Vaidyakirti (Honoris Causa, Sri Lanka)
Born at Allahabad in 1932. Brilliant academic
career with medical eduction at Lucknow,
Edinburgh and Toronto. A widely travelled
Paediatric Surgeon and Historian of Medicine,
Rotarian Dr. Singhal was Professor & Head of
the Paediatric Surgery Section and former
Head of the Dept. of Surgery, Institute of
Medical Sciences, Banaras Hindu University,
Prof. Singhal was a Fellow of the International
Society of History of Medicine and was the
President of the B.H.U. History of Medicine
Society; he was also a Fellow/Member of many
national/international academic bodies on
Surgery/Paediatric Surgery/History of Medi-
cine and was recognised as an authority on
Ancient Indian Surgery. His monumetal ency-
clopaedic Ayurvedic works on Sushruta
Samhita and Madhava Nidana have already
won national/international recognition are
changing the History of Medicine and are
stimulating research on Ayurveda all over the
Prof. Singhal claimed Sushruta of India to be
called the ‘Father of Surgery" and frequently
invited to give authentic talks on the subject in
India and abroad.
It is a great pleasure to introduce the English translation of Susruca
Samhita being brought out under the editorship of Dr. G. D. Singhal. Susrura
Samhica is one of the important treatises of Ayurveda and has a lot of valuable
information among others from the surgical point of view. A diligent search of
this treatise reveals the presence of seeds of conceptual thoughts relating to
many surgical aspects which are practised in current period,
Ayurveda has been handed over from generation to gencration almost in an
uninterrupted continuity. In Susruta Samhita one finds a systematised approach
and the deeper understanding of this is likely to open new vistas of thought and
the present English version is aimed to apprise the modern worker the intti-
cacies present in this great treatise.
The editorial board while translating has also presented a picture of gen-
esis of cach concept and its place in the current surgical practice can be easily
appreciated through this. This will enable the reader to know its impact on the
art and practice of surgery today.
The entire work is divided into various sections almost faithfully based on
the original text. The sections purport to highlight the surgical aspects practised
in those days with their relevance to the present day surgical methods, manouvers
Susruta was considered a surgeon and he belonged to Dhanwanrari school
of thought. The evolution of a medical system was invariably preceded by cura-
tive spells and other religious and traditional folk customs. Medical and surgical
procedures written at that remote period cannot ignore these fundamental
traits. Following this a system of medical practice with considerable refinement
emerg: d and it did not fully shelve the magic spells and traditions into oblivion
in view of their hold on society and life.
The wars, in ancient days, to some extent contributed for the development
and progress of different branthes of medical knowledge including surgery. War
surgery developed in this way. References to Vedic surgery like uniting che head
of the God of sacrifice to his decapitated body provides insight into the surgical
acumen that existed then. War free period provided scope for leading a peaceful
and stately life during which men travelled in chariots and other kinds of ve-
hicles for enjoyment and as a luxury in a carefree mannet and got involved in
road accidents. This provided scope for the development of the surgery of acci-
dents and injuries. Midwifery also developed since the war surgery had litde
place in peace time. Evolution and advances of surgery, or as a matter of fact of
any branch of knowledge, is with reference to needs, circumstances and environ-
ment in addition to other factors connected with life. Susrutarin surgery almost
followed Vedic surgery. The credit of providing a systematised approach goes to
Susruta since he was the earliest to make elaborate efforts to keep it on a sound
footing so far as his age is concerned in practice and of imparting practical
knowledge. Instrumentology also developed during his time since this has a
greater potential for success in this field. The plastic surgery and rhino-plasty
described by Suiruta have been acclaimed even today as the greatest of the sur-
gical techniques and they may be treated as important landmarks in the field of
surgery. Obviously by advancement of this and other techniques the country
sowed sceds for the development of a high class surgical approach of sophis-
ticated nature. India made original contribution to the corpus of surgical
knowledge. Reference to cataract crouching, amputation of limbs, abdominal
operations, setting of fractures and dislocations, treatment of hacmorrhoids and
fistula, treating of hernia, etc. and the basic principles behind these numerous
operations which were described by Suéruta are as much valid today as it was
then. Lithotomy and post-operative management of these cases are discussed in
detail. A number of obstetrical manouvers and operative techniques have been
elaborated. Ophthalmic surgery was practised in the days of Susruta. Practical
training was considered essential and reference to methods to be adopted to
provide effective practical knowledge in those days in surgical methods and
techniques will be found to be interesting. Surgical incisions are practised on
vegetables having different consistencies and textures; this provided a practical
knowledge and experience regarding the force to be adopted, the extenvdepth
to which the incisions were to be made in addition to making the surgical stu-
dent steady. Another therapeutic measure mentioned was blood-letting.
With a view to provide the required knowledge. the treatise of Suiruta laid
emphasis on a study of the anatomy and the dissection of cadavers. The work of
Susruta dealt with cmbryology, biology. cosmogony, physiology, materia
medica and therapeutics and a number of fields which have relevance to the
study of Ayurveda. The medical aspect has also been mentioned by Susrura
almost in the same manner though stress is laid on surgical aspects.
Susruta Samhita can be considered as an excellent surgical treatise which
was much eulogised by a number of occidental and other experts.
With the availability of an English version with a detailed commentary
and helpful notes, the treatise will benefit a wider circle of readers not only in
India but also abroad with potentiality to contribute further in the art and
practice of surgery. The planning of the work provides an advantage of a rapid
reference to the subject/topic in which the reader is interested. The long felt
need for such a work is expected to be solved by the series of volumes envisaged.
I have every confidence that this will prove to be a valuable addition to
every medical institution whatever be the system it is handling. Research work-
ers, scholars, teachers, surgical experts and scientists irrespective of the field of
medicine to which they belong are sure to find the work useful and rewarding.
The editorial board composed of experts of Ayurveda and allopathic system pro-
vide an acceptable interpretation of the concepts and substance of Suéruta
Samhita. The much felt need for an English version of Sugruca Samhiea having
interpretative and working information will be met with by this compendium.
India has a great and ancient cultural heritage. Medical treatment
(Ayurveda) flourished here centuries ago when people in other parts of the
world were not so advanced. There is no dearth of evidence to prove these state-
ments as is shown by the Vedas, Puranas and other subsequent Indian publica-
Ayurveda, the ancient Indian system of medicine, was practised about
1000 B.C. It is available today in three classical Samhitas or treatises, the
Caraka, Susrura and Vagbhata (in addition to many other smalicr later publications).
All were written in Sanskrit, the ages old Indian language comparable to
the Greek or Latin of the Wester World. Caraka and Vagbhata books are mainly
on medicine whereas Suiruta is chiefly a surgical treatise.
As all these classical creatises have so far been available in Sanskrit only,
they have been comparatively less well known to the modern world, A great
necessity was felt to bring out the proud possessions of ours accepted as invaluable
national literary treasures using contemporary scientific and medical terminology
in a language understandable easily in many other parts of the world.
Susruta, the surgical treatise has been selected to be brought our firse.
A great necessity has been felt by the scientists of the modern world, doc-
tors, surgeons, historians, research workers and the educated class of public in
general to be able ca get to know Suéruta-Samhitd in the language understand-
able by them. English written in Roman script was selected as the language for
translation as it is one of the international languages and myself and other
authors and translators here have a working knowledge of it.
Other attempts at Translation and their Drawback
The first accempt at cranslation of Suiruta-Samhitt was made in 1897 by
Dr. A.ER. Hoernle, C.1.E. His preface is quoted verbatim below
"The present translation of che Suruta-Samhité has been undertaken by
me at the special request of the Council of the Asiatic Society of Bengal. The
original translation made by Dr. Udoy Chand Dutt was stopped by the untimely
death of the translator, after the publication of his second fasciculus. Its
continuation by another translator proved so unsatisfactory that it had to be
abandoned, after one more fasciculus. Dr. U. Ch. Durt's translation, though a
very fair performance, laboured under che disadvantage, owing to the translator's
want of knowledge of Sanskrit, of not being made dircctly from the original
language. It also lacked elucidation from the works of commentators. Both
points are remedied in the present translation, which accordingly has been com-
menced de novo." - Calcutta, 26th November, 1897 A.R.H.
The next attempr at translation only (without any comments etc.) of
Suéruta-Samhit3, was made by Kaviraja Kunj Lal Bhisagratna in 1907. He was a
great Sanskrit scholar without modern medical or surgic +l background. Conse-
quently, his book, though a brave and creditable attempt, could neither provide
much help to the scientist, the research worker or the historian, nor could his
interpretations be corrclated with modern medical terminology. Kaviraj
Bhisagratna’s translation, at places gives the impression of being explanatory
rather than literal and of being somewhat biased.
Hoernle's Translation was more accurate than that of Kunjlal or U.Ch.
Dutr’s bur the scientific comments were lacking and one could not find our the
historical facts of importance or the problems on which scientists and research
workers should concentrate. But whatever it is, he could bring out only one
fasciculas of 98 pages of this much needed book.
The original has 186 chapters (1000 pages) in Sanskrit. Every verse or
stanza in each chapter is numbered. Translation of each verse or stanza has now
been done as accurately as possible. Each verse or a few verses together have been
given followed immediately by their English syntex; each unit has been given a
heading in modern terminology which is usually self-explanatory. Hence, foor-
notes have been given sparsely and only if their necessity has been felt strongly.
In addition, the volume has an ‘Introduction’ in the beginning which in-
cludes a "four line gist" of each chapter contained in chat particular volume.
Thus even a casual reader by reading the introduction would get to know the
broad contents of the book. IF the gist of any chapter interests him he could read
more about it in the "Summary" given at the beginning of the chapter con-
cemed. If any point further arouses his curiosity, he could turn over to the verse
or stanza concerned with the heading outlined for him alongwith the original
Sanskrit and its literal (syntex) translation "ready on the plate" as it were. And
the reader has not got to go further than turning to the end of the chapter to
look for the research problems that he may be interested in.
Importance of the Book.
It is believed that this book would be a fundamental contribution to the
History of Medicine. Our entire concept of History of Medicine would need to
be reoriented, e.g, classification of burns would begin by Susrura and nor
Dupuytrens, lichotomy operations should mention Suiruta before Ambroise
Pare, credit for describing signs of inflammation first should go to Susruta and
nor to Celsus and a host of other things such as piles, fistula, skin diseases, cye
In addition, the research problems outlined in this book would interest
the Pharmacology Deptt., Botany Depet., pharmaceutical drug companies, the
surgeons and physicians, and the research workers in the experimental surgery
and other sections.
Presentation of this terse, ancient Sanskrit medicinal classic in such a sci-
entific yet easy and lucid way is something unique. If even one good drug is
found such as that mentioned in S.S. 1. 14. which could be of value in
haemostasis, e.g. after prostatectomy or a bleeding discase, or its counterpart, a
drug which has anticoagulating properties of possible use in the prevention and
cure of cerebral or coronary thrombosis, it would be a drug worth its price.
Translation has been checked many times by competent authorities. Sum-
mary and research aspects, comments and references have been carefully writ-
ten. Still it would be a great wonder if scope for improvement was not found.
Many mistakes would certainly be pointed out by the learned readers which
would be tried to be rectified in subsequent editions.
Book 3 on Diagnostic Considerations is being brought out first because of
its greater practical utility. It is expected that the other books of the serics would
be published in rapid succession.
Susruta Samhita is probably the carliest treatise which has deale with
surgery as the foremost speciality of the medical science. In contrast, in the West
it was considered an inferior calling relegated to barbers from the time of
Hippocrates till the 19th century. This Samhitd is not only the most com-
prehensive treatise on the ethical, philosophical and practical aspects of surgery,
it has also given due importance to other specialities of the medical and related
sciences! and in addition has made original contributions to Internal Medicine
(Kaya-cikita) and Pharmacology (Dravyaguna) Evidently, the knowledge
presented in a crystallized form in this treatise must have been based on a long
period of earlier experience. It is generally accepted (Thorwald)? that Susruta's
lucid and systematic presentation of the conceptual and technical aspects of
surgery, as well as the philosophy and ethics of medicine was quite advanced and
may have relevance even today.
Surgical feats as replacement of the lost leg of Queen Vispala by an artificial
iron leg and replacement or hetero-transplantation of the head and testicles
by the divine win physicians Asvini Kumaras are mentioned in the Vedas, the
ancientmost repository of human knowledge.’ It is only in Sugruta Samhita chat
we find surgery systematized and presented in a scientific manner. It is specially
significant because Susruta, the author of this Samhita and his preceptor
Divodisa Dhanvantari lived carlier than Buddha (600 B. C.) as per opinion of
the eastern as well as the western medical historians. Thus there is no doubt that
this Samhita ancedates Hippocrates (300 B. C.) by several centuries.
The surgical practice of Susruca was of a high standard is evident by his
insistence on the surgeon's theoretical and practical expertise and ethical qualities,
his precise, lucid and classified descriptions of the surgical procedures in
general and of the individual surgical operations, his innovations in the use of
various blunt and sharp instruments and his basic concepts in the total surgical
management of patients. A few examples will amply testify to the above state-
Status of surgery of any age can be best evaluated by the variety and
quality of the surgeon's armamentarium. Suéruta has described 106 blunt! and
20 sharp? instruments which can be said to be the precursors of modern surgical
instruments. In fact a number of them have similar names : as simhamukha
yantna" (lion jaw forceps), mudrika iastra? (finger knife), etc. Fourteen differenc
types of bandages fulfil all exigencies of bandaging.’ Varieties of needles
(straight, curved, blunt and sharp), suture materials," splints and fracture bed
for immobilization of fractures at different sites, and parasurgical measures as
cautery,’ etc. for bleeding are some other examples. Susruta may well be the first
surgeon to have used endoscopes; he has described adi yantras (tubular inscru-
ments) which were to be used for direct visual examination of the lesion (roga
darianartham." Specific measurements of some of these have also been given.
e.g. of arioyantra"' and bhagandana yantra'? for visualizing piles and fistula. Ara’
dastra' used for the diagnosis of suppuration may be said to be the fore-runner
of biopsy needles. Similarly, mudrika iastra (Finger knife) was an ideal innovation
for conducting blind surgical procedures like opening a retropharyngeal abscess
or removal of a dead foetus per vaginum."
Suéruta further advised surgeons nor to be dogmatic but improvise instru-
ments according to necessity, taking his descriptions as guidelines only.
Susruta Samhita is the first ancient treatise which has advocated dissection
of the human cadavers'® much against che prejudices which must have been
prevalent in his times. Sugruta was the oldest teacher who insisted on dissection
as an essential prerequisite for learning surgery. His method of dissection may
not be considered ideal in the modern circumstances, bur the very fact that he
insisted on dissection and direct observation of human organs in the remote past
is very significant.
Besides, Susruta’s ingenious experimental surgery (yogya)' models for
teaching various surgical procedures is unique in the history of surgery. His
method of surgery was not of trial and error on human patients. His scudents
besides undergoing rigorous clinical apprenticeship were required to be fully
trained with the help of these experimental models. His experimental models
are not only notable for their simplicity, but also for their similarity to the actual
surgical procedures and thus Suéruta is unique amongst the teachers of surgery
of all times.
Based on the accurate observation of facts Sustuta has scientifically classi-
fied in a systematic manner a wealth of clinical material and the principles of
management which are valid even today.
Classification of traumatic wounds, their prognostic evaluation and man-
agement, insistence on primary suturing in clean wounds, avoidance of sepsis
and excision of extruded omentum and careful suturing of intestinal perfora-
tions in che management of perforating abdominal wounds, etc. are remarkable
for their modern outlook. Similarly, classification of intestinal perforation in the
management of perforating abdominal wounds, etc. are remarkable for their
modern outlook?. Similarly, classification of skeletal injuries into dislocations
and fractures, varieties of fractures such as green-stick, transverse, fissured, etc.
according to the type of bones involved, principles of their management by
reduction and immobilization and the criteria of an ideally healed fracture with
no shortening, deformity or restriction of movement can be cited as other ex-
amples’. Further, he was the first to recognize the similar basic pathology of all
thermogenic injuries - hot or cold; he coined the word ‘dta-dagdha™ (cold burn),
a term which has come in modern surgery only
Ayurveda is the Science of life. Ayurveda considers life as a combination of
sattva (mind), arma (soul) and dartra (body). Thus life is an integrated psycho-
somatic-spiritual entity. Ayurveda has twofold objectives, firstly to preserve
the health of the healthy persons and secondly to cradicate the disease from
the ailing. Through these objects Ayurveda longs for the ideal of aragya, which is
considered to be the basis of the four-fold values of life, i.e. dharma, artha, kama
Thus Ayurveda is not only a system of Medicine, but is an unique
discipline which deals very comprehensively with the human science and
philosophy. Therefore while studying the Ayurvedic texts specially the classics,
onc must keep in view this basic approach and should refrain from only gross
Susruta Samhita is one of the three major classical texts on Ayurveda, popu-
larly known as Vehat-trayis, Suéruta Samhita is considered a surgical text on
Indian Medicine. Sugruta was a surgeon and he compiled his Samhita as a text
book on Surgery. Susruta is therefore rightly being called by Dr. G. D. Singhal
and his colleagues from Varanasi as the Father of Surgery. [tis true that to a large
extent Susruta Samhita is a surgically oriented classic; however, it must be em-
phasized that Sugruta Samhita is not only a text on ancient Indian Surgery but is
a ‘Samhit’’ in che true sense of the word. It actually deals, in addition, with all
other disciplines of Ayurvedic Science and Philosophy. !t provides equally rich
material on Medicine as on Surgery. Considering it a surgical treatise only will
be to undermine its significance and scope. As a matter of fact Suruta Samhiti is
a classical text on Ayurveda as a whole with additional emphasis on anatomy and
surgical and gynaecological practice.
The present volume would greatly support the above contention. This
volume deals with such basic non surgical problems which are very fundamental
to the practice of Ayurveda, i.e. the disciplines of Svastha-urtta, Rastyana,
Bajtkarana, Parica-karma and allied Samiodhana measures. These considerations
are of equal significance to a surgeon as well as to a physician.
Thus this volume deals with the Ayurvedic concepts of social and preven-
tive medicine, personal hygiene, restorative and rejuvenative measures and
purificatory therapy. In general this volume describes the fundamentals of pre-
ventive medicine. In this context a number of such unique ideals are presented
which may prove entirely new in today’s perspective. Susruta’s ideas of internal
purification of the body as a preventive measure and as a preparatory procedure
before specific medical or surgical intervention, the extent of complete mental
and physical transformation through nesdyana therapy, etc. are some unique
ideas which need scientific enquiry. The authors of this book suggest numerous
problems on such ideas on which research should be carried out in the modern
medical institutions for the benefit of the humanity.
It is a pleasure to nore that Dr. Singhal and his colleagues are working on
Susruta Samhita and are tying to bring out the entire text in English in 12
volumes. An authentic English presentation of Sugruta Samhita has been a real
need. The carlier English translation presented by Shri Kunja Lal has many
falacies and it has been really criticised by many scholars. Ac this juncture this
new series will be most welcome. The authors have done a very goed job in
presenting an authentic, casy reading, English translation, comments, summa-
ries for cach chapter and a list of probable research problems along with cross
This volume in particular is a highlight of the entire series, due to the fact
that it deals with subjects of some interesting specialities of Ayurveda which are
original to Ayurveda and whose significance and scope is increased in present
times, namely Svasthaurtta, Rasdyana, Bajikarana and Paica-karma. These
subjects are prescribed in undergraduate and postgraduate curricula of all
Ayurvedic faculties and as such this particular volume should find a place as a
text book for this purpose.
In short this work demands a change in the history of medicine of the
world to enable Susruta of India to be recognised as the Father of Surgery, pre-
sents the concepts of Ayurveda in a lucid way easily understandable by even a
non-Ayurvedic person, provides numerous ideas for original research and stimu-
lates all to use Ayurveda clinically; in addition it is full of excellent quotations
with cross references.
The authors of this volume Dr. G.D. Singhal and Dr. RH. Singh are
known to me for several years. They have done full justice to the job undertaken.
Dr. Singhal is a renowned Paediatric surgeon and a teacher of modern medicine.
He has widely travelled all over the world and is in touch with the current
trends of international medicine and due to his interest in the History of
Medicine he has developed an understanding of the historical perspectives of
Medicine. The other author Dr. R. H. Singh is one of che brightest scholars
of younger generation in Ayurveda. He is seriously engaged in research on
Ayurveda and is a postgraduate teacher in Indian Medicine at Banaras Hindu
University for several years. He has been specialising in specialities of Ayurveda
such as Rasiyana therapy, Paiica-karma and Psychosomatic Medicine. Therefore
he has a full authority to write such a volume. I congratulate the authors for
having come out with such an authoritative volume on a subject of current
interest in Ayurveda. They are privileged to have the support of many other
scholars in the Editorial Board and I hope this work will go a long way in the
revival of our great heritage, the Science of life, Ayurveda.
One of the objectives of Ayurveda as defined in Caraka Samhita is to
describe materials, drugs and diets, etc., which are unwholesome for life or anta-
gonistic to life processes. That is why onc of the sections (aaga) or branch of
Ayurveda is Agada-Tantra or Visa- Tantra, All the Samhitds, to remain true to the
object of expounding Ayurveda in toro-describe all the cight branches buc
choose one branch as their main theme. Thus, Suéruta Samhita, chough deals
mainly with surgery, also deals with other branches in lesser details, Bur in the
matter of description of poisons Acarya Susruta has shown such mastery and
dealt with such specificity that he has devoted one full section of eight chapters
for this particular branch which he has named as Kalpa-Schana. In this respect
he excells over other ancient authors, In this section he has classified che poisons,
described the modes of action of different types of poisons, dealt with the symp-
tomatology and pathology and also given in detail the modes of treatment and
the drugs used. He has even pointed to the examination of poisoned food and
utensils, the culprits who try to poison the food and the post-mortem examina-
tion of some internal organs. One simply wonders for the keen clinical observa-
Recent developments in biochemistry particularly in the field of synthetic
medicines, has brought us to an era in which we are encountered with a flood of
life saving chemo-therapeutic agents on the one hand and life destroying chemi-
cal poisons of ever increasing intensity on the other. Humanity is passing
through a situation which is reminiscen of the graphic mythological story of
churning the ocean which was really started for bringing forth the ambrosia bur
which incidentally brought forth virulent lethal poison Aalahala also life saving
and life destroying agents are at all times simultaneously produced by the man
‘The sources of poisons at present are not limited, as in the days of classics,
to the two natural classes of animal (jaigama) or vegetable-cum-minerals
(sthavara) i. c. IA: Prez or vo the extra class of poisons resulting from the
incompatibilities produced by the combinations of some innocent substances
like food or medicines but include the counteracting poisonous effects also as a
result of the processing of a particular preparation i. ¢. dara: and Fear:
faraiht. Chemical poisons in the form of gas, spray or liquids or pills, powders
and injections are a legion now a days and even latest books of toxicology might
mx be in a position co cover all of them. In this state of civilised world, we have
wo judge how useful the knowledge of toxicology (Vida and Agada tantra) as
described in Ayurvaidika texts can prove helpful, because it is quite obvious that
the poisons which we encounter today and the intensity with which they act,
were out of question in ancient times when texts were compiled or redacted.
I think we should not concern overselves much with the poisons described
im the texts but with the agadas and the other drugs mentioned as antidotes in
general or against some particular poison and to find out ar what particular stage
or visa vega, they should be prescribed to be effective. There is a particular group
of poisons classified as disi visa which relates to the effects of poisons not fully
neutralised, not fully eliminated, but remaining dormant and having a cumula-
tive effect or giving repeated exacerbations on getting accentuated by the par-
Geular scason, food or diseases, ctc. These effects of chronic poisons may simu-
fare the allergic effects of drugs, foods or other allergens and antigens and the
drugs prescribed there may be examined to see in what manner they act, if they
really act ar all.
Drugs used as antidotes in acute or chronic poisoning in combination, in
the form of agadas or in the form of single drugs fall under the categories of
rasayana, jivaniya or visahara group of drugs. Assessment of their effects is a field
of research which is full of possibilities of bringing new light and new agents in
fighting against diseases and death. The hope is not baseless because encoura-
ging reports are coming from the research workers in the field that reputed
Ayurvedic rasdyanas c.g. Asvagandha and vasa have some antibiotic activity,
pastimadhu and guggulu contain corticosteroids of vegetable origin and that
guggulu, gudici, etc., have antiarthritic, hypolipidacmic, etc. effects. Similarly, if
agadas ot single visahara drugs arc tried in chronic degencrative conditions they
may show some new hopes.
In the same way concept of ojas, its scat in the particular vital parts of
tissues like heart and blood, concept of poisons having such a powerful effect
due to fast diffusion all over the body, bypassing the normal barriers of vipaka
(digestion/detoxication), having an effect of either coagulation or anticoagula-
son on the blood, on flesh producing necrosis and on the heart producing such
changes that it does not easily burn in the fire after death. Concept of the visas
having more or less similarity in their all or a few gunas which are antagonistic to
those of ojas and having ten, 31, sari, firefet and srepsrd gunas in common
but having peculiar affinity with and provocative effects on individual
vita, pitta and kapha; peculiarity of the mode of action of different visas - some
going upwards i. ¢. from distal parts to the proximal parts, or having emetic
effects, some having downward movement and producing purgation at the same
time producing effects on internal vital parts like asshi and mayja: the concept
thar the use of agadas immobilises or prevents the diffusion of the poison in the
body; while by che use of aFRM drugs (heart protecting drugs) the poison is
prevented from going to the mind (making the patient unconscious); all such
concepts require to be verified. A resolute effort churning the ocean of Ayurveda
to get the real nectar is the necessity of the time.
‘With these considerations in mind I welcome the new edition of Susruta
Samhita with its English translation being brought our by Dr. Singhal and his
learned associates. I am glad to know that the edition of this section is enteusted
to my learned friend Shri Ramanath Dwivedi, who is quite dependable for such
a task, being an erudite scholar, a teacher and a physician of long standing. I
congratulate the whole team and wish thar this section will be greeted by the
scholars and students alike.
Medicine had its beginning in mystery and superstitions in ‘the dark
backyard and abysm of time’. The mystery, the magic and the medicine were
one and the same. Medicine was first a religion, then ir became a science.
The Pre-Vedic Age
When we look back into the diamond distant past we sce the primitive
man terrified by the world around him and ascribing diseases as well as his other
misfortunes to supernatural malevolent forces and to the influence of spirits to
be placated by sacrifice. It was the age of wizard doctor, the medicine man, che
fetish and talisman, an age which has perhaps even yet not entirely passed away.
Asa matter of fact the medicine man represents the oldest professional class of
which we have record. The oldest surgical opcration of which we have evidence
is trephining which consisted in opening the skull with a sharp stone instru-
ment with the object of letting out the evil spirit.
When we trace back to the Vedic age (8000 B. C.) where we sce the first
dawn of Aryan civilization, we find in Rgveda, the oldest and the first treatise of
the World, there is a mention of the revival of the lost eye-sight and the lost
hearing by che great physician of the time, the Asvini Kumaras' > and the Lord
Indra.‘ This is perhaps the first evidence of flourished medical knowledge and
the treatment of the cye and the car diseases of which we have record in the
history of human race.
Atharvaveda is the chief source of origin of Ayurveda. In Kenasitra of
Atharvaveda we find that there are descriptions of sensory organs, seven aper-
tures of the skull’ and the location of the cye in the skull over the vertebrae of
the neck, etc. Not only chis much, there is a citation also about the local appli-
cation of antimony ( yamuneyam, the sroriijana) in cye diseases mentioning
its source of origin and qualities. Its other uscs as antipyretic, antianacmic and
antivenum, etc. have also been indicated. Further, it has also been said thar this
drug protects the life of the human beings and other animals."
The candle of medical knowledge continued to burn. In Upanigada period
we observe that a separate treatise Netropanisada was composed consis-
ting of 40-45 verses enumerating the names of different parts of the eye and the
various descriptions related to it. This Upanisada is still available. The others,
particularly Aranyakopanisada tells us in greater detail about the anatomy and
physiology of the eye. viz. blood vessels of the eye, the iris, the pupil, lacrima-
tion, lids of the eye and the clements taking part in their formation.’
After Upanisada age, the third important period belongs to the glorious
age of Samhitas. We sce that it was the real age of organisation, shaping, creation,
preservation and particularly specification of Ayurveda as a separate branch. In
this age this great science was specified into its different sections namely, Sur-
gery (Salya) and Medicine (Kayacikitsa), ctc. Sugruta Samhita, the treatise of
Surgery, and Caraka Samhita, the treatise of Medicine are the two greatest con-
tributions of this age available today morc or less in complete forms after having
gone through their two or three redactions. These are the two of the three chief
constituents of the greater triad, the Brhattrayt.
At this stage it is also important to note that before the birth of Suéruta
Samhita the knowledge pertaining to Ophthalmology and Otorhinolaryngology
(Salakya) was so organised and advanced that specialists had written separate
treatises of their own. Perhaps with the culcural lag these treatises have been lost
for ever and at present we have only records of them. Dalhana, the great com-
mentator of Susruta Samhita and others have quoted many of them, viz. : (1)
Videha-Tantra - It was a complete Salakya treatise. Susruta has given many quo-
tations from it; (2) Nimi-Tantra - Nimi was a specialist of eye diseases and to
make him immortal in this field the disease nimesa has been described. It ap-
pears that he was a specialist in the lid diseases; (3) Gargya-Tantra and Galava
Tantra - Both have been quoted by Dalhana in connection with eye diseases; (4)
Satyiki-Tantra - Satyiki was the first inventor of couching system. He has been
quoted by many, e.g. Dalhana, Madhava, Vijayaraksica and Srikantha Datta;
Karal-Tantra - It was also a urcatise of eye discases. It has been quoted by
Scikantha and Cakrapanidatta; (6) Bhrgu-Tantra - Bhrgu was also the well
known specialist of eye diseases. This treatise is also not available. He has
iadicated the use of decoction prepared from herbal drugs in the treatment
of eve diseases."
Susruta has been the pioncer of Indian Surgery. Controversies prevail
among historians regarding determination of his period. According to some he
was born before 600 B.C. whilst others believe that he came into existence
seoch more anterior to it, about 2500 B.C.
Suirura Samhita, being the main treatise on surgery, deals with Ophtha-
bmology and Otorhinolaryngology giving the aetiology, pathogenesis, symp toms,
complications and treatment etc. of the eye, car, nose and throat discases
in the Salakya-tantra portion of its Utrara-Tantra. Dalhana defines that Salakya
is the branch where the instruments" used are chiefly rod shaped, i.c. it belongs
to the section of the head and the neck diseases.
It appears that Susruta has completely followed Videha Tantra in describ-
ing the science of Ophthalmology and Otorhinolaryngology.'? While cnume-
rating only 76 types of diseases of the cye’? based on Videha Tantra, Suéruta
himself has uttered thar the branch of Ophthalmology and Ororhinolaryngol-
ogy, the Salakya-tantra, is as wide and as deep as an ocean. It is this reason that
he has shown his inability to describe all of them. Above all, he has said that it
is quite impossible for those who have little knowledge of the subject" to under-
stand these diseases. This version of Susruta in itself is more than sufficient to
emphasize how much this branch of surgery was developed even before the birth
of Sugruca Samhita.
Salakya is the only branch of Ayurveda where Susruta has developed a new
tradition to describe diseases affecting individual structures. It is a matter of
great surprise that Suéruta’s descriptions of eye diseases in many respects appear
to be completely new even today when we compare them with the advanced
branch of modern ophthalmology. He has described nearly all diseases of the eye
which we come across today.
Susruta has described diseases of the lids, the conjunctiva, the lacrymal
apparatus, anterior chamber, the iris and the lens, etc. Twenty-one different
kinds of diseases of the lids have been mentioned. We find a nice description of
successful operation in diseases like pterygium, entropion, cataract and tra-
choma. In the very beginning Susruta has mentioned that out of a total of 76 cye
diseases, 11,9, 5 and 15 diseases can be cured by the process of cutting, scrap-
ing. splitting and needling (puncturing) respectively; 12 diseases are such
which cannot be operated; and 7 discases can be cured with great difficulty
while 15 diseases are completely incurable.
Treatment : It can be divided into (1) General treaement; (2) Local treat-
ment; and (3) Surgical operations. Regarding general treatment indications for _
the purification of the body through medical processes (iarira-iodhana), inhala-
tion (nasya) and smoking of medicated pipe (d/iimrapana) have been made.
As regards local treatment spray (pariseka), fomentation (sveda), local appli-
cations of fine powders in the eyes (aiijana), chemotherapy (putapaka and tarpana)
blood-letting from the veins and needling, etc. have been mentioned. A otal
number of 167 medicines have been described for local use but out of these only
30 are in common use today. According to Suiruta ordinary water is acidic in
reaction; therefore he has advocated the use of distilled water (parifruta jala)in the
treatment of eye diseases. Antimony has been prescribed for use as an ailjana.
Triphala has been widely used for the purpose of oral administration, washing and
in the form of ghrta. Honcy has also been recommended for local use.
An important thing which Suiruta has indicated for local use in the eye is
snake poison and fat to check the development of cataract in the eye. Such type
of treatment is nowhere indicated in modern medical science. It is a unique
contribution of Susruta which should be given an experimental trial. Further, to
check night blindness he advised spleen and liver to be taken as food, which is
There is also a description of the errors of refraction. But we find nowhere
a mention of spectacles, perhaps because in the period of Susruta such diseases
might have been cured with medical treatment only.
Regarding the third, i. ¢. the surgical procedures, scraping (lekhana), cut-
ting (chedana), needling, puncturing and trephining (bhedana) have been
dearly indicated. There is a good description of blood-letting also in some dis-
eases like circumciliary congestion (sirospata), acute orbital cellulitis (siraharya),
ophthalmoplegia (suska netra-poka), corneal ulcer (savrana jukra), glaucoma
(anyatovata), dacryocystitis (pilyalasa) and acute glaucoma (adhimantha), Also.
temporal veins (upandsa fina) and frontal veins (lalaja dird) have been advised to
be punctured for the diseases of the eye and the head. There is a mention of
trephining for the cure of staphyloma and acute glaucoma.
In the period of Suéruta as well, threads were used for sewing purposes.
There is a good description of caustic alkaline touches and cauterisation also.
Today we use silver nitrate and copper sulphate touches. To reduce tension of
the eye there is an advice for the use of leeches. The important thing is that even
in the age of Suéruta, there possibly was an invention of such an apparatus chat
they could see the interior of the eye because description is available about
macula and pupil also.
I congratulate Dr. G. D. Singhal, M.S., FR.C.S. (Ed.) and Dr. Kavi Ratna
Sharma and the other scholars of the team for bringing out such a high standard
piece of work on ‘Salikya’ portion of Uttara Tantra of Suiruta Samhita. This
monumental work merits every praise and will prove a good asset for research
scholars of Ayurveda.
Lam very happy to be associated with the labours of the learned scholars of
Banaras Hindu University, under the Chief Editorship of Dr. G. D. Singhal,
who are bringing out an authentic version of the Suiruta Samhita, in a series
of wwelve self-contained volumes as Ancient Indian Surgery series and to
contribute this preface to the volume entitled ‘Paediatric and Gynaccological
Considerations and Aphorisms in Ancient Indian Surgery’ by Dr. G.D. Singhal
and Dr. Jyotir Mitra.
This undertaking has been long overdue. Dr. Singhal and his colleagues
have endeavoured to present the original Sanskrit text with a faithful English
rendering, necessary annotations and thought-provoking suggestions for
research. The value of these publications has already been emphasized by the
medical historians of the eminence of Dr. Adalberto Pazzini, Dr. FN. L Poynter
and Dr. N. H. Keswani, with all of whom I fully agree.
Non-availability of the original texts of Ayurvedic Samhitis to che medical
historians of the West has often lead them to rely on indifferent translations
which reached Europe through circuitious routes, often giving a distorted ver-
sion, becoming corrupt on the way. Thus the history of evolution of medicine in
India through the millennium and its contributions to other medical systems
either received their scant attention or appeared in a truncated and distorted
version in their works, to the extent thar much useful knowledge contained in
ancient Indian medicine has sometimes been traced even to the Greek or Arabic
Susruta Samhita, which is now being brought out as Ancient Indian Sur-
gery series by Dr. Singhal and colleagues, therefore, paves the way for better
understanding of the subject and promotes a correct appreciation of the Indian
contributions ro the development of medicine in the world.
The subjects dealt with in the present volume are devoted to graha cikinsa
or pacdiatric diseases (Ch. 27-37), striroga cikitsa or gynaecological disorders
(Ch. 38) and tantra-bhisana or aphorisms (Ch. 63-66).
Discases of children have been described by Suéruta to be of nine types
alleged to be caused by their affliction with nine different grahas (evil spirits).
One feature common to most of them was convulsions. The common predispo-
sing factors described were neglect of maternal and infant hygiene during the
period of suckling, failure to perform the benedictory rituals and the frightening
of the child which exposed the child to infection and mental trauma of varying
Susruta has given a great importance to the sclection of a wet nurse’ and
the harmful consequences following improper breast feeding.’
As emotional stress in the mother/wet nurse could inhibit the breast milk
secretion, Susruta has advised the maintenance of equanimity of the suckling
woman's mind and to give her special diet and drugs.’ some of which could well
The terms ‘raksoghna’, ‘nakzoghna dhipas, ‘rakoghna dravyas'and ‘rakjoghna
mantras used in the context of surgery extended to paediatrics also are of signifi-
cance. The term ‘raksa’ used as a verb implies ‘to protect’. All these usages mean
the destruction of harmful living things (pathogens), drugs, fumigating mea-
sures and recitation of hymns.
It would contribute to the science of today if some investigations could be
carried our on the various antiseptic drugs, especially those used for fumigation,
as found at different places in the various Ayurvedic Samhitas.
The Vedas, specially Atharvaveda and Rgveda have deale with various
aspects of medicine and diseases in a very interesting way. However, along
interval of time intervened until che highly systematised and scientific Samhius
of Sugruta and Caraka appeared. Suéruca pointed Ayurveda to be a subdivision of
Indra has been regarded by both Caraka and Susruta as the proximate
source of their knowledge of rational Ayurveda described in its eight specialities.
There is an ample evidence to show the radical departure from the extra and
supernatural etiological factors of diseases as mentioned in the medicine,
Atharvans wo the more systematic and rational treatment of the subject dealt
with by Ayurveda.
Some consider there were two Suérutis - a senior and a junior; the senior
Susruta wrote Salya-tantra ( the Science of Surgery ) in five sections only and the
junior onc revised all of it. An anonymous writer (Nagarjuna, according to
Dalhana added the sixth section, Urtara-tantra, at a much larer period. Senior
Susruta flourished abour 1000 B.C. and the junior about 600 B.C.‘ in Kasi
The senior Suéruta is considered to be the son of the sage Visvimitra and
an immediace disciple of Kagiraja Divodasa Dhanvantari. That there existed
a junior Susruta is inferred by references made to the Vrddha Susruta by
Vijayaraksita and Srikantha Darta in their commentaries on Madhava Nidina
and by Siva Dasa Sena in his glossary on Caraka-Samgraha; his identity, however,
has yet to be satisfactorily established. The exact identity of Nagarjuna also is
controversial as scholars have recognised at least four Nagarjunas, viz. Darianika
Nagarjuna, Siddha Nagarjuna (the founder of the Mahayana Buddhism),
Nageéa Nagarjuna and Bhadanta Nagarjuna (a Keralite bhiksu).
An interesting view based on the historical synchronism of several perso-
nalities, chronology of the Ikyviku dynasty and on the horoscope of Sri
Ramacandra (as found in Valmiki Ramayana and Campa Ramayana of Bhoja)
suggests the period of senior Susruta to be 3000 B.C.-2500 B.C. Details of
these evidences would be given by me in another communication.
I wish to congratulate Dr. G. D. Singhal, Dr. Jyotir Mitra and other siem-
bers of the editorial board for bringing out this portion of Sugruta Sachicd in
such a nice way. I am confident these books will change the History of Mcdicine
one day when India will again be looked upon to have been the pioneer in the
field of Medicine and Surgery in ancient times.
This book is based on Urtaratantra (Ch. 32-62) of Susruta Samhitd and
deals with all aspects of Medical and Psychiatric Considerations in Ancient
Indian Surgery (Vol. X ), it is the most authentic, scientific and research
oriented interpretation of the subject available comprising Kayacikits’ (i. ¢.
Internal Medicine) and Bhitavidya ( i. ¢. Psychiatry). With a unique English
syntax translation of Sanskrit stanzas, the book provides exact references to its
readers, ready on the plate even if he is not conversant with Sanskrit.
The present volume consists of twenty-four chapters of Uttara-tantra; the
initial rwenty-one chapters deal with Kayacikitsa while the last three chapters
are on Bhitavidys. Chapters on Kayacikitsd or Internal medicine are based on
medical considerations dealing mostly on symptoms encountered in surgical
practices such as fever, diarrhoea, vomiting, cough, hiccough, loss of appetite,
fainting etc, and they are discussed as a disease entity in itself, whereas diseases
like heart diseases, consumption, alcoholism, asthma, and worm infestations
etc. are purely medical, while a few chapters are more surgical as they are
devoted on retention of urine and obstructive uropathies, etc.
The chapters on Bhiitavidya or Psychiatry are based on discussions with
afflictions by grahas or superhuman agencies, and deal with diseases like
epilepsy and psychoses.
The work is a collaborative attempt of eminent surgeons, physicians and
scholars (Modern and Ayurvedic) of Institute of Medical Sciences, Banaras
Hindu University, Varanasi (India) and mostly it has been carried out by the
long intelligence efforts of Dr. G.D. Singhal and Dr. K.P. Shukla.
By performing ycoman's task, the authors have done a great service to the
Ayurvedic community. This is an excellent work in all respects indeed. Ic is weil
planned and scientifically written for the benefit of physicians, surgeons, stu-
dents, research workers and others who are concerned with the subject. It may
be recalled that the whole work on Suiruta has been carried our in twelve
volumes (series ) and out of them, ten volumes deal with the text while owo
volumes are on drugs and synopsis, comprising a total of more than 5000
pages, and in a duration of fast 14 ycars. I think this publication is the last in the
Ic is a demand of the time that fruits of scientific research should be made
available to each and everyone. However, it is my firm faith that the authors
have been successful in their efforts to fulfil the scarcity of source material of
Ayurveda in general and medicine and ancient Indian surgery in particular.
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