- Email: [email protected]
Susruta: The Father of Surgery
Perspectives Commentary on: Susruta and Ancient Indian Neurosurgery by Banerjee et al. pp. 320-323.
Basant Kumar Misra, M.Ch. Department of Neurosurgery and Gamma Knife Centre, P. D. Hinduja National Hospital and Medical Research Centre
Susruta: The Father of Surgery Basant Kumar Misra
W
ith his [Susruta’s] exemplary contributions to all of the branches of surgery, it is apt to call him the Father of Surgery,” wrote Natarajan (5). Susruta has also been credited with pioneering work on plastic surgery (rhinoplasty), ophthalmology (cataract surgery), and dental surgery (2, 4, 6). Dwivedi and Dwivedi (1) credit him with the first description of circulation much before William Harvey. Susruta had described “hritshoola,” meaning heart pain or angina, as it is known today in the Susruta Samhita. In spite of all of the credit attributed to him, Susruta is shrouded in controversy and myth. Who was this Susruta? When did he exist? Was it one person or a group? Did Susruta really exist? Johann Hermann Bass, the German historian, offered the extreme argument that Susruta never existed. According to him, historians in India confused Socrates with Hippocrates and Socrates was rechristened Susruta in India. All that was attributed to Susruta was indeed the contribution of Hippocrates. Susruta was presumed to have been born in Kasi, the ancient name for Banaras. According to Hermann Bass, Kasi was the distorted name of Kos, the Greek island where Hippocrates was born. The absurdity of this theory was aptly summarized by Gordon, “How one clever enough to read Hippocrates in the original and reproduce it in his own language, could mistake the name of Socrates for Hippocrates surpasses one’s imagination.” Be that as it may, the major body of opinion available in the literature indicates the existence of Susruta, a sage physician, a man far ahead of his time. Susruta’s time period is variously attributed to 300 BC, 600 – 800 BC, to 1000 BC. Professor M. S. Valiathan, in his authoritative work The Legacy of Sushruta, places the period of Susruta as 1000 BC (7). He bases his inference on the observations of Hoernle, who pioneered studies on Ayurvedic texts in the early part of the 20th century, and Hessler, who prepared a Latin edition of Susruta Samhita. Another clue to Susruta’s time being 1000 BC is the reference made by Panini, the great grammarian of Sanskrit, to Susruta. Panini’s time has been unanimously fixed as 700 BC.
Key words 䡲 Ancient 䡲 Indian 䡲 Neurosurgery 䡲 Susruta
WORLD NEUROSURGERY 75 [2]: 231-232, FEBRUARY 2011
It is more or less accepted that Susruta taught and practiced medicine in Kasi. A bust of his imagined appearance has been installed in the University Teaching Hospital of Banaras Hindu University, located in the same city, to commemorate his contribution to medicine. The Susruta Samhita is one of the two early texts that form the cornerstone of the Indian medical tradition of Ayurveda (Ayurveda means science of life). The other text is called Charaka Samhita. Samhita is Sanskrit, and means a collection of systematically arranged verses, or a text or compendium. In ancient India, for easy learning and memorizing, the works of art, science, and scriptures were composed in verse form. The Susruta Samhita contains 184 chapters and is divided into six sections, and like the Charaka Samhita refers to eight branches of Ayurveda. However, Susruta Samhita, unlike the Charaka Samhita, discusses surgery at great length. He also emphasizes the need of dissection for understanding anatomy, an integral part of neurosurgeons’ training today. It is indeed remarkable that a sage in ancient India, some 3000 years ago, emphasized the importance of laboratory training in anatomy for surgeons! There is more! He was also a social scientist. He admitted members of the lowest of the four classes for medical training, against the standard practice of restricting access of medical training to the three higher orders of the society. He was indeed an exceptional man, if there was ever one. So why has Susruta not gotten his due in the west? Of the many reasons cited by the authors of “Susruta and Ancient Indian Neurosurgery”, the one by Johnston Saint is probably the main one. He writes, “Our system of classical education had already given us an apparent beginning for all the arts and sciences. A disproportionate part of our education was devoted to ancient Rome and Greece where we learned all about Apollo and Aesculapius and in Greek history we come to Hippocrates. Here we had got a founder of medicine already for us and that there might have been anyone before him, few of us were disposed to inquire.”
From the Department of Neurosurgery and Gamma Knife Centre, P. D. Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India To whom correspondence should be addressed: Basant Kumar Misra, M.Ch. [E-mail: [email protected]] Citation: World Neurosurg. (2011) 75, 2:231-232. DOI: 10.1016/j.wneu.2010.10.023
www.WORLDNEUROSURGERY.org
231
PERSPECTIVES
The authors Banerjee et al. have done an excellent job in an attempt to understand Susruta and his contribution to surgery in general and to neurosurgery in particular. The article is systematically organized, starting with the controversy of Susruta’s existence, his medical training, Susruta as a surgeon and teacher, and finally, Susruta as a scientist. Their description of Susruta’s contribution to neurosurgery and neuroscience and Susruta’s structured training program is particularly impressive. Susruta says, “anyone desirous of acquiring a thorough knowledge of anatomy should prepare a dead body and carefully observe, by dissecting it and examine his different parts;
REFERENCES 1. Dwivedi G, Dwivedi S: Sushruta—the clinician– teacher par excellence. Indian J Chest Dis Allied Sci 49:243-244, 2007. 2. Eisenberg I: A history of aminoplasty. South Afr Med J 82:286-292, 1982. 3. Johnston-Saint PJ. An outline of the history of medicine in India. G. Bell; 1929. 4. Kansupada KB, Sassani JW: Sushruta. The father of Indian surgery and ophthalmology. Doc Ophthalmol 93:159-167, 1997.
232
www.SCIENCEDIRECT.com
for a thorough knowledge can be acquired only be comparing the accounts given in the authorative texts (sastras) with direct observation” (3). I congratulate the authors for this attempt. Although Susruta’s contribution to medicine is too extensive and not the subject of their work, they have given us a glimpse of Susruta’s greatness. Susruta’s teachings were for both the body and the soul. He outlined the principles of ethical practice and rigorous, lifelong training. He was also a visionary. Can you believe he described endoscopes, the ‘in’ thing in neurosurgery today, in 1000 BC! How about, “Susruta–The Father of Surgery!”
5. Natarajan K: Surgical instrument and endoscopes of Susruta, the sage surgeon of ancient India. Indian J Surg 70:219-223, 2008. 6. Tewari M, Shukla HS: Sushruta; the father of Indian surgery. Indian J Surg 67:229-230, 2005. 7. Valiathan MS: Ancient Physicians of India. Oration at the 10th Annual Conference of Indian Society of Cerebrovascular Surgery. Manipal, India, September 11, 2009.
financial relationships that could be construed as a potential conflict of interest. Citation: World Neurosurg. (2011) 75, 2:231-232. DOI: 10.1016/j.wneu.2010.10.023 Journal homepage: www.WORLDNEUROSURGERY.org Available online: www.sciencedirect.com 1878-8750/$ - see front matter © 2011 Elsevier Inc. All rights reserved.
Conflict of interest statement: The authors declare that this article was composed in the absence of any commercial or
WORLD NEUROSURGERY, DOI:10.1016/j.wneu.2010.10.023
Basant Kumar Misra, M.Ch. Department of Neurosurgery and Gamma Knife Centre, P. D. Hinduja National Hospital and Medical Research Centre
Susruta: The Father of Surgery Basant Kumar Misra
W
ith his [Susruta’s] exemplary contributions to all of the branches of surgery, it is apt to call him the Father of Surgery,” wrote Natarajan (5). Susruta has also been credited with pioneering work on plastic surgery (rhinoplasty), ophthalmology (cataract surgery), and dental surgery (2, 4, 6). Dwivedi and Dwivedi (1) credit him with the first description of circulation much before William Harvey. Susruta had described “hritshoola,” meaning heart pain or angina, as it is known today in the Susruta Samhita. In spite of all of the credit attributed to him, Susruta is shrouded in controversy and myth. Who was this Susruta? When did he exist? Was it one person or a group? Did Susruta really exist? Johann Hermann Bass, the German historian, offered the extreme argument that Susruta never existed. According to him, historians in India confused Socrates with Hippocrates and Socrates was rechristened Susruta in India. All that was attributed to Susruta was indeed the contribution of Hippocrates. Susruta was presumed to have been born in Kasi, the ancient name for Banaras. According to Hermann Bass, Kasi was the distorted name of Kos, the Greek island where Hippocrates was born. The absurdity of this theory was aptly summarized by Gordon, “How one clever enough to read Hippocrates in the original and reproduce it in his own language, could mistake the name of Socrates for Hippocrates surpasses one’s imagination.” Be that as it may, the major body of opinion available in the literature indicates the existence of Susruta, a sage physician, a man far ahead of his time. Susruta’s time period is variously attributed to 300 BC, 600 – 800 BC, to 1000 BC. Professor M. S. Valiathan, in his authoritative work The Legacy of Sushruta, places the period of Susruta as 1000 BC (7). He bases his inference on the observations of Hoernle, who pioneered studies on Ayurvedic texts in the early part of the 20th century, and Hessler, who prepared a Latin edition of Susruta Samhita. Another clue to Susruta’s time being 1000 BC is the reference made by Panini, the great grammarian of Sanskrit, to Susruta. Panini’s time has been unanimously fixed as 700 BC.
Key words 䡲 Ancient 䡲 Indian 䡲 Neurosurgery 䡲 Susruta
WORLD NEUROSURGERY 75 [2]: 231-232, FEBRUARY 2011
It is more or less accepted that Susruta taught and practiced medicine in Kasi. A bust of his imagined appearance has been installed in the University Teaching Hospital of Banaras Hindu University, located in the same city, to commemorate his contribution to medicine. The Susruta Samhita is one of the two early texts that form the cornerstone of the Indian medical tradition of Ayurveda (Ayurveda means science of life). The other text is called Charaka Samhita. Samhita is Sanskrit, and means a collection of systematically arranged verses, or a text or compendium. In ancient India, for easy learning and memorizing, the works of art, science, and scriptures were composed in verse form. The Susruta Samhita contains 184 chapters and is divided into six sections, and like the Charaka Samhita refers to eight branches of Ayurveda. However, Susruta Samhita, unlike the Charaka Samhita, discusses surgery at great length. He also emphasizes the need of dissection for understanding anatomy, an integral part of neurosurgeons’ training today. It is indeed remarkable that a sage in ancient India, some 3000 years ago, emphasized the importance of laboratory training in anatomy for surgeons! There is more! He was also a social scientist. He admitted members of the lowest of the four classes for medical training, against the standard practice of restricting access of medical training to the three higher orders of the society. He was indeed an exceptional man, if there was ever one. So why has Susruta not gotten his due in the west? Of the many reasons cited by the authors of “Susruta and Ancient Indian Neurosurgery”, the one by Johnston Saint is probably the main one. He writes, “Our system of classical education had already given us an apparent beginning for all the arts and sciences. A disproportionate part of our education was devoted to ancient Rome and Greece where we learned all about Apollo and Aesculapius and in Greek history we come to Hippocrates. Here we had got a founder of medicine already for us and that there might have been anyone before him, few of us were disposed to inquire.”
From the Department of Neurosurgery and Gamma Knife Centre, P. D. Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India To whom correspondence should be addressed: Basant Kumar Misra, M.Ch. [E-mail: [email protected]] Citation: World Neurosurg. (2011) 75, 2:231-232. DOI: 10.1016/j.wneu.2010.10.023
www.WORLDNEUROSURGERY.org
231
PERSPECTIVES
The authors Banerjee et al. have done an excellent job in an attempt to understand Susruta and his contribution to surgery in general and to neurosurgery in particular. The article is systematically organized, starting with the controversy of Susruta’s existence, his medical training, Susruta as a surgeon and teacher, and finally, Susruta as a scientist. Their description of Susruta’s contribution to neurosurgery and neuroscience and Susruta’s structured training program is particularly impressive. Susruta says, “anyone desirous of acquiring a thorough knowledge of anatomy should prepare a dead body and carefully observe, by dissecting it and examine his different parts;
REFERENCES 1. Dwivedi G, Dwivedi S: Sushruta—the clinician– teacher par excellence. Indian J Chest Dis Allied Sci 49:243-244, 2007. 2. Eisenberg I: A history of aminoplasty. South Afr Med J 82:286-292, 1982. 3. Johnston-Saint PJ. An outline of the history of medicine in India. G. Bell; 1929. 4. Kansupada KB, Sassani JW: Sushruta. The father of Indian surgery and ophthalmology. Doc Ophthalmol 93:159-167, 1997.
232
www.SCIENCEDIRECT.com
for a thorough knowledge can be acquired only be comparing the accounts given in the authorative texts (sastras) with direct observation” (3). I congratulate the authors for this attempt. Although Susruta’s contribution to medicine is too extensive and not the subject of their work, they have given us a glimpse of Susruta’s greatness. Susruta’s teachings were for both the body and the soul. He outlined the principles of ethical practice and rigorous, lifelong training. He was also a visionary. Can you believe he described endoscopes, the ‘in’ thing in neurosurgery today, in 1000 BC! How about, “Susruta–The Father of Surgery!”
5. Natarajan K: Surgical instrument and endoscopes of Susruta, the sage surgeon of ancient India. Indian J Surg 70:219-223, 2008. 6. Tewari M, Shukla HS: Sushruta; the father of Indian surgery. Indian J Surg 67:229-230, 2005. 7. Valiathan MS: Ancient Physicians of India. Oration at the 10th Annual Conference of Indian Society of Cerebrovascular Surgery. Manipal, India, September 11, 2009.
financial relationships that could be construed as a potential conflict of interest. Citation: World Neurosurg. (2011) 75, 2:231-232. DOI: 10.1016/j.wneu.2010.10.023 Journal homepage: www.WORLDNEUROSURGERY.org Available online: www.sciencedirect.com 1878-8750/$ - see front matter © 2011 Elsevier Inc. All rights reserved.
Conflict of interest statement: The authors declare that this article was composed in the absence of any commercial or
WORLD NEUROSURGERY, DOI:10.1016/j.wneu.2010.10.023