Most of the early Indian culture stems from the area around the Indus river. Archaeological evidence shows that around about 3000 years B.C. , India had a thriving advanced community that grew rapidly, and then about 1500 years B.C. the population shrunk, and the advancement was halted.
This it is presumed was as a result of a natural catastrophe such as flood drought earthquake or such. It seems however that the Indian medical system and training had been influenced by the other powers of the day, namely Egypt, Babylonia and Greece.
The one thing it had in common was the reliance on the medicine man or witch doctors for their guidance.
India however has a rich history, and also has produced one of the best physicians the world has known. The initial thought given to Indian medicine is that of religious witch doctors, or local superstitious beliefs handed down over the ages, and this might be true, as an enormous country with such a large poor population will not have the resources to expand its medical knowledge other than that based upon old wives tales.
The Bower ManuscriptThis manuscript was purchased by Hamilton Bower in Kucha from Haji Ghulam Qadir.
Bower forwarded the manuscript, made up of 51 birch-bark leaves, to the Asiatic Society of Bengal, where it eventually made its way into the hands of Dr Augustus Hoernle, although at first considered unintelligible, it was eventually deciphered by Hoernle.1
This is one of the oldest surviving Indian works and contains remedies using divination and mentions the healing powers of garlic and other herbs.
SushrutaSushruta was an Indian physician who is believed to have lived around the 1st century AD (Although there is some confusion over the exact date as some say as much as 3000 years ago).
He wrote Matsushita-Samhita or “The Collection of Sushruta”, an Indian surgical repair textbook.
This enormous book has 184 chapters, and an incredible 1,120 conditions are listed including 51 eye conditions that can be treated surgically are listed.
The book also describes 101 blunt and 20 sharp surgical instruments, many of which are surprisingly similar to instruments used today, although he does recognize that the hand is the most important.
If Sushruta was proved to be in existence 3,000 years ago, it would certainly be one of the oldest concise surgical textbooks with only the Egyptian Papyri to rival it.
Sushruta has said "The Greatest medicine of all, is to teach people not to need it."
"Until a physician has killed one or two, he is not a physician."2
Sushruta is thought to have been living in Northern India by the Ganges River, to the Indian medical profession he is known as the father of surgery. He can certainly be called the father of workshop surgery as it is widely believed he had his students practice on pots and fruit before tackling the patient proper.
"The Collection of Sushruta" mentioned earlier, also lists various surgical procedures including amongst others, caesarean section and rhinoplasty. Though this work is mainly devoted to surgery, it also includes medicine, pathology, anatomy, midwifery, biology, ophthalmology, hygiene and a little psychology and understanding of what would today be called the bedside manner.
Here is an excerpt from the manuscript by Sushruta, it tells of the operation of Rhinoplasty :“The portion of the nose to be covered should be first measured with a leaf. Then a piece of skin of the required size should be dissected from the living skin of the cheek, and turned back to cover the nose, keeping a small pedicle attached to the cheek. . The part of the nose to which the skin is to be attached should be made raw by cutting the nasal stump with a knife. The physician then should place the skin on the nose and stitch the two parts swiftly, keeping the skin properly elevated by inserting two tubes of eranda (the castor-oil plant) in the position of the nostrils, so that the new nose gets proper shape. The skin thus properly adjusted, it should then be sprinkled with a powder of liquorice, red sandal-wood and barberry plant. Finally, it should be covered with cotton, and clean sesame oil should be constantly applied. When the skin has united and granulated, if the nose is too short or too long, the middle of the flap should be divided, and an endeavour made to enlarge or shorten it.”3
It has always been argued that the absence of powerful anaesthetics, how this Indian surgeon carried out such major operations. Sushruta suggest that strong alcohol should be used. “Wine should be used before operation to produce insensibility to pain.”
He again remarks: "The patient who has been fed, does not faint, and he who is rendered intoxicated, does not feel the pain of the operation.”
I would suggest that he also mixed herbs with the wine to increase the effectiveness of the anaesthetic"
Sushruta also recommended using leeches to keep wounds free of blood clots. This has only recently been rediscovered and is now used, especially in plastic surgery, to help reduce congestion in tissues, especially in wounds and in flaps used for reconstructing body parts.
Sushruta attempted to arrange systematically the experiences of older surgeons, collect-scattered facts about medicine into workable series of lectures or manuscripts.
The accuracy of Sushruta descriptions and classifications of diseases is remarkable.
Ancient Indian doctors were obsessed with classification of diseases Surgery was described and was divided into incision, excision, scraping, puncturing, probing, extraction, provoking secretion, and suturing.3
It was Islam that brought new ideas to India, mainly translating the Galen ideas into Indian society.
"When a lot of remedies for a disease are suggested, it generally means it cannot be cured." 4
The British RajWhen the British started to arrive in the early seventeenth century, along came the British ideas on civilisation and medicine (firmly grounded in Christian doctrine).
However, the East India Company was keen to learn from the Vaidyas and Hakims (Indian and Muslim Physicians) about the methods for treating not only diseases that were prevalent in that part of the world, but also the treatment for surgical conditions.
This is where it became apparent that Sushruta works were highly consulted.
On the other side of the coin the Indian doctors were also very interested in the way that the western doctors treated their patients. It seems to be the case that the native physicians held a great deal of respect by the local people and also by the British Ruling Class. However, the Indian surgeons were held in lesser esteem, the British Surgeons were far more accepted to the Indian ruling class.
When the Medical colleges were founded under the British Raj the local Ayurveda ("the complete knowledge for long life") was given some support alongside British Medicine.5
Today however the trend in the Indian medical system is to move more to Western ideas but India does provide more doctors around the world than any other country.
In the future, it will be countries such as India and China that will lead the way in Medicine, as the enormous populations, growing economy and the natural wealth of resources in these nations will boost their standing on the world stage.
At this time, the 70th year since the bloody partition of India and Pakistan, we should at least remember that the nation of India has been responsible for providing the world with many doctors and medical scientists that have allowed certainly in this country, the NHS to function well.
“You British believe in fair play,” said a Punjabi official to a young British social worker in 1947. “You have left India in the same condition of chaos as you found it.” 6
"When diet is wrong medicine is of no use. When diet is correct medicine is of no need."7
2 Kashmiri Proverb
3 http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijps/vol4n2/sus hruta.xml
4 Anton Chekov "The Cherry Orchard"
5 The Greatest Benefit to mankind Roy Porter p146
7 Ayurvedic Proverb