler|2003|pp=416-463}} Following Engler's study, contemporary scholars have abandoned the distinction "religious" vs. "empirico-rational" as no longer being a useful analytical distinction. The text may have Buddhist influences, since a redactor named [[Nagarjuna]] has raised many historical questions, although he cannot have been the person of Mahayana Buddhism fame.{{Sfn|Meulenbeld|1999|pp = 347–350 (Volume IA)}} Zysk produced evidence that the medications and therapies mentioned in the Pāli Canon bear strong resemblances and are sometimes identical to those of the ''Suśrutasaṃhitā'' and the ''Carakasaṃhitā.''{{Cite book |last=Zysk |first=Kenneth G. |title=Asceticism and healing in ancient India: medicine in the Buddhist monastery |date=1991 |publisher=Oxford University Press |isbn=978-0-19-505956-4 |location=New York}} In general, states Zysk, Buddhist medical texts are closer to ''Sushruta'' than to ''Caraka'',{{Sfn|Zysk|2000|p=100}} and in his study suggests that the ''Sushruta Samhita'' probably underwent a "Hinduization process" around the end of 1st millennium BCE and the early centuries of the common era after the [[Hindu philosophy|Hindu orthodox]] identity had formed.{{Sfn|Zysk|2000|p=4-6, 25-26}} Clifford states that the influence was probably mutual, with Buddhist medical practice in its ancient tradition prohibited outside of the Buddhist monastic order by a precedent set by Buddha, and Buddhist text praise Buddha instead of Hindu gods in their prelude.Terry Clifford (2003), Tibetan Buddhist Medicine and Psychiatry: The Diamond Healing, Motilal Banarsidass, {{ISBN|978-8120817845}}, pages 35-39 The mutual influence between the medical traditions between the various Indian religions, the history of the layers of the ''Suśruta-saṃhitā'' remains unclear, a large and difficult research problem.{{Sfn|Meulenbeld|1999|pp = 347–350 (Volume IA)}} ''Sushruta'' is reverentially held in Hindu tradition to be a descendant of [[Dhanvantari]], the mythical god of medicine,[[Monier-Williams]], ''A Sanskrit Dictionary'', s.v. "suśruta" or as one who received the knowledge from a discourse from Dhanvantari in Varanasi. ===Manuscripts and transmission=== [[File:Page of text from the Susrutasamhita Wellcome L0034906.jpg|thumb|260px|A page from the ancient medical text, Susruta Samhita.]] The oldest known [[palm-leaf manuscript|manuscript]] of ''the Sushruta Samhita'' is preserved at the [[Kaiser Mahal|Kaiser Library]], Kathmandu, Nepal as manuscript MS Kathmandu Kaiser Library 699. A microfilm copy of the MS was created by Nepal-German Manuscript Preservation Project (NGMCP C 80/7) and is stored in the National Archives, Kathmandu. The partially damaged manuscript consists of 152 folios, written on both sides, with 6 to 8 lines in transitional Gupta script. The manuscript has been verifiably dated to have been completed by the scribe on Sunday, April 13, 878 CE (Manadeva Samvat 301). Much of the scholarship on the ''Suśruta-saṃhitā'' is based on editions of the text that were published during the nineteenth and early twentieth centuries. This includes the important edition by Vaidya Yādavaśarman Trivikramātmaja Ācārya that also includes the commentary of the scholar Dalhaṇa.{{Cite book|title = Suśrutasaṃhitā, Suśrutena viracitā, Vaidyavaraśrīḍalhaṇācāryaviracitayā Nibandhasaṃgrahākhyavyākhyayā samullasitā, Ācāryopāhvena Trivikramātmajena Yādavaśarmaṇā saṃśodhitā|last = Ācārya|first = Yādavaśarman Trivikrama|publisher = Nirnaya Sagara Press|year = 1938|location = Mumbayyāṃ|ref = trikamji}} The printed editions are based on the small subset of surviving manuscripts that was available in the major publishing centers of Bombay, Calcutta and elsewhere when the editions were being prepared – sometimes as few as three or four manuscripts. But these do not adequately represent the large number of manuscript versions of the ''Suśruta-saṃhitā'' that have survived into the modern era. Taken together, all printed versions of the Suśrutasaṃhitā are based on no more than ten percent of the more than 230 manuscripts of the work that exist today.{{Cite book|last=Kumarapuram.|first=Kunjunni Raja|url=http://worldcat.org/oclc/157800144|title=New catalogus catalogorum : an alphabet. register of Sanskrit and allied works and authors|date=1973|oclc=157800144}} ==Contents== {{Quote box |width=26em | bgcolor=#FFE0BB |align=right |salign = right |quote='''Anatomy and empirical studies''' The different parts or members of the body as mentioned before including the skin, cannot be correctly described by one who is not well versed in anatomy. Hence, any one desirous of acquiring a thorough knowledge of anatomy should prepare a dead body and carefully, observe, by dissecting it, and examine its different parts. |source =—''Sushruta Samhita'', Book 3, Chapter V
Translators: Loukas et al{{Sfn|Loukas|2010|pp = 646–650}}}} The Sushruta Samhita is among the most important ancient medical treatises.{{Sfn| Meulenbeld|1999|pp = 203–389 (Volume IA)}} It is one of the foundational texts of the medical tradition in India, alongside the ''[[Charaka Samhita|Caraka-Saṃhitā]]'', ''the Bheḷa-Saṃhitā'', and the medical portions of the [[Bower Manuscript]].{{Sfn| Meulenbeld|1999|pp = 203–389 (Volume IA)}}{{Sfn|Rây|1980}} ===Scope=== The relative chronology of the ''Sushruta Samhita'' and the ''[[Charaka Samhita]]'' remains an open research question (in 2025). Except for some topics and their emphasis, both discuss many similar subjects such as General Principles, Pathology, Diagnosis, Anatomy, Sensorial Prognosis, Therapeutics, Pharmaceutics and Toxicology.{{cite journal| author=Menon IA, Haberman HF| title=Dermatological writings of ancient India | journal=Med Hist | year= 1969 | volume= 13 | issue= 4 | pages= 387–392 | pmid=4899819 | pmc=1033984 | doi=10.1017/s0025727300014824}}{{Cite book|title = Suśruta Saṃhita (a Scientific Synopsis)|last1 = Ray|first1 = Priyadaranjan|publisher = INSA|year = 1980|location = New Delhi|last2 = Gupta|first2 = Hirendra Nath|last3 = Roy|first3 = Mira}}{{Sfn| Meulenbeld|1999|pp = 203–389 (Volume IA)}} The ''Sushruta'' and ''Charaka'' texts differ in one major aspect, with ''Sushruta Samhita'' providing more detailed descriptions of surgery, surgical instruments and surgical training. The ''Charaka Samhita'' mentions surgery, but only briefly. ===Chapters=== The ''Sushruta Samhita'', in its extant form, is divided into 186 chapters and contains descriptions of 1,120 illnesses, 700 medicinal plants, 64 preparations from mineral sources and 57 preparations based on animal sources.Dwivedi & Dwivedi (2007){{page needed|date=November 2018}} The ''Suśruta-Saṃhitā'' is divided into two parts: the first five books (Skt. Sthanas) are considered to be the oldest part of the text, and the "Later Section" (Skt. ''Uttaratantra'') that was added perhaps by an author named Nagarjuna.Prof.P.V.Sharma, Ayurveda Ka Vaijnannika Itihas,7th ed., Ch. 2, Pg.87, Chaukhambha orientalia, Varanasi (2003) The ''Uttaratantra'' is itself divided into internal subsections: surgery (Śālakyatantra 1-26), children's medicine (Kumāratantra 27-38), therapy (Kāyacikitsā 39-59), supernatural beings (Bhūtavidyā 60-62), and generic supplement (Tantrabhūṣaṇa 63-66). The content of these 186 chapters is diverse, some topics are covered in multiple chapters in different books. A summary according to the Bhishagratna's translation is as follows:{{Sfn| Bhishagratna|1907}}{{sfn| Bhishagratna|1911}}{{Sfn| Bhishagratna|1916}} {| class="wikitable" align=center style = " background: transparent; " |+ Sushruta Samhita |-style="text-align: center;" | width=80px style="background: #ffad66;" | Book | width=80px | Chapter | width= 450px | Topics (incomplete){{refn|group=note|name=selby1|Bhishagratna translation includes parts of Dalhana commentary, and used modern medical terminology and Western words such as "egg" for ''sonita'' (menstrual blood), an approach that has led scholars to question parts of his translation.Martha Ann Selby (2005), Asian Medicine and Globalization (Editor: Joseph S. Alter), University of Pennsylvania Press, {{ISBN|978-0812238662}}, page 124RP Das (1991), Medical Literature from India, Sri Lanka, and Tibet (Editors: Gerrit Jan Meulenbeld, I. Julia Leslie), BRILL Academic, {{ISBN|978-9004095229}}, pages 25-26}} | width=80px | Translation
Comments |- | colspan=4 | {| class="wikitable collapsible collapsed" ! colspan=4 style="background: #ffcd66;" | 1. Sutra-sthana |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 1.I | width= 450px style="text-align: left;" | '''Origin of the Ayurveda''': eight divisions, history, definition of ''Purusha'' (patient), what is a disease, stages of a disease, classifications | width=80px | {{Sfn| Bhishagratna|1907|pp=1-15}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 1.II | width= 450px style="text-align: left;" | '''Medical education''': qualifications of a student, oath of care, promise of the student to the teacher, ethical prohibitions | width=80px | {{Sfn| Bhishagratna|1907|pp=16-20}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 1.III | width= 450px style="text-align: left;" | '''Classification of (Original) Samhita''': Table of contents, synopsis of the text, skilful and unskilful physicians, how to study for medical practice, need for "constant practice to attain perfection" | width=80px | {{Sfn| Bhishagratna|1907|pp=21-32}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 1.IV | width= 450px style="text-align: left;" | '''Preface and explanations''': Need for clear exposition, defects resulting from unclear statements, duties of a student | width=80px | {{Sfn| Bhishagratna|1907|pp=33-35}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 1.V | width= 450px style="text-align: left;" | '''Preliminary surgical measures''': Types of surgical operations, collecting equipment and accessories, prophylactics, modes of incision, post surgical steps, dressing wounds, instructions to the patient after surgery, measures to remove pain | width=80px | {{Sfn| Bhishagratna|1907|pp=36-44}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 1.VI | width= 450px style="text-align: left;" | '''Seasons and their influence on health and medicine''': effect of weather, change in weather, causes of epidemics, prophylactic measures, natural and unnatural seasons | width=80px | {{Sfn| Bhishagratna|1907|pp=45-55}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 1.VII | width= 450px style="text-align: left;" | '''Surgical appliances, their use and construction''': names, dimensions, use and functions, excellence of each appliance, defect of each appliance, accessories | width=80px | {{Sfn| Bhishagratna|1907|pp=56-63}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 1.VIII | width= 450px style="text-align: left;" | '''Surgical instruments, their use and construction''': handling instruments, sharpening, edging, tempering, maintenance, when should each be used and not used | width=80px | {{Sfn| Bhishagratna|1907|pp=64-70}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 1.IX | width= 450px style="text-align: left;" | '''Training for surgery''': use of dummies and fruits to learn and pre-practice surgery | width=80px | {{Sfn| Bhishagratna|1907|pp=71-73}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 1.X | width= 450px style="text-align: left;" | '''Qualifications and certification of a physician''': effect of weather, change in weather, causes of epidemics, prophylactic measures, natural and unnatural seasons | width=80px | {{Sfn| Bhishagratna|1907|pp=74-77}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 1.XI | width= 450px style="text-align: left;" | '''Preparing Alkalis, their uses''': how to prepare the solutions, external and internal uses, cauterization, potencies, defects, dangers, reaction, preventing abuse | width=80px | {{Sfn| Bhishagratna|1907|pp=78-87}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 1.XII | width= 450px style="text-align: left;" | '''Cauterization''': preparation and process for various injuries and diseases, various types of cauterization | width=80px | {{Sfn| Bhishagratna|1907|pp=88-97}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 1.XIII | width= 450px style="text-align: left;" | '''Leeching''': suitable and unsuitable patients, mode of vitiating ''dhatu'' (blood), finding, collecting and keeping leeches, good leeches and bad leeches, post-treatment measures | width=80px | {{Sfn| Bhishagratna|1907|pp=98-105}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 1.XIV | width= 450px style="text-align: left;" | '''Lymph chyle''': menstrual blood and its nature, swellings, venesection, causes of excessive bleeding, causes of scanty bleeding, measures to be adopted in either | width=80px | {{Sfn| Bhishagratna|1907|pp=106-119}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 1.XV | width= 450px style="text-align: left;" | '''Excretory disorders''': nature, locations, theory of why they increase or decrease | width=80px | {{Sfn| Bhishagratna|1907|pp=120-140}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 1.XVI | width= 450px style="text-align: left;" | '''Ear piercing and bandages''': proper piercing, accidents, treatments | width=80px | {{Sfn| Bhishagratna|1907|pp=141-154}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 1.XVII | width= 450px style="text-align: left;" | '''Swellings''': types, suppurating and non-suppurating, causes, symptoms, treatments, dangers of misdiagnosis, anaesthesia, lancing, surgery | width=80px | {{Sfn| Bhishagratna|1907|pp=155-161}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 1.XVIII | width= 450px style="text-align: left;" | '''Ulcers''': classification, preparing medicinal plasters, dressing, evils of not bandaging, benefits of bandaging, when not to bandage, lubricating bandage for faster healing | width=80px | {{Sfn| Bhishagratna|1907|pp=162-175}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 1.XIX | width= 450px style="text-align: left;" | '''Nursing and management''': bed, chamber, prohibited articles, prophylaxis and mantras against monsters and demons, diet, conduct, care | width=80px | {{Sfn| Bhishagratna|1907|pp=176-182}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 1.XX | width= 450px style="text-align: left;" | '''Food and regimen for patient's recovery''': Food and drinks, their role in patient's recovery, salutary regiment, non-salutary regimen | width=80px | {{Sfn| Bhishagratna|1907|pp=183-193}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 1.XXI | width= 450px style="text-align: left;" | '''Vayu, Pittam and Shleshma''': the role and impact of diseases on Vayu, Pittam and Shleshma (body aeration, body fluids) | width=80px | {{Sfn| Bhishagratna|1907|pp=194-211}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 1.XXII | width= 450px style="text-align: left;" | '''Boils and ulcers, secretions''': shapes, types, secretion, role of ''Vayu'', pains and their kinds associated with different types of ulcers, colors of ulcers | width=80px | {{Sfn| Bhishagratna|1907|pp=212-219}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 1.XXIII | width= 450px style="text-align: left;" | '''Prognosis of ulcers''': symptoms, identification of curable and incurable types, palliation, factors which reopen healed ulcer | width=80px | {{Sfn| Bhishagratna|1907|pp=220-227}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 1.XXIV | width= 450px style="text-align: left;" | '''Classification of diseases, deciding if medicine or surgery is needed''': types of diseases, congenital, mental, physical, providential; causes of fever | width=80px | {{Sfn| Bhishagratna|1907|pp=228-237}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 1.XXV | width= 450px style="text-align: left;" | '''Eight forms of surgery''': description, suitability in different cases, avoiding injuries to blood vessels and ligaments, action if accidentally injured | width=80px | {{Sfn| Bhishagratna|1907|pp=238-246}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 1.XXVI | width= 450px style="text-align: left;" | '''Injuries from splinters''': ''Shalyam'', accidental injuries, arrow injuries, necessity for removing arrow shafts | width=80px | {{Sfn| Bhishagratna|1907|pp=247-255}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 1.XXVII | width= 450px style="text-align: left;" | '''Injuries, extraction of splinters''': fifteen methods of extraction, dangers of not extracting splinters completely from a wound | width=80px | {{Sfn| Bhishagratna|1907|pp=256-265}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 1.XXVIII | width= 450px style="text-align: left;" | '''Progress in treating ulcer''': signs of improvement, signs of worsening, fatal symptoms | width=80px | {{Sfn| Bhishagratna|1907|pp=266-269}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 1.XXIX | width= 450px style="text-align: left;" | '''Disease prognosis, use of omens, augury''': Dreams and their analysis for diagnosis | width=80px | {{Sfn| Bhishagratna|1907|pp=270-283}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 1.XXX | width= 450px style="text-align: left;" | '''Prognosis from sense organs''': Testing sensory functions of a patient for symptoms and disease prognosis | width=80px | {{Sfn| Bhishagratna|1907|pp=284-287}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 1.XXXI - 1.XLVI | width= 450px style="text-align: left;" | Various topics | width=80px | {{Sfn| Bhishagratna|1907|pp=288-571}} |} |- | colspan=4 | {| class="wikitable collapsible collapsed" ! colspan=4 style="background: #ffcd66;" | 2. Nidana-sthana |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 2.I | width= 450px style="text-align: left;" | '''Nervous system diseases''': causes, pathology, symptoms, prognosis. Epilepsy, Hemiplegia, Torticellis, Facial paralysis, Indistinct speech, etc. | width=80px | {{Sfn| Bhishagratna|1911|pp=1-17}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 2.II | width= 450px style="text-align: left;" | '''Haemorhoids''': classification, causes, pathology, symptoms, prognosis. | width=80px | {{Sfn| Bhishagratna|1911|pp=18-24}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 2.III | width= 450px style="text-align: left;" | '''Urinary calculli''': Aetiology, symptoms, indications, theory on how bladder stones are formed | width=80px | {{Sfn| Bhishagratna|1911|pp=25-30}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 2.IV | width= 450px style="text-align: left;" | '''Fistula''': classification, pathology, symptoms, prognosis. | width=80px | {{Sfn| Bhishagratna|1911|pp=31-34}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 2.V | width= 450px style="text-align: left;" | '''Skin diseases''': classification, aetiology, symptoms, treatment, contagious nature, avoiding its spread, prognosis. | width=80px | {{Sfn| Bhishagratna|1911|pp=35-42}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 2.VI | width= 450px style="text-align: left;" | '''Urinary diseases''': pathology, symptoms, prognosis. | width=80px | {{Sfn| Bhishagratna|1911|pp=43-49}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 2.VII | width= 450px style="text-align: left;" | '''Dropsy''': classification, causes, pathology, symptoms, prognosis. | width=80px | {{Sfn| Bhishagratna|1911|pp=50-54}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 2.VIII | width= 450px style="text-align: left;" | '''Birth, Difficult labor''': causes, classification, symptoms, abortion, miscarriage, prognosis. | width=80px | {{Sfn| Bhishagratna|1911|pp=55-60}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 2.IX | width= 450px style="text-align: left;" | '''Abscess, Vidradhi''': classification, curability, treatment | width=80px | {{Sfn| Bhishagratna|1911|pp=61-66}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 2.X | width= 450px style="text-align: left;" | '''Mammary glands diseases (women)''': classification, symptoms, healthy breast milk and its character, abnormal traits, baby care | width=80px | {{Sfn| Bhishagratna|1911|pp=67-71}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 2.XI | width= 450px style="text-align: left;" | '''Tumors and goitres''': classification, symptoms, causes, prognosis | width=80px | {{Sfn| Bhishagratna|1911|pp=72-78}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 2.XII | width= 450px style="text-align: left;" | '''Andrology and gynecology''': genital organ diseases, classification, symptoms, causes, prognosis | width=80px | {{Sfn| Bhishagratna|1911|pp=79-84}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 2.XIII | width= 450px style="text-align: left;" | '''Kshudra roga''': minor diseases, classification, symptoms, causes, prognosis | width=80px | {{Sfn| Bhishagratna|1911|pp=85-93}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 2.XIV | width= 450px style="text-align: left;" | '''Shuka dosha''': classification, symptoms, prognosis | width=80px | {{Sfn| Bhishagratna|1911|pp=94-96}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 2.XV | width= 450px style="text-align: left;" | '''Fracture and dislocation''': causes, features, symptoms, classification, curable and incurable types, treatment, management | width=80px | {{Sfn| Bhishagratna|1911|pp=97-100}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 2.XVI | width= 450px style="text-align: left;" | '''Mouth, tongue, larynx and lip diseases''': classification, causes, symptoms, classification, prognosis | width=80px | {{Sfn| Bhishagratna|1911|pp=101-111}} |} |- | colspan=4 | {| class="wikitable collapsible collapsed" ! colspan=4 style="background: #ffcd66;" | 3. Sarira-sthana |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 3.I | width= 450px style="text-align: left;" | '''Theory of Being''': Tattvas, Purusha and Prakriti, ''[[Samkhya]]'' theories and its use in medical practice, human mind | width=80px | {{Sfn| Bhishagratna|1911|pp=113-121}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 3.II | width= 450px style="text-align: left;" | '''Reproductive health''': classification of semen and menstrual fluid, disorders, treatment, sexual activity for conception, difficulty in conception, causes, description of fetus | width=80px | {{Sfn| Bhishagratna|1911|pp=122-133}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 3.III | width= 450px style="text-align: left;" | '''Pregnancy''': Theory of ''Sarira'' (body, matter), ''Atman'' (soul), theory on gender formation, signs of pregnancy, care of pregnant woman, fetal development, cravings, twin, time of delivery, care during labor | width=80px | {{Sfn| Bhishagratna|1911|pp=134-143}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 3.IV | width= 450px style="text-align: left;" | '''Womb, baby development''': theory on placenta, limbs, organ development during pregnancy | width=80px | {{Sfn| Bhishagratna|1911|pp=144-158}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 3.V | width= 450px style="text-align: left;" | '''Human anatomy''': Enumeration of limbs, body organs, their numbers, vessels, bones, joints, ''Sandhis'', ligaments, muscles, differences between organs of men and women, reproductive organs | width=80px | {{Sfn| Bhishagratna|1911|pp=158-172}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 3.VI | width= 450px style="text-align: left;" | '''Marmas, vital organs''': classification, numbering and location of organs, different theories on which organs are vital, symptoms associated with specific organs when injured | width=80px | {{Sfn| Bhishagratna|1911|pp=173-190}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 3.VII | width= 450px style="text-align: left;" | '''Vascular system''': classification, numbering and location of ''Siras'' (vascular system) | width=80px | {{Sfn| Bhishagratna|1911|pp=191-197}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 3.VIII | width= 450px style="text-align: left;" | '''Venesection''': classification and definition, determining who is fit and who unfit for venesection | width=80px | {{Sfn| Bhishagratna|1911|pp=198-208}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 3.IX | width= 450px style="text-align: left;" | '''Arteries, Nerves and Ducts''': classification, locations, theory on their roles, symptoms in cases of disorder | width=80px | {{Sfn| Bhishagratna|1911|pp=209-215}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 3.X | width= 450px style="text-align: left;" | '''Nursing, care of pregnant women''': needs from conception to parturition, regimen during gestation, diet, natal rites, lactation, infantile diseases, miscarriage and its treatment, management of pregnancy | width=80px | {{Sfn| Bhishagratna|1911|pp=216-238}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | |} |- | colspan=4 | {| class="wikitable collapsible collapsed" ! colspan=4 style="background: #ffcd66;" | 4. Cikitsa-sthana |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 4.I | width= 450px style="text-align: left;" | '''Ulcers''': causes, symptoms, traumatic and idiopathic ulcers, dosha-originated ulcers, therapeutics, sixty treatments of different types of ulcers | width=80px | {{Sfn| Bhishagratna|1911|pp=259-264}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 4.II - 4.XXIII | width= 450px style="text-align: left;" | Various topics: Treatment of ulcers, wounds, sores, fractures, nervous disorders, urinary infections, skin infections, tumors, swellings, hernia, hydrocele, genital sores, urethra infections, mouth infections, other minor ailments | width=80px | {{Sfn| Bhishagratna|1907|pp=265-477}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 4.XXIII - 4.XL | width= 450px style="text-align: left;" | Various topics on '''Hygiene''': tooth brushing, dental care, face care, hands and feet washing, bathing, exercise, healthy meal, rules on drinking water, benefits of ''Dahi'' (yoghurt), good sleep, effect of not taking care of body, improving strength, elixirs, rejuvenators, remedial agents, Soma, tonics, Sneha, Sveda, Emetics, Purgatives, effects of abusing or overdosing medicine and solutions, use of Dhuma (fumes) and Kavala (gargling) for relief from some symptoms. | width=80px | {{Sfn| Bhishagratna|1907|pp=478-671}} |} |- | colspan=4 | {| class="wikitable collapsible collapsed" ! colspan=4 style="background: #ffcd66;" | 5. Kalpa-sthana |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 5.I | width= 450px style="text-align: left;" | '''Preserving food and drink''': theory on why food or drink poisons, how to detect poisoned food or drink, treatment of food poisoning | width=80px | {{Sfn| Bhishagratna|1911|pp=673-684}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 5.II - 5.VIII | width= 450px style="text-align: left;" | Various topics on '''Poisons''': Classification, description and treatment of animal poisons, snake bite, rat poisoning, scorpions, spiders, other insect bites | width=80px | {{Sfn| Bhishagratna|1907|pp=685-736}} |} |- | colspan=4 | {| class="wikitable collapsible collapsed" ! colspan=4 style="background: #ffcd66;" | 6. Uttara-tantra |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 6.I-6.XIX | width= 450px style="text-align: left;" | '''Eye disorders, injuries and infections''': eye diseases, appendages, causes of eye diseases, symptoms, eyelid infections and their treatment, classification of eye lens problems and prognosis, need and protocols for eye surgery, eye injuries and their treatment | width=80px | {{Sfn| Bhishagratna|1916|pp=1-105}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 6.XX-6.XXI | width= 450px style="text-align: left;" | '''Ear disorders, injuries and infections''': ear diseases, causes and their treatment | width=80px | {{Sfn| Bhishagratna|1916|pp=106-117}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 6.XXII-6.XXIII | width= 450px style="text-align: left;" | '''Nose disorders, injuries and infections''': classification of nose diseases, symptoms and their treatment | width=80px | {{Sfn| Bhishagratna|1916|pp=117-123}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 6.XXV-6.XXVI | width= 450px style="text-align: left;" | '''Head diseases''': classification of head diseases, symptoms and their treatment | width=80px | {{Sfn| Bhishagratna|1916|pp=131-140}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 6.XXVII-6.XXXVII | width= 450px style="text-align: left;" | '''Malignant grahas''': attack by grahas (superhuman influences), symptoms, procedures for sprinkling, fumigation and mantra recitals | width=80px | {{Sfn| Bhishagratna|1916|pp=141-163}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 6.XXXIX-6.LIII | width= 450px style="text-align: left;" | '''Fever, diarrhea, phthisis, gulma, heart disease, jaundice, hemorrhage, alcoholism, vomiting, asthma, cough''': classification, symptoms, causes, prognosis, changes in diet as cure, use of drinks, milk and meat as medicine. | width=80px | {{Sfn| Bhishagratna|1916|pp=169-337}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 6.LIV-6.LIX | width= 450px style="text-align: left;" | '''Worms, problem urinating, other diseases''': classification, symptoms, causes, prognosis | width=80px | {{Sfn| Bhishagratna|1916|pp=338-372}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 6.LXII | width= 450px style="text-align: left;" | '''Insanity''': type, symptoms and treatment | width=80px | {{Sfn| Bhishagratna|1916|pp=387-391}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 6.LXIV | width= 450px style="text-align: left;" | '''Rules of health''': indications and importance of health, knowledge of foods, varying food intake with seasons, effective ways to administer medicines, proper time for taking food and medicines | width=80px | {{Sfn| Bhishagratna|1916|pp=396-405}} |-style="text-align: center;" | width=80px style="background: #ffcd62;" | | width=80px | 6.LXV-6.LXVI | width= 450px style="text-align: left;" | '''Glossary and short list''': technical terms in the text, their definitions, list of diseases and drugs, various lists and their numbers | width=80px | {{Sfn| Bhishagratna|1916|pp=406-416}} |} |} ===Prevention versus cure=== Sushruta, states Tipton, asserts that a physician should invest the effort to prevent diseases as much as curative remedial procedures.{{Sfn|Tipton|2008|p=1554}} An important means for prevention, states Sushruta, is physical exercise and hygienic practices.{{Sfn|Tipton|2008|p=1554}} The text adds that excessive strenuous exercise can be injurious and make one more susceptible to diseases, cautioning against such excess.{{Sfn|Tipton|2008|pp=1553-1556}} Regular moderate exercise, suggests Sushruta, improves resistance to disease and physical decay.{{Sfn|Tipton|2008|p=1554}} Sushruta has written Shlokas on the prevention of diseases. ===Human skeleton=== The Sushruta Samhita states, per Hoernle's translation, that "the professors of Ayurveda speak of three hundred and sixty bones, but books on ''Shalya-Shastra'' (surgical science) know of only three hundred".{{Sfn|Hoernle |1907 |p = 70}} The text then lists the total of 300 as follows: 120 in the extremities (e.g. hands, legs), 117 in the pelvic area, sides, back, abdomen and breast, and 63 in the neck and upwards.{{Sfn|Hoernle |1907 |p = 70}} The text then explains how these subtotals were empirically verified.{{Sfn|Hoernle |1907|pp = 70-72}} The discussion shows that the Indian tradition nurtured diversity of thought, with Sushruta school reaching its own conclusions and differing from the Atreya-Caraka tradition.{{Sfn|Hoernle |1907|pp = 70-72}} The osteological system of Sushruta, states Hoernle, follows the principle of [[Homology (biology)|homology]], where the body and organs are viewed as self-mirroring and corresponding across various axes of symmetry.{{Sfn|Hoernle |1907 |p = 72}} The differences in the count of bones in the two schools is partly because Charaka Samhita includes thirty two teeth sockets in its count, and their difference of opinions on how and when to count a cartilage as bone (both count cartilages as bones, unlike current medical practice).{{Sfn|Hoernle |1907 |pp = 73-74}}{{Sfn| Bhishagratna|1907|p=xxiv-xxv}} ===Surgery=== {{Quote box |width=26em | bgcolor=#FFE0BB |align=right |salign = right |quote='''Training future surgeons''' Students are to practice surgical techniques on gourds and dead animals. |source =—''Sushruta Samhita'', Book 1, Chapter IX
Translator: Engler{{Sfn|Engler|2003|pp=416-463}}}} The Sushruta Samhita is best known in non-specialist sources on medical history for its approach and discussions of surgery. It is amongst the first medical treatises in history to suggest that a student of surgery should learn about human body and its organs by systematically examining a dead body.{{Cite journal |last=Zysk |first=Kenneth G. |date=1986 |title=The Evolution of Anatomical Knowledge in Ancient India, with Special Reference to Cross-Cultural Influences |url=https://www.jstor.org/stable/603532 |journal=Journal of the American Oriental Society |volume=106 |issue=4 |pages=687–705 |doi=10.2307/603532|jstor=603532 |pmid=11617255 |url-access=subscription }} A student should practice, states the text, on objects resembling the diseased or body part.{{Cite journal |last=Majno |first=Guido |title=The Healing Hand |date=February 1976 |url=http://dx.doi.org/10.1097/00006534-197602000-00022 |journal=Plastic and Reconstructive Surgery |volume=57 |issue=2 |pages=230 |doi=10.1097/00006534-197602000-00022 |s2cid=10270499 |issn=0032-1052|url-access=subscription }} Incision studies, for example, are recommended on squash (Skt. puṣpaphala, ''[[Cucurbita maxima]]''), gourd (Skt. alābu, ''[[Calabash|Lagenaria vulgaris]]''), cucumber (Skt. trapuṣa, ''[[Cucumis pubescens]]''), leather bags filled with fluids and bladders of dead animals.{{Sfn| Bhishagratna|1907|p=xxi}} The ancient text, state Menon and Haberman, describes haemorrhoidectomy, amputations, plastic, rhinoplastic, ophthalmic, lithotomic and obstetrical procedures. The ''Sushruta Samhita'' mentions various methods including sliding graft, rotation graft and pedicle graft.{{cite book|title=Plastic Surgery|author=Lana Thompson|page=8|publisher=ABC-CLIO}} Reconstruction of a nose (rhinoplasty) which has been cut off, using a flap of skin from the cheek is also described.{{Cite book |last=Wujastyk |first=Dominik |url=https://hasp.ub.uni-heidelberg.de/catalog/book/1203 |title=On the Plastic Surgery of the Ears and Nose: The Nepalese Recension of the Suśrutasaṃhitā |last2=Birch |first2=Jason |last3=Klebanov |first3=Andrey |last4=Parameswaran |first4=Madhu K. |last5=Rimal |first5=Madhusudan |last6=Chakraborty |first6=Deepro |last7=Bhatt |first7=Harshal |last8=Lele |first8=Vandana |last9=Mehta |first9=Paras |date=2023-08-22 |publisher=Heidelberg Asian Studies Publishing |isbn=978-3-948791-62-9 |language=en}}{{cite book|title=Advanced Aesthetic Rhinoplasty: Art, Science, and New Clinical Techniques|author=Melvin A. Shiffman, Alberto Di Gi|page=132|publisher=Springer Science & Business Media}} Labioplasty too has received attention in the samahita.{{cite book|title=History BA (Programme) Semester II: Questions and Answers, University of Delhi|page=147|author=Sharma, Kumar|publisher=Pearson Education India}} === Rhinoplasty === Rhinoplasty, surgery to repair the flesh of the nose, is performed to achieve two results: * To improve the breathing function of the nose * To improve the cosmetic appearance of the nose Sushruta's treatise provides the first written record of a cheek flap rhinoplasty, a technique still used today to reconstruct a nose.{{Cite book |last=Wujastyk |first=Dominik |url=https://hasp.ub.uni-heidelberg.de/catalog/book/1203 |title=On the Plastic Surgery of the Ears and Nose: The Nepalese Recension of the Suśrutasaṃhitā |last2=Birch |first2=Jason |last3=Klebanov |first3=Andrey |last4=Parameswaran |first4=Madhu K. |last5=Rimal |first5=Madhusudan |last6=Chakraborty |first6=Deepro |last7=Bhatt |first7=Harshal |last8=Lele |first8=Vandana |last9=Mehta |first9=Paras |date=2023-08-22 |publisher=Heidelberg Asian Studies Publishing |isbn=978-3-948791-62-9 |language=en}} The text mentions more than 15 methods to repair it.  These include using a flap of skin from the cheek, which is akin to the most modern technique today.{{Cite web|title=An English Translation of the Sushruta Samhita, Based on Original Sanskrit Text. Edited and Published by Kaviraj Kunja Lal Bhishagratna. With a Full ... Notes, Comperative Views, Index, Glossary An (Book)|url=https://www.worldhistory.org/books/1296562271/|access-date=2021-05-15|website=www.worldhistory.org|language=en}} ===Medicinal herbs=== The Sushruta Samhita, along with the religious text the Atharvaveda and the other medical encyclopedia Charak Samhita, describe more than 700 medicinal herbs.{{cite journal | doi = 10.1038/436486a | volume=436 | issue=7050 | title=Ayurveda | journal=Nature | page=486| year=2005 | last1=Padma | first1=T. V. | pmid=16049472 | bibcode=2005Natur.436..486P }} The descriptions include the herbs' taste, appearance, digestive effects, recommended dosage, and purported benefits.{{Cite book |last=Roy |first=Mira |url=http://n2t.net/ark:/13960/t64511t6v |title=Suśruta Saṃhitā: A Scientific Synopsis |publisher=Indian National Science Academy |year=1980 |edition=1 |location=New Delhi |pages=64-82}} == Reception == {{See also|Sushruta#Legacy}} === Transmission outside South Asia === The text was [[Indian influence on Islamic science|translated to Arabic]] as ''Kitab Shah Shun al-Hindi''' in Arabic, also known as ''Kitab i-Susurud'', in Baghdad during the early 8th century at the instructions of a member of the [[Barmakids|Barmakid]] family of Baghdad.{{Sfn| Meulenbeld|1999|p = 352 (Volume IA)}}Ramachandra S.K. Rao, Encyclopaedia of Indian Medicine: historical perspective, Volume 1, 2005 Reprint (Original: 1985), [https://books.google.com/books?id=QRvzRGn9QqkC&pg=PA94 pp 94-98], Popular Prakashan Yahya ibn Barmak facilitated a major effort at collecting and translating Sanskrit texts such as Vagbhata's ''Astangahrdaya Samhita'', Ravigupta's ''Siddhasara'' and Sushruta Samhita.Charles Burnett (2015), The Cambridge World History, Volume 5, Cambridge University Press, {{ISBN|978-0521190749}}, page 346 The Arabic translation reached Europe by the end of the medieval period. There is disputed evidence that in [[Renaissance Italy]], the Branca family of [[Sicily]]{{cite book |last1=Scuderi |first1=Nicolò |last2=Toth |first2=Bryant A. |title=International Textbook of Aesthetic Surgery |year=2016 |publisher=Springer |isbn=9783662465998 |url=https://books.google.com/books?id=iXhBDAAAQBAJ&q=sushruta+samhita+Branca+italy&pg=PA583 |language=en}} and [[Gasparo Tagliacozzi]] ([[Bologna]]) were familiar with the rhinoplastic techniques mentioned in the ''Sushruta Samhita''.Lock etc., page 607New Scientist Jul 26, 1984, p. 43{{cite web |last1=Menick |first1=Frederick J |title=Paramedian Forehead Flap Nasal Reconstruction: History of the Procedure, Problem, Presentation |date=11 October 2017 |url=https://emedicine.medscape.com/article/1293154-overview |access-date=30 July 2018}} The text was known to the Khmer king Yaśovarman I (fl. 889-900) of [[Cambodia]]. Suśruta was also known as a medical authority in Tibetan literature.{{Sfn| Meulenbeld|1999|p = 352 (Volume IA)}} === Commentaries === The earliest surviving commentary on the whole text, known as ''Nibandha-samgraha'', was written by [[Dalhana]] in ca. 1200 CE. Earlier commentaries existed but have only been transmitted to modern times in fragmentary form. These include lost or partially-lost commentaries by Jejjaṭa (ca. 700 CE),{{Cite web |title=Jejjaṭa's commentary on the Suśrutasaṃhitā (Work) - Pandit |url=https://www.panditproject.org/entity/108209/work |access-date=2023-08-23 |website=www.panditproject.org}} Gayadāsa (ca. 1000 CE),{{Cite web |title=Nyāyacandrikā (Work) - Pandit |url=https://www.panditproject.org/entity/108025/work |access-date=2023-08-23 |website=www.panditproject.org}} and Cakrapāṇidatta (ca. 1025 CE).{{Cite web |title=Bhānumatī (Work) - Pandit |url=https://www.panditproject.org/entity/109613/work |access-date=2023-08-23 |website=www.panditproject.org}} Commentaries continued to be written on the work into the nineteenth century, e.g., the ''Suśrutārthasandīpanī'' by Haranachandra written in the 19th century AD. === Modern reception === A number of Sushruta's contributions have been discussed in modern literature. Some of these include ''Hritshoola'' (heart pain), circulation of vital body fluids (such as blood (''[[rakta dhatu]]'') and [[lymph]] (''rasa dhatu''), Diabetes (''Madhumeha''), obesity, and hypertension. Kearns & Nash (2008) state that the first mention of [[leprosy]] is described in ''Sushruta Samhita''.Kearns & Nash (2008)Aufderheide, A. C.; Rodriguez-Martin, C. & Langsjoen, O. (page 148) The text discusses kidney stones and its surgical removal.Lock etc., page 836 == Editions and translations == The first printed edition of the text was prepared by [[Madhusudan Gupta]] (2 vols, Calcutta 1835, [[iarchive:in.ernet.dli.2015.406017/page/n251|1836]]). A partial English translation by U. C. Datta appeared in 1883. The first complete English translation of the Sushruta Samhita was by Kaviraj Kunjalal Bhishagratna, who published it in three volumes between 1907 and 1916 (reprinted 1963, 2006).Kenneth Zysk (2010), Medicine in the Veda: Religious Healing in the Veda, Motilal Banarsidass, {{ISBN|978-8120814004}}, page 272 with footnote 36{{refn|group=note|name=selby1}} Although Bhishagratna's translation is now obsolete, it is often still cited by non-specialists because it is out of copyright, has been reprinted often, and is also now easily available as online scans. An alternative English translation of both the ''Sushruta Samhita'' and Dalhana's commentary was published in three volumes by [http://viaf.org/viaf/5152653 P. V. Sharma] in 1999.{{Cite book|title = Suśruta-Saṃhitā, with English Translation of Text and Ḍalhaṇa's Commentary Along with Critical Notes|last = Sharma|first = Priya Vrata|publisher = Chowkhambha Visvabharati|year = 2001|location = Varanasi|volume = 3 vols|series = Haridas Ayurveda Series 9|oclc = 42717448}} ==See also== * [[Hindu texts]], Indian religious literature * ''[[On Ancient Medicine]]'', Greek medical text, written c. 450–400 B.C. * [[Sushruta]] * [[Ayurveda]] * [[History of embryology]] ==Notes== {{reflist|group=note}} ==References== {{reflist|30em}} ==Bibliography== * {{cite book|first = Sarah|last = Boslaugh|year= 2007|title = Encyclopedia of Epidemiology| volume= 1|publisher= SAGE Publications| isbn= 978-1412928168}} * {{cite journal|pmc= 3172459| last= Balodhi| first= J. P. | year=1987| title= Constituting the outlines of a philosophy of Ayurveda: mainly on mental health import | journal= Indian Journal of Psychiatry| volume= 29 |issue =2 | pmid=21927226 | pages=127–31}} * {{cite journal | last=Banerjee | first=Anirban D. | title=Susruta and Ancient Indian Neurosurgery | journal=World Neurosurgery | volume=75 | issue=2 | year=2011 | doi=10.1016/j.wneu.2010.09.007 | pmid=21492737 |display-authors=etal | pages=320–323}} * {{cite book|last=Bhishagratna |first= Kaviraj KL| title=An English Translation of the Sushruta Samhita in Three Volumes, ''(Volume 1, Archived by University of Toronto)'' |year=1907 |publisher= Calcutta| url=https://archive.org/stream/englishtranslati01susruoft#page/n5/mode/2up|archive-date=2008-11-04| archive-url=https://web.archive.org/web/20081104042126/http://www.archive.org/stream/englishtranslati01susruoft#page/n5/mode/2up }} [http://cincinnatitemple.com/articles/Bhishagratna-K-K-L-Susruta-Samhita-English-Translation-2.pdf Alt URL] * {{cite book|last=Bhishagratna |first= Kaviraj KL| title=An English Translation of the Sushruta Samhita in Three Volumes, ''(Volume 2, Archived by University of Toronto)'' |year=1911 |publisher= Calcutta| url=https://archive.org/stream/englishtranslati00susruoft#page/n3/mode/2up|archive-date=2008-08-31| archive-url=https://web.archive.org/web/20080831101209/http://www.archive.org/stream/englishtranslati00susruoft#page/n3/mode/2up }} [http://cincinnatitemple.com/articles/Bhishagratna-K-K-L-Susruta-Samhita-English-Translation-2.pdf Alt URL] * {{cite book|last=Bhishagratna |first= Kaviraj KL| title=An English Translation of the Sushruta Samhita in Three Volumes, ''(Volume 3, Archived by University of Toronto)'' |year=1916 |publisher= Calcutta| url=https://archive.org/stream/englishtranslati03susruoft#page/n5/mode/2up| archive-date=2010-02-04| archive-url=https://web.archive.org/web/20100204052726/http://www.archive.org/stream/englishtranslati03susruoft#page/n5/mode/2up }} [http://cincinnatitemple.com/articles/Bhishagratna-K-K-L-Susruta-Samhita-English-Translation-2.pdf Alt URL] * {{cite journal|last1=Dwivedi|first1= Girish|last2= Dwivedi|first2= Shridhar| year= 2007| url= http://medind.nic.in/iae/t07/i4/iaet07i4p243.pdf | title=History of Medicine: Sushruta – the Clinician – Teacher par Excellence| journal= Indian Journal of Chest Diseases and Allied Sciences| volume= 49 |issue= 4 }} * {{cite journal| last=Engler |first= Steven| year= 2003|title= " Science" vs." Religion" in Classical Ayurveda| journal= Numen| volume=50| issue=4| doi=10.1163/156852703322446679 | pages=416–463|hdl= 11205/105| hdl-access=free}} * {{Cite book|title = Studies in the Medicine of Ancient India: Osteology or the Bones of the Human Body|last = Hoernle|first = A. F. Rudolf|publisher = Clarendon Press|year = 1907|author-link = Rudolf Hoernle|location = Oxford, UK | url = https://archive.org/stream/studiesinmedicin01hoeruoft#page/n3/mode/2up }} * {{cite book| last=Kutumbian |first= P. | year=2005| title= Ancient Indian Medicine |publisher= Orient Longman |isbn= 978-812501521-5 }} * {{Cite journal | year = 2010| last = Loukas| first = M| title = Anatomy in ancient India: A focus on the Susruta Samhita| journal = Journal of Anatomy| volume = 217| issue = 6| pages = 646–650| doi = 10.1111/j.1469-7580.2010.01294.x|display-authors=etal| pmid=20887391| pmc=3039177}} * {{cite journal| last1= Rana| first1= R. E.| last2 = Arora| first2= B. S. |year= 2002| title= History of plastic surgery in India| journal= Journal of Postgraduate Medicine| volume= 48| issue =1| pages= 76–8| pmid= 12082339}} * {{Cite book|title = Suśruta saṃhitā: a scientific synopsis|oclc = 7952879 |publisher = Indian National Science Academy|year = 1980 |first = Priyadaranjan|last = Rây |display-authors=etal}} * {{Cite book|title = A History of Indian Medical Literature|last = Meulenbeld|first = Gerrit Jan| publisher = Brill (all volumes, 1999-2002)| year = 1999|isbn = 978-9069801247|location = Groningen}} * {{cite book|last= Sharma |first= P. V. |year = 1992 | title= History of medicine in India, from antiquity to 1000 A.D. |location=New Delhi| publisher= Indian National Science Academy| oclc=26881970}} * {{cite book|first =E. |last= Schultheisz| year= 1981| title= History of Physiology| publisher= Pergamon Press |isbn = 978-0080273426}} * {{cite journal | last=Raveenthiran | first=Venkatachalam | title=Knowledge of ancient Hindu surgeons on Hirschsprung disease: evidence from Sushruta Samhita of circa 1200-600 bc | journal=Journal of Pediatric Surgery | volume=46 | issue=11 | year=2011 | doi=10.1016/j.jpedsurg.2011.07.007 | pmid=22075360 | pages=2204–2208}} * {{cite journal|first = Charles| last= Tipton| year= 2008| title= Susruta of India, an unrecognized contributor to the history of exercise physiology| journal= Journal of Applied Physiology|volume= 104| number= 6| doi=10.1152/japplphysiol.00925.2007| pages=1553–1556| pmid=18356481| s2cid= 22761582}} * {{Cite book |title = The legacy of Suśruta| oclc= 137222991|publisher = Orient Longman| year = 2007| isbn = 9788125031505| first = M. S| last = Valiathan}} * {{cite book | last=Walton | first=John | title=The Oxford medical companion | publisher=Oxford University Press | location=Oxford New York | year=1994 | isbn=978-0-19-262355-3 | url-access=registration | url=https://archive.org/details/isbn_9780192623553 }} * {{cite book | last=Zysk| first= Kenneth| title=Asceticism and Healing in Ancient India: Medicine in the Buddhist Monastery| publisher= Motilal Banarsidass| isbn= 978-8120815285|year= 2000}} * Chari PS. [http://www.ijps.org/article.asp?issn=0970-0358;year=2003;volume=36;issue=1;spage=4;epage=13;aulast=Chari 'Sushruta and our heritage'], ''Indian Journal of Plastic Surgery''. ==External links== * [https://archive.org/details/SusrutaSamhitaAfrHoernle1897bis_201804/page/n11 Sushruta Samhita], Translated by [[Rudolf Hoernle]] * [https://archive.org/stream/englishtranslati01susruoft#page/n5/mode/2up Sushruta Samhita Volume 1, in English], Translated by KK Lal Bhisaghratna * [https://archive.org/stream/englishtranslati00susruoft#page/n3/mode/2up Sushruta Samhita Volume 2, in English], Translated by KK Lal Bhisaghratna * [https://archive.org/stream/englishtranslati03susruoft#page/n5/mode/2up Sushruta Samhita Volume 3, in English], Translated by KK Lal Bhisaghratna * [https://www.wisdomlib.org/hinduism/book/sushruta-samhita-volume-1-sutrasthana Sutrasthana], Translated by Kaviraj Kunja Lal Bhishagratna * [https://www.wisdomlib.org/hinduism/book/sushruta-samhita-volume-2-nidanasthana Nidanasthana], Translated by Kaviraj Kunja Lal Bhishagratna * [https://www.wisdomlib.org/hinduism/book/sushruta-samhita-volume-3-sharirasthana Sharirasthana], Translated by Kaviraj Kunja Lal Bhishagratna * [https://www.wisdomlib.org/hinduism/book/sushruta-samhita-volume-4-cikitsasthana Cikitsasthana], Translated by Kaviraj Kunja Lal Bhishagratna * [https://www.wisdomlib.org/hinduism/book/sushruta-samhita-volume-5-kalpasthana Kalpasthana], Translated by Kaviraj Kunja Lal Bhishagratna * [https://www.wisdomlib.org/hinduism/book/sushruta-samhita-volume-6-uttara-tantra Uttaratantra], Translated by Kaviraj Kunja Lal Bhishagratna *[https://sushrutaproject.org The Sushruta Project]: The textual and cultural history of medicine in South Asia based on newly-discovered manuscript evidence. An academic research project at the [[University of Alberta]] (2020-2024). {{Ancient anaesthesia-footer}} {{History of medicine}} [[Category:Ayurvedic texts]] [[Category:Hindu texts]] [[Category:Encyclopedias of medicine]] [[Category:Indian surgeons]] [[Category:Indian encyclopedias]] [[Category:Ancient Indian medical works]]