The Sushruta Samhita is an ancient Sanskrit text on medicine and surgery, and one of the most important such treatises on this subject to survive from the ancient world.

The Compendium of Suśruta is one of the foundational texts of Ayurveda (Indian traditional medicine), alongside the Caraka-Saṃhitā, the Bheḷa-Saṃhitā, and the medical portions of the Bower Manuscript.

It is one of the two foundational Hindu texts on medical profession that have survived from ancient India.

Date

The early scholar Rudolf Hoernle proposed that given that the author of Satapatha Brahmana – an ancient Vedic text, was aware of Sushruta doctrines, those Sushruta doctrines should be dated based on the composition date of Satapatha Brahmana.

The composition date of the Brahmana is itself unclear, added Hoernle, and he estimated it to be about the sixth century BCE.

While Loukas et al. date the Sushruta Samhita to the mid-1st-millennium BCE, Boslaugh dates the currently existing text to the 6th-century CE.

Rao in 1985 suggested that the original layer to the Sushruta Samhita was composed in 1st millennium BCE by “elder Sushruta” consisting of five books and 120 chapters, which was redacted and expanded with Uttara-tantra as the last layer of text in 1st millennium CE, bringing the text size to six books and 184 chapters. Walton et al., in 1994, traced the origins of the text to 1st millennium BCE.

Meulenbeld in his 1999 book states that the Suśruta-saṃhitā 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.

It is likely that the Suśruta-saṃhitā was known to the scholar Dṛḍhabala (fl. 300-500 CE, also spelled Dridhabala), which gives the latest date for the version of the work that has survived into the modern era.

Tipton in a 2008 historical perspectives review, states that uncertainty remains on dating the text, how many authors contributed to it and when. Estimates range from 1000 BCE, 800–600 BCE, 600 BCE, 600–200 BCE, 200 BCE, 1–100 CE, and 500 CE.

Partial resolution of these uncertainties, states Tipton, has come from comparison of the Sushruta Samhita text with several Vedic hymns particularly the Atharvaveda such as the hymn on the creation of man in its 10th book, the chapters of Atreya Samhita which describe the human skeleton, better dating of ancient texts that mention Sushruta’s name, and critical studies on the ancient Bower Manuscript by Hoernle.

This information trace the first Sushruta Samhita to likely have been composed by about mid 1st millennium BCE.

Contents

The Sushruta Samhita is among the most important ancient medical treatises. It is one of the foundational texts of the medical tradition in India, alongside the Caraka-Saṃhitā, the Bheḷa-Saṃhitā, and the medical portions of the Bower Manuscript.

Scope

The Sushruta Samhita was composed after Charaka Samhita, and 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.

The Sushruta and Charaka texts differ in one major aspect, with Sushruta Samhita providing the foundation of surgery, while Charaka Samhita being primarily a foundation of medicine.

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.

Prevention versus cure

Sushruta, states Tipton, asserts that a physician should invest the effort to prevent diseases as much as curative remedial procedures.

An important means for prevention, states Sushruta, is physical exercise and hygienic practices. The text adds that excessive strenuous exercise can be injurious and make one more susceptible to diseases, cautioning against such excess.

Regular moderate exercise, suggests Sushruta, improves resistance to disease and physical decay. Sushruta has written Shlokas on prevention of diseases.

Human skeleton

The Sushruta Samhita states, per Hoernle translation, that “the professors of Ayurveda speak of three hundred and sixty bones, but books on Salya-Shastra (surgical science) know of only three hundred“.

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.

The text then explains how these subtotals were empirically verified. 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.

The osteological system of Sushruta, states Hoernle, follows the principle of homology, where the body and organs are viewed as self-mirroring and corresponding across various axes of symmetry.

The differences in the count of bones in the two schools are partly because Charaka Samhita includes thirty-two teeth sockets in its count, and their difference of opinions on how and when to count cartilage as a bone (both count cartilages as bones, unlike current medical practice).

Surgery

The Sushruta Samhita is best known for its approach and discussions of surgery. It was one of the first in human history to suggest that a student of surgery should learn about the human body and its organs by dissecting a dead body.

A student should practice, states the text, on objects resembling the diseased or body part. Incision studies, for example, are recommended on Pushpaphala (squash, Cucurbita maxima), Alavu (bottle gourd, Lagenaria vulgaris), Trapusha (cucumber, Cucumis pubescent), leather bags filled with fluids and bladders of dead animals.

The ancient text, state Menon and Haberman, describes haemorrhoidectomy, amputations, plastic, rhinoplastic, ophthalmic, lithotomic and obstetrical procedures.

The Sushruta mentions various methods including sliding graft, rotation graft, and pedicle graft. Reconstruction of a nose (rhinoplasty) which has been cut off, using a flap of skin from the cheek is also described. Labioplasty too has received attention in the Samhita.

Medicinal herbs

The Sushruta Samhita, along with the Sanskrit medicine-related classics Atharvaveda and Charak Samhita, together describe more than 700 medicinal herbs.

The description, states Padma, includes their taste, appearance and digestive effects to safety, efficacy, dosage, and benefits.

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), Madhumeha, obesity, and hypertension.

Kearns & Nash (2008) state that the first mention of leprosy is described in Sushruta Samhita. The text discusses kidney stones and its surgical removal.

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*This article was originally published at en.wikipedia.org.