Suśruta, a physician and sage, wrote Suśruta Samhitā, a medical compendium of verses about health, disease, and longevity; it is a cornerstone of Āyurvedic medicine and is particularly renowned for the chapter on surgery.

Suśruta of Benares (now Varanasi, a Hindu holy city on the Ganges River in India) was a sage and physician. In India, he is known as the Father of Surgery and the Pioneer Anatomist. His name is sometimes spelled Sushruta or Suśrata. He wrote Suśruta Samhitā (An English Translation of the Sushrata Samhita, 1907-1916), a medical treatise that is renowned for its descriptions of sophisticated surgical techniques and its lengthy plant-based pharmacopoeia. The treatise is one of the key texts of Āyurveda (literally, knowledge of life), a classical system of ancient medicine, and is written in Sanskrit verse. Suśruta of Benares

Orthodox Hindus believe that Āyurveda is derived from the Atharvaveda (c. 1500-1100 b.c.e.; The Hymns of the Atharva-veda, 1895-1896), one of the holy Vedas said to have been revealed before 5000 b.c.e. It was a gift from Brahmā, the creator of the universe, who gave the knowledge of life to a succession of teachers. Eventually, Dhanvantari, the god-king of Kāúi (Varanasi), revealed Āyurvedic medicine to Suśruta. The codification of Āyurveda, however, probably took place during the sixth century b.c.e. Much of the Vedas are hymns of praise and worship, as well as prayers for health, longevity, and sons. The families of priests or brāhmana memorized thousands of Vedic verses and orally transmitted them throughout the ages. Hence, an Āyurvedic physician would prescribe a regimen of care or would opt for a particular surgical procedure depending on the verses he recalled from his memory.

Contemporary scholars, such as Roy Porter, the British historian of science, and Dominik Wujastyk, a Sanskrit specialist, dispute the ancient Vedic origin of Āyurveda and attribute this claim to religious fundamentalism or nationalism. They posit that Āyurveda may have come from heterodox ascetic communities, especially Buddhist monastic groups, no earlier than the fourth century b.c.e. Nevertheless, faithful Hindus believed (and still believe) that the ancient holy Vedas were revealed by the gods to the sages and that the Āyurveda has divine origins.

Āyurveda is the foundation for much of the Suśruta Samhitā. Āyurveda and Suśruta’s treatise are more rational and empirical than The Hymns of the Atharva-veda. Suśruta described herbal and mineral therapeutics and wrote commentaries on health and disease, longevity, and living well. His tone is more pragmatic than magico-religious.

The Vedics believed that all matter is made of five elements: earth, air, fire, water, and ether. The elements are vivified by the prānas (vital breaths), which act on the three humors: vāta (wind, breath, or air), pitta (bile or fire), and kapha (phlegm, mucus, or water). Humoral balance depends, in part, on climate and diet. Humoral imbalance is symptomatic of disease or human suffering, and the root cause of disease is sin, either in this life or in a previous life. To cure sickness, promote health, and enhance longevity, the humors are brought into equilibrium by means of diet, botanical and mineral therapeutics, surgery, and prayer.

Suśruta believed that the good physician should treat a patient like a son because the patient has faith in the doctor; in an emergency, the physician must respond as if his house were on fire. Moreover, a good surgeon is bold and swift, with a steady hand and instruments of steel sharp enough to split a hair. Among the blunt instruments, such as his own feet, magnets, linen, stones, and hammers, the surgeon’s hands are the most important.

Suśruta described operations resembling modern reconstructive plastic surgery, as well as methods for extracting arrows and splinters. He detailed how to make an incision to extract urinary stones, couching for cataracts (a procedure that displaces the cloudy lens), suturing, and the anatomical study of corpses. He wrote of etiology and symptoms of disease and appropriate therapeutics. As part of the materia medica, he classified about seven hundred plants by structure, exudates, and extracts, such as oil and ash, and listed animal by-products such as ghee (an oil from clarified butter), honey, and milk. Common methods for redressing humoral imbalance included enemas and purgatives for intestinal evacuation, emetics to induce vomiting, bloodletting, cupping, and the application of leeches.

Suśruta also gave advice regarding a healthful diet and exercise regimen. For example, one should eat good food in moderate amounts with due consideration of the humors and season. To reduce fat and gain strength, one should exercise every day regardless of the season, exercising just up to the point of rapid breathing.

Although many of the surgical techniques are surprisingly modern, the context of care is more spiritual than is typical of Western medicine. The operations commence with prayer and offerings. For an auspicious outcome, the patient is placed facing east and the physician facing west. After the operation, Vedic hymns are sung to ward off evil spirits.

With regard to severed or displaced body parts, Suśruta suggested that ears should be stitched in place, stumps of legs should be cauterized, and eyes out of sockets should be gently replaced by exerting pressure over lotus leaves. If the belly is opened and the guts have come out, they should be cleaned with ghee and milk; if there is a rupture, black ants may be applied to the edges of the perforation until they bite; then their bodies should be cut off and the belly sutured.

The surgical methods of Suśruta appear to have been neglected for hundreds of years. Scholars hypothesize that as the caste system became more rigid, taboos prohibiting physical contact grew stricter. Physicians were less inclined to invade the body. Diagnostic techniques, such as reading the pulse, smelling and tasting urine, and examining the tongue took precedence over surgery, along with a range of less invasive therapies, such as purging, sweating, and massage. Furthermore, no ancient or medieval surgical instruments have survived that could corroborate the idea that the methods of Suśruta were practiced by educated physicians in later periods. On the other hand, his methods probably were passed down as caste skills outside the Āyurveda mainstream.

There is a famous anecdote supporting caste transmission of Suśruta’s surgical methods. In the late eighteenth century, a man named Cowasjee, who had served in the English army, was captured by the forces of Tipu Sultan. They cut off one hand and his nose, traditionally a punishment for adultery. A year later, Cowasjee found a man from the brickmakers’ caste near Poona who rebuilt his nose with consummate skill. The eyewitness reports of two British surgeons, Thomas Cruso and James Trindlay, were published in London in 1794. The superior skin-grafting and reconstruction of the nose were astounding; Europeans adopted the new procedure for rhinoplasty and referred to it as the Hindu method.

In his treatise, Suśruta wrote that rhinoplasty is similar to repairing a cleft palate, except that two reeds for lifting the skin flap are unnecessary in the latter procedure. Also, to qualify as royal physician, a man must be capable of successfully performing both of these operations.

In the Western world, Āyurveda is viewed as an alternative to mainstream medicine. According to physician K. D. Sharma of New Delhi, India, 20 percent of the world’s population makes use of Āyurveda today. The ancient system for healing the sick and injured and for promoting health and longevity is especially popular in the rural villages of India. Even in cosmopolitan areas, traditional medicine is practiced alongside biomedicine, commonly typified as Western. Contemporary caregivers familiar with the canonical texts, including Suśruta Samhitā, are able to design and deliver programs that meet the needs of women and men of all castes who turn to Āyurveda.

• Leslie, Charles, and Allan Young, eds. Paths to Asian Medical Knowledge. Berkeley: University of California Press, 1992. In the chapter “Death and Nurturance in Indian Systems of Healing,” Margaret Trawick, an anthropologist, discusses four indigenous systems, including Āyurvedic medicine, and Suśruta’s role. Transcription of a modern Āyurvedic healer’s interview of a patient with commentary is included.
• Ninivaggi, Frank John. An Elementary Textbook of Āyurveda: Medicine with a Six-Thousand-Year-Old Tradition. Madison, Wis.: Psychosocial Press, 2001. First chapter is a historical overview of Āyurvedic medicine up to the modern period. Includes a discussion of Suśruta’s contribution. Appendices include time line of Āyurveda, a glossary of Sanskrit terms, a classification of diseases, and clinical cases.
• Porter, Roy. The Greatest Benefit to Mankind: A Medical History of Humanity. New York: W. W. Norton, 1997. Chapter 6, “Indian Medicine,” is a very good introduction with some mention of research controversies. Includes comments on Suśruta Samhitā. Suggested sources for further reading by chapter. Index.
• Singhal, G. D., and T. J. S. Patterson. Synopsis of Āyurveda: Based on a Translation of the “Suśruta Samhitā” (The Treatise of Suśruta). Delhi: Oxford University Press, 1993. A summary in English of Suśruta’s medical compendium with citations given for the relevant canto(s), chapter(s), and verse(s). English and Sanskrit keywords in margins serve as pointers to topics. Index of Sanskrit terms for drugs, minerals, and recipes. General index.
• Suśruta. An English Translation of the “Sushruta Samhita.” 3d ed. Varanasi: Chowkhamba Sanskrit Series Office, 1981. A revised edition of the translation originally published in 1907-1916.