Sushruta

The Sushruta Saṃhitā occupies a distinctive place in classical South Asian medicine as a surgical manual, a textbook of general medicine, and an ethical primer woven into one. Its chapters inventory scalpels, forceps, needles, probes, cautery devices, and bandages; set out classifications of wounds and ulcers; and describe step‑by‑step protocols for treating fractures, dislocations, and soft‑tissue injuries. Among its most discussed sections are reconstructive procedures—especially rhinoplasty—whose careful staging, flap design, and postoperative care have drawn attention in modern histories of plastic surgery. Ophthalmic procedures, including early couching for cataracts, are placed amid a larger scheme of preoperative preparation, asepsis (via herbs, heat, and cleanliness), and convalescence managed through diet and regimen. Pedagogy is central. Students are instructed to practice incisions and sutures on plantain stems, gourds, and pieces of leather; to learn hand stability and pressure; and to observe the condition of patients over time. Ethics are not an afterthought: the Saṃhitā emphasizes consent, restraint, compassion, and the sober assessment of one’s competence—counseling referral when necessary. These values express an awareness that surgery is powerful and dangerous, and that character is a clinical instrument no less than a knife. The text also integrates surgery into Ayurveda’s systematic physiology and pathology. Concepts of doṣa balance, tissue nourishment (dhātu), and channels (srotas) frame diagnosis and treatment, while diet, daily routine, and seasonal adjustments modulate recovery. At the same time, the surgical chapters read with a strikingly empirical cadence: lists of instruments, vectors of incision, and techniques of hemostasis feel like notes distilled from practice. Historically, the Saṃhitā is likely layered, with later redactors shaping an earlier surgical tradition. Exact dates are debated; what matters for the historian of science is the demonstration that a serious, teachable surgical culture existed, combining craft with text, procedure with principle. Its later reception ranges from scholastic commentary to modern nationalist pride and medical curiosity. In contemporary education, the book still serves as a reminder that technical skill matures within a matrix of ethics, hygiene, and attention to the whole patient—concerns that every operating theater must continually relearn.