Knowledge

TRADITIONS & PRACTICES

OF INDIA
Textbook for Class XI

Module 6
Life Sciences (2) The Historical Evolution of
Medical Tradition in Ancient India - Part 2

CENTRAL BOARD OF SECONDARY EDUCATION

Shiksha Kendra, 2, Community Centre, Preet Vihar,
Delhi-110 092 India
 Knowledge
TRADITIONS & PRACTICES
OF INDIA
Textbook for Class XI

Module 6
Life Sciences (2) The Historical Evolution of
Medical Tradition in Ancient India - Part 2

CENTRAL BOARD OF SECONDARY EDUCATION

Shiksha Kendra, 2, Community Centre, Preet Vihar, Delhi-110 092 India
No part of this publication may be reproduced or stored in a retrieval system or
transmitted in any form or by any means, electronic, mechanical
photocopying, recording or otherwise, without the prior permission of the
Central Board of Secondary Education (CBSE).
 Preface
India has a rich tradition of intellectual inquiry and a textual heritage that goes back to several
hundreds of years. India was magnificently advanced in knowledge traditions and practices
during the ancient and medieval times. The intellectual achievements of Indian thought are found
across several fields of study in ancient Indian texts ranging from the Vedas and the Upanishads to
a whole range of scriptural, philosophical, scientific, technical and artistic sources.
As knowledge of India's traditions and practices has become restricted to a few erudite scholars
who have worked in isolation, CBSE seeks to introduce a course in which an effort is made to make
it common knowledge once again. Moreover, during its academic interactions and debates at key
meetings with scholars and experts, it was decided that CBSE may introduce a course titled
‘Knowledge Traditions and Practices of India’ as a new Elective for classes XI - XII from the year
2012-13. It has been felt that there are many advantages of introducing such a course in our
education system. As such in India, there is a wide variety and multiplicity of thoughts,
languages, lifestyles and scientific, artistic and philosophical perceptions. The rich classical and
regional languages of India, which are repositories of much of the ancient wisdom, emerge from
the large stock of the shared wealth of a collective folklore imagination. A few advantages given
below are self explanatory.
• India is a land of knowledge and traditions and through this course the students will become
aware of our ancient land and culture.
• Learning about any culture particularly one's own culture - whatever it may be - builds
immense pride and self-esteem. That builds a community and communities build harmony.
• The students will be learning from the rich knowledge and culture and will get an objective
insight into the traditions and practices of India. They will delve deeply to ascertain how these
teachings may inform and benefit them in future.
• The textbook has extracts and translations that will develop better appreciation and
understanding of not only the knowledge, traditions and practices of India but also
contemporary questions and issues that are a part of every discipline and field in some form or
another.
This course once adopted in schools across India can become central to student learning: each
student brings a unique culture, tradition and practice to the classroom. The content is devised in a
way that the educator becomes knowledgeable about his/her students' distinctive cultural
background. This can be translated into effective instruction and can enrich the curriculum
thereby benefitting one and all. This insight has close approximation with the pedagogy of CCE.
The course is designed in a way that it embodies various disciplines and fields of study ranging
from Language and Grammar, Literature, Fine Arts, Agriculture, Trade and Commerce,
Philosophy and Yoga to Mathematics, Astronomy, Chemistry, Metallurgy, Medicine and
Surgery, Life Sciences, Environment and Cosmology. This can serve as a good foundation for
excellence in any discipline pursued by the student in her/his academic, personal and
professional life.
This book aims at providing a broad overview of Indian thought in a multidisciplinary and
interdisciplinary mode. It does not seek to impart masses of data, but highlights concepts and
major achievements while engaging the student with a sense of exploration and discovery. There
is an introduction of topics so that students who take this are prepared for a related field in higher
studies in the universities.
The examination reforms brought in by CBSE have strengthened the Continuous and
Comprehensive Evaluation System. It has to be ascertained that the teaching and learning
methodology of CCE is adopted by the affiliated schools when they adopt this course. The
contents have to cultivate critical appreciation of the thought and provide insights relevant for
promoting cognitive ability, health and well-being, good governance, aesthetic appreciation,
value education and appropriate worldview.
This document has been prepared by a special committee of convenors and material developers
under the direction of Dr. Sadhana Parashar, Director (Academic & Training) and co-ordinated by
Mrs. Neelima Sharma, Consultant, CBSE.
The Board owes a wealth of gratitude to Professor Jagbir Singh, Professor Kapil Kapoor,
Professor Michel Danino, and all those who contributed to the extensive work of conceptualizing
and developing the contents. I sincerely hope that our affiliated schools will adopt this new
initiative of the Board and assist us in our endeavour to nurture our intellectual heritage.

Vineet Joshi
Chairman
 Convenor’s Note by Professor Jagbir Singh
In 2012, CBSE decided to introduce an Elective Course 'Knowledge Traditions and Practices of
India' for classes XI and XII and an Advisory Committee was constituted to reflect on the themes
and possible content of the proposed course. Subsequently Module-Preparation Committees were
constituted to prepare ten modules for the first year of the programme to include the following
Astronomy, Ayurveda (Medicine and Surgery), Chemistry, Drama, Environment, Literature,
Mathematics, Metallurgy, Music and Philosophy.

Each module has;

I. A Survey article

ii. Extracts from primary texts

iii. Suitably interspersed activities to enable interactive study and class work

iv. Appropriate visuals to engender reading interest, and

v. Further e- and hard copy readings.

Each module in the course has kept in mind what would be a viable amount of reading and
workload, given all that the class IX students have to do in the given amount of time, and controlled
the word-length and also provided, where needed, choices in the reading materials.

Each Module consists of:

I. A Survey Essay (about 1500-2000 words) that introduces and shows the growth of ideas, texts
and thinkers and gives examples of actual practice and production.

ii. A survey-related selection of extracts (in all about 2000 words) from primary sources (in
English translation, though for first hand recognition, in some cases, where feasible, the
extracts are also reproduced in the original language and script).

iii. Three kinds of interactive work are incorporated, both in the survey article and the extracts -
comprehension questions, individual and collective activities and projects (that connect the
reading material and the student to the actual practice and the environment).

iv. Visuals of thinkers, texts, concepts (as in Mathematics), practices.

v. Internet audiovisual resources in the form of URLs.

vi. List of further questions, and readings.

The objective of each module, as of the whole course, is to re-connect the young minds with the
large body of intellectual activity that has always happened in India and, more importantly, to
enable them (i) to relate the knowledge available to the contemporary life, theories and practices,
(ii) to develop, wherever feasible, a comparative view on a level ground of the contemporary
Western ideas and the Indian theories and practices, and (iii) to extend their horizons beyond what
is presented or is available and contemplate on possible new meanings, extensions and uses of the
ideas - in other words to make them think.

We have taken care to be objective and factual and have carefully eschewed any needless claims or
comparisons with western thought. Such things are best left to the readers' judgement.

This pedagogical approach clearly approximates CBSE's now established activity-oriented

interactive work inviting the students' critical responses.

It is proposed to upload the first year's modular programme to be downloaded and used by
schools, teachers and students.

As a first exercise, we are aware that the content selection, a major difficult task, can be critically
reviewed from several standpoints. We do not claim perfection and invite suggestions and
concrete proposals to develop the content. We are eagerly looking forward to receiving the
feedback from both teachers and students. That would help us refining the content choice, the
length and the activities. We will also thankfully acknowledge any inadvertent errors that are
pointed out by readers.

The finalisation of this course is thus envisaged as a collective exercise and only over a period of
time, the Course will mature. We know that perfection belongs only to God.

If our students enjoy reading these materials, that would be our true reward.

Prof. Jagbir Singh

Convenor
 Acknowledgment
e
CBSE ADVISORS
• Shri Vineet Joshi, Chairman
• Dr. Sadhana Parashar, Director (Academic & Training)

CONVENOR
Prof. Jagbir Singh
Convenor, Former Head Department of Punjabi Delhi University

MATERIAL PRODUCTION TEAM

Prof. Kapil Kapoor Prof. Shrawan Kumar Sharma Ms. Uma Sharma
Prof. of English & Former Pro Vice Head Dept. of English Director, Centre for Ex Craft Coordinator CCRT, Ex TGT,
Chancellor, Jawahar Lal Nehru University Canadian Studies Gurukul Kangri RPVV, Vasant Kunj, New Delhi.
University
Prof. Michel Danino Haridwar, Uttarakhand Ms. Archana Sharma
Guest Professor, IIT Gandhinagar, Freelancer: Content Developer, Resource
& Visiting Faculty, IIM Ranchi Ms. Kiran Bhatt Person - SCERT, DIET (RN) New Delhi.
(Retd.) Head of Dept. (English), Modern
Prof. Avadhesh Kumar Singh School, Vasant Vihar, New Delhi Ms. Anjali Shukla
Professor & Director School of Translation DAV Public School, Sector - 7, Rohini,
IGNOU Ms. Heemal Handoo Bhat New Delhi - 110085
Shaheed Rajpal DAV Dayanand Vihar, New
Dr. P. Ram Manohar, Delhi Dr. Sandhya S. Tarafdar
MD (Ayurveda) PGT History, K.V. Vikaspuri, New Delhi
Director and CSO, AVP Research Mr. Pundrikakash
Foundation, 36/137, Trichy Road, Vice Principal, Physics, RPVV, DoE, Kishan Dr. B. S. Dashora
Ramanathapuram P.O., Coimbatore- Ganj, New Delhi ELT Group (Retd. Principal), Bhopal,
641045, Tamil Nadu, India Madhya Pradesh.
Ms. Rashmi Kathuria
Dr. J. Sreenivasa Murthy Maths, Kulachi Hansraj Model School, Ms. Shubhika Lal
(Sanskrit/Philosophy) Ashok Vihar, New Delhi Modern School, Vasant Vihar, New Delhi
Head, Department of Sanskrit, Ms. Kusum Singh
M.E.S College, Bangalore - 560 003 Dr. Sanjay Kumar
K.V., SPG Complex, Sector - 8, Dwarka, DAV Public School, Sector-14, Gurgaon
Prof. Bharat Gupt New Delhi
Ms. Gayatri Khanna
(Retd) Associate Professor, Delhi
University, Founder member and Trustee Ms. Bindia Rajpal ELT, Free Lancer, New Delhi
International Forum for India's Heritage. The Air Force School, Subroto Park, New
Delhi Grateful Thanks to:
PO Box 8518, Ashok Vihar, Delhi 110052.
Ms. Reeta Khera Dr. Rajnish Kumar Mishra, JNU
Dr. Vipul Singh
MLNC, University of Delhi, South Campus, VVDAV Public School, D- Block, Vikaspuri, Dr. Santosh Kumar Shukla, JNU
New Delhi New Delhi
Mr. Albert Abraham
Former Report Writer, CBSE

CO-ORDINATOR EDITORS
Ms. Neelima Sharma Prof. Kapil Kapoor, Prof. of English & Former Pro Vice- Chancellor
Consultant (ELT), CBSE New Delhi Jawahar Lal Nehru University

Prof. Michel Danino, Guest Professor, IIT Gandhinagar & Visiting Faculty, IIM Ranchi

SUPPORTING MEMBERS (CBSE)

Mr. Yogeshwar Mr. Abhimanyu Kumar Gupta Ms. Prabha Sharma
Asstt. Record Keeper Computer Assistant Computer Assistant
 Content of Module 6

Life Sciences (2) The Historical Evolution of 1

Medical Tradition in Ancient India - Part 2
 LIFE SCIENCES (2)

The historical evolution of medical tradition

in ancient India: A survey

Specialization into eight branches

The history of medicine in India spans a period of several thousand years, definitely
dating back to a few centuries before the Common Era. There is evidence that the earliest
textbooks of Ayurveda like Caraka Saṃhitā (General Medicine), Suśruta Saṃhitā (Surgery),
and Kāśyapa Saṃhitā (Paediatrics) were edited and revised several times over a thousand
years. They attained their current form in the first few centuries of the Common Era. It is
an amazing fact that so early, Sanskrit texts were composed dealing exclusively with
specialties like Paediatrics, Surgery, Ophthalmology, ENT and so on. In these texts,
Ayurveda is already seen in a developed form specialized into eight branches: General
Medicine, Surgery, Ophthalmology-ENT-Dentistry, Paediatrics, Psychiatry, Toxicology,
Rejuvenative Medicine and Reproductive Medicine. Around the
To what extent do
6th or 7th centuries CE, the renowned physician Vāgbhaṭa compiled
the eight branches
the specialized knowledge of the eight branches of Ayurveda into of Ayurveda cover
one compendium; the larger version is known as Aṣṭāṅga the medical field as
we know it today?
Saṃgraha and the shorter version is called Aṣṭāṅga Hṛdaya.

The tradition of surgery

The tradition of surgery in Ayurveda has a long history. Researchers at the University of
Missouri-Columbia discovered that physicians in ancient India had developed technology
to drill teeth and remove decay 8,000 to 9,000 years ago. Study of fossils from Mehrgarh,

1
now in Pakistan, revealed tiny holes drilled into teeth on the biting surface of male
molars. Evidence has also been unearthed from Harappa and Lothal revealing an ancient
surgical practice on a Bronze Age skull dating back to nearly 4,300 years ago.
Trepanation, a common means of surgery practised in prehistoric societies starting with
the Stone Age, involved drilling or cutting through the skull vault, often to treat head
injury or to remove bone splinters or blood clots caused by a blow to the head.

A mesolithic (15,000 – 6,000 BCE) rock painting from Bhimbetka, Madhya Pradesh,
seems to depict surgery being performed on a subject’s head or eye.

A folio from a manuscript of the Suśruta Saṃhitā, an Ayurvedic textbook on various surgical
procedures and surgical instruments. (Courtesy: Wellcome Library, London)

2
 The saga of Indian surgery continued to flourish and reached its acme in the time
of Suśruta, who is believed to have lived in the 2nd century BCE. Suśruta is now revered as
the father of surgery and advocated a thorough study of anatomy by dissecting the dead
body. He introduced the method of sterilizing surgical instruments to prevent sepsis
after surgical procedures. The compendium of Suśruta describes hundreds of sharp and
blunt surgical instruments and many of them resemble instruments used by surgeons
today. Suśruta is recognized for having developed innovative surgical procedures like
reconstruction of the nose or rhinoplasty through plastic surgery, use of a specific
species of ants as dissolvable sutures to close the intestines, surgical removal of cataract,
and surgical management of urinary calculi.

Medical and surgical implements of 19th century origin from India. (Courtesy: Science
Museum, London)

3
 How far do you think
one can learn surgery
by practising on
vegetables?

This painting shows Suśruta’s

disciples learning surgery by
working on vegetables.

This painting by James Wales, commissioned

in 1794 by two British surgeons, was
published along with the first known
description of plastic surgery in the West.
(Courtesy: Wellcome Institute, London)

4
 The Indian rhinoplasty technique was (re)discovered by Western medicine in the
18th century, when the East India Company surgeons Thomas Cruso and James Findlay
witnessed Indian rhinoplasty procedures at the British Residency in Poona. The surgeons
published photographs of the procedure and its nasal reconstruction outcomes in the
October 1794 issue of the Gentleman’s Magazine of London.

An oculist treating a patient with specialized instruments.

(Painting of 1825, courtesy The British Library, London)

5
Medical genetics in Ayurveda

In the Caraka Saṃhitā one comes across the earliest reference to the genetic basis of
diseases. Caraka points out that the reproductive element is composed of seeds (bīja)
which are further divided into parts (bījabhāga) and subparts (bījabhāgāvayava). Each part
or subpart of a seed represents a particular organ of the body and damage to the part can
damage the organ.

Inoculation for smallpox

In the 18th century, British officials and travellers observed and documented the practice
of inoculation for smallpox, which was in vogue in India centuries before vaccination was
discovered by Edward Jenner. In an account written for London’s College of Physicians,
J.Z. Holwell, who studied and himself practised the Indian method of inoculation,
testified to its great effectiveness in preventing the occurrence of smallpox.

Microbiology and parasitology

There are references to microbial life in textbooks of medicine like Caraka Saṃhitā dating
back to several centuries before the Common Era. Lower life forms were classified into
pathogenic and non-pathogenic. The pathogenic organisms include microbes that cannot
be seen with the naked eye. Technical nomenclature was developed for different types of
microbes and their shapes and sizes have also been described. How those physicians
were able to provide such descriptions, or even conceive of microbes, centuries before
microscopes were invented remains a mystery.

Communicable diseases and epidemics

Suśruta Saṃhitā describes communicable diseases and explains that disease can be
transmitted from one person to the other by close contact, through air, sharing of

6
clothes, sleeping together and so on. Fumigation is mentioned as a measure to prevent
infectious diseases from spreading. Caraka Saṃhitā devotes an entire chapter to
epidemiology and prescribes methods to prevent epidemics as well as manage the
outbreak of epidemics. During the period of King Aśoka, an efficient public healthcare
system was established.

An evolving pharmacopoeia

The practice of medicine in Ayurveda is based on the principle that there is no substance
in the world that does not potentially have medicinal property. The evolution of
Ayurvedic pharmacopoeia represents a continuous and unfinished quest for discovering
new medicines from natural resources. About 1,500 medicinal plants have been described
and formulated into thousands of medicines in the tradition of Ayurveda. Hundreds of
animals and animal products have also been mentioned in the texts. Around the 6th
century in the Common Era, the branch of medicine specializing in the use of minerals
and metals known as Rasaśāstra developed and established itself, especially in the North
of India (see module on Chemistry in India). The older tradition of herbal medicines
continued to be practised in India’s southern states. In Tamil Nadu, the system of Siddha
medicine (traditionally regarded as having been founded by eighteen ‘Siddhars’ or
realized beings, but in practice similar to Ayurveda) added to its pharmacopoeia drugs
metallic and mineral components.

Pluralistic approach to healthcare

Ayurveda nurtured a pluralistic approach to healthcare in India. From ancient times,

healthcare in India developed in the two streams of the folk and classical expressions.
India has a rich tradition of folk medicine, which was organized into a paramedical force
of health practitioners, bonesetters, poison healers and birth attendants who delivered

7
primary healthcare for the people. Many of these
How is India’s pluralistic
traditions have survived into modern times. Today India healthcare in tune with
is perhaps the only country in the world that officially Indian conditions and ethos?

recognizes a pluralistic healthcare system patronizing

medical systems like Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy.

This painting shows an Ayurvedic surgeon attending to a wound with his surgical
instruments. (Courtesy: Wellcome Library, London)

Cross-cultural interactions

Ayurveda benefited from cross-cultural interactions and spread out of India into
neighbouring countries like China, Sri Lanka, Tibet, Thailand and Indonesia. Buddhism
played a major role in the spread of Ayurveda outside India. When Alexander the Great

8
invaded India in 325 BCE, he was so impressed by the snakebite healers and Ayurvedic
physicians that he invited them to Greece. There is historical evidence indicating
interactions between the physicians of Greek medicine and Ayurveda. Important
textbooks of Ayurveda like Caraka Saṃhitā, Suśruta Saṃhitā and Aṣṭāṇga Hṛdaya were
translated into Tibetan, Persian and Arabic languages in the Middle Ages.

Travellers from China and the Middle East narrated in their accounts the advanced
state of medical practice in India.

A dynamic literary tradition

The history of Ayurveda reveals the evolution of a vibrant and dynamic medical tradition
with compendia, medical lexicons, pharmacopoeias, handbooks, manuals of treatment
and so on being composed at important chronological and geographical landmarks. For
example, in the 8th century CE, a treatise devoted exclusively to diagnostics was composed
by Mādhava known as Mādhava Nidāna. In the 11th century, a new treatise was composed
on dietetics by Viśvanātha Sena called Pathyāpathyaviniścaya. In the 13th century the
Śārngadhara Saṃhitā was composed on the subject of pharmacy and pharmaceuticals,
providing the first description of the physiology of respiration. When pulse diagnosis
was introduced in Ayurveda, independent treatises were composed on the subject. This
tradition of constant updating and documentation of medical knowledge continued
without a break right up to the colonial period. In the 19th century, Ayurveda suffered a
setback when unfavourable policies and regulations were enforced by the colonial rulers.
However, with the publication of the main Ayurvedic texts, a revival set in around the
turn of the 20th century, with a few leading Indian scholars coming out in defence of the
discipline.

9
Global resurgence of Ayurveda

In the post-independence period, Ayurveda’s resurgence Why should Western

continued, and in recent years it has been gaining prominence nations be taking a
as a whole system approach to healthcare under the banner of growing interest in
Ayurveda?
Complementary and Alternative Medicine. Although it is not
fully recognized in the West, Ayurveda is taught and practised in many countries like
Germany, Italy, United Kingdom, Austria, Netherlands and so on. There are many schools
of Ayurveda in the United States.

Contemporary status

Ayurveda continues to manage a wide range of conditions effectively like chronic

degenerative diseases and life style disorders and is being sought after by people around
the globe. As the world is moving towards an integrative approach to healthcare,
Ayurveda continues to inspire visions of healing that is holistic, pluralistic and
integrative at the same time through a tradition that has exhibited remarkable
continuity, resilience and adaptiveness to the vicissitudes of time.

***

Comprehension questions

¾ Did you expect people to drill teeth or cut open skulls thousands of years ago? If
not, why not?

¾ Name three fundamental texts of Ayurveda. What do they deal with?

¾ What areas of specialization do these texts reveal for Ayurveda?

¾ What important information regarding diseases does Caraka Saṃhitā contain?

10
 ¾ Why do you think were British surgeon interested in India’s method of nasal
reconstruction?

Project ideas

¾ Make a list of the traditional systems of medicine in operation in India, and

identify commonalities as well as differences.

¾ Studying closely the above photograph of surgical instruments, identify those that
look like modern instruments and describe their functions. Then propose possible
uses for those have not been identified.

¾ Fill up the table below with all names at your disposal:

Physician Period Contribution Relevance
Suśruta
Caraka
Vāgbhaṭa
Etc.

Extension activities

¾ Dharampal’s book, Science and Technology in 18th Century India (which can be
downloaded from the Internet*), has material (in chapters 3 and 7) on the
smallpox inoculation practised in India up to colonial times. Study the material
and prepare a two-page summary of it.

*
http://multiworldindia.org/wp-content/uploads/2010/05/Indian-Science-and-Technology1.pdf

11
 ¾ The same book has some data on eye and nose surgery (clue: search the text for
‘surgery’, ‘nose’ and ‘caute’). Prepare a brief note, and compare the nose surgery
with the procedure spelt out by Suśruta (see Extracts from Primary Texts below).

¾ Aśoka’s Edicts are easily available on the Internet (for instance,

www.cs.colostate.edu/~malaiya/ashoka.html). Locate the passages where he refers
to healthcare and elaborate.

Further Reading

1. Dharampal, Science and Technology in 18th Century India, Other India Press, Goa, 1971
2. Hirendra Nath Gupta & Priyadaranja Ray, Caraka Saṃhitā: A Scientific Synopsis, Indian National
Science Academy, New Delhi, 1965
3. P.V. Sharma, Indian Medicine in the Classical Age, The Chowkhamba Sanskrit Studies, vol.
LXXXV, Varanasi, 1972
4. P. Ray, H.N. Gupta & M. Roy, Suśruta Saṃhitā: A Scientific Synopsis, Indian National Science
Academy, New Delhi, 1993
5. P.V. Sharma, History of Medicine in India, Indian National Science Academy, New Delhi, 1992
6. G.J. Meulenbeld & Dominik Wujastyk, Studies in Indian Medical History, Motilal Banarsidass,
New Delhi, 2001
7. G.J. Meulenbeld, A History of Indian Medical Literature [Ia and Ib], Egbert Forsten, Groningen,
1999

Internet Resources (all URLs accessed in May 2012)

¾ Rhinoplasty
Dominik Wujastyk, a historian of Indian medicine explains the contributions of
Suśruta in developing an effective method of plastic surgery for reconstruction of
severed noses, which paved the way for modern rhinoplasty.
www.youtube.com/watch?v=kEpHFesE30E&feature=youtu.be

12
¾ Eye Surgery
This video clip captures a traditional Ayurvedic eye specialist performing a minor
surgical procedure on the eyelids of a patient using the stalk of the buds of the
hibiscus flower. This is safer than and as effective as using a sharp surgical
instrument.
www.youtube.com/watch?v=7wk7F2yA2h8&feature=youtu.be

YZ

13
 Extracts from Primary Texts

Dead body dissection

Verifying textual descriptions

Therefore the surgeon who desires to obtain undisputed knowledge should
examine a cadaver and observe the anatomy of the body in detail. What is
observed by direct perception and that which has been learnt from the texts
will together enhance one’s knowledge (1).*

One should take a cadaver of a person whose body is intact (2), who was not
killed by poison (3), was not afflicted by chronic disease (4) and was below 100
years of age at the time of death. The intestines along with faecal matter
should be removed and the body should be enclosed in a cage (5) after being
packed with muñja [Saccharum munja] grass, kuśa [Desmostachy abipinnata]
grass, sun hemp or other similar material (6). The body should be then
immersed in a flowing stream and allowed to decompose in an area where
there is not much light (7). After the body has decomposed, it should be
examined thoroughly within a span of seven days, by scraping the skin layer
by layer so that one can see clearly with one’s own eyes the external and
internal parts of the body. Suśruta Saṃhitā, Śārīrasthāna, 5.47-49 (tr. Dr. P. Ram
Manohar).

*
Numbers inserted in the extracts refer to the notes that follow them.

14
Notes

1. Suśruta makes it clear that one should gain practical knowledge of anatomy to
become a surgeon.

2. The body has to be intact to ensure that all parts and organs are preserved. Otherwise,
the observations will contradict the textual descriptions.

3. The body of a person who has been poisoned should be avoided as the toxic effect of
the poison will change the natural appearance of the skin and internal organs.

4. The characteristics of skin and other organs will be abnormal in a person who has
been afflicted by chronic diseases. Bodies of such persons should not be used for
dissection.

5. The body has to be kept in a cage when it is immersed in the stream to prevent the
strong flow of the water from damaging it.

6. The body has to be packed with grass or bark to prevent it from being eaten by fish,
which would result in deformation of the body parts.

7. If the body is kept in a very bright place, it will be attacked by vultures and eagles.
***

Rhinoplasty

Surgical repair of nose

I shall explain the procedure for repairing a nose that has been severed (1, 2).
The portion of the nose to be covered should be first measured with a leaf (3).
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

15
 should be made raw by cutting the nasal stump with a knife (4). The physician
then should place the skin on the nose and stitch the two parts swiftly,
keeping the skin properly elevated by inserting two hollow reeds in the
position of the nostrils, so that the new nose gets proper shape (5). The skin
thus properly adjusted, it should then be sprinkled with a powder of licorice,
red sandal-wood and barberry plant. Finally, it should be covered with cotton,
and clean sesame oil should be constantly applied. Ghee should then be
administered to the patient and when it has been digested, purgation should
be induced as per the guidelines. 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 (6). Suśruta Saṃhitā, Sūtrasthāna,
16.27-31 (tr. adapted from Gunakar Muley, ‘Susruta: Great Scientists of
ancient India’, www.vigyanprasar.gov.in/dream/july2000/article1.htm).

Notes

1. This procedure of nose repair was practised in India right up to modern times and was
witnessed by British surgeons during the colonial rule (see the first part of this
module). A documentary can be viewed on YouTube: www.youtube.com/watch?v=cV-
xZFIc6m4

2. Rhinoplasty was attempted in other parts of the world, but Suśruta’s method was far
superior because he used the skin close to the site of the injured nose to reconstruct
it. In the 16th and 17th centuries, Tagliocozzi used a tubed pedicle flap from the skin of
the inner upper arm to reconstruct the nose, which was not very successful. On 23
October 1814, Joseph Carpue successfully reconstructed a nose using the Indian
method, 30 years after he had first read about it. In due course of time, it became an
established practice in modern plastic surgery and even today textbooks of surgery

16
 refer to this procedure as the Indian Method and credit Suśruta for having invented
this technique.

3. A leaf was used as a template to cut the skin from the cheek. In due course of time, the
surgeons in India preferred to use skin from forehead instead of the cheek.

4. The edges of the severed nose would be scraped to ensure blood supply and to
facilitate union with the graft skin from the cheek.

5. Two hollow reeds are inserted into the nostrils to keep the airway patent so that the
patient can breathe easily.

6. A second sitting was sometimes necessary to give the final shape and contour to the
nose.
***

Genetic basis of diseases

Damage of seed and its parts

When the doṣas cause derangement in the seed or part of the seed
representing a specific organ of the body, that particular organ becomes
deranged (1).

In the female reproductive element, when the part of the seed representing
the uterus becomes deranged, then the woman becomes infertile, if part of
the seed is deranged, then the woman gives birth to a deformed baby (2), and
if a fraction of the part of the seed representing the uterus is damaged, then a
eunuch who looks like a woman but is devoid of the true characters of a
woman is born (3). Caraka Saṃhitā, Śārīrasthāna, 4.30 (tr. Dr. P. Ram Manohar).

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Notes

1. In these passages from the Caraka Saṃhitā, we find earliest speculations on genetic
basis of disease. The genetic transmission of diseases was understood in many cultures
and systems of medicine. However, the Caraka Saṃhitā stands out in having proposed a
theory to explain the mechanism of transmission of genetic diseases. According to this
text, every organ in the body is represented in a seed form in the reproductive
elements of the father and the mother. When the seed or its part that is responsible
for the development of a particular organ is damaged, then that organ is malformed
from birth.

2. Here the consequences of the damage to the part of the seed or fraction of the part of
the seed responsible for development of the uterus are explained. This means that
Caraka was aware of the fact that every organ of the body was represented in seed
form in the zygote and there were further fractions representing parts of these
organs.

3. It is interesting to note Caraka pointing out the genetic basis for development of the
secondary sexual characters in an individual.
***

Communicable Diseases

Modes of transmission
By repeated association, touching the body, by means of breath, eating
together, sleeping together and using another’s clothes and garlands, diseases
like leprosy, fever, consumption, conjunctivitis and other communicable
diseases spread from one person to another (1, 2). Suśruta Saṃhitā,
Nidānasthāna, 5.33-34 (tr. Dr. P. Ram Manohar).

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Notes

1. Communicable diseases have been identified and described by ancient medical

traditions. However, Suśruta was far ahead of his times in elaborating the mechanisms
of transmission of disease.

2. In Ayurveda, the existence of invisible microorganisms was recognized. These

microorganisms were also held responsible for causing diseases. (Refer to the first
part of this module.) But microorganisms had not been identified as the cause for
transmission of diseases from one person to the other. Nevertheless, Suśruta Saṃhitā
refers to flies as vectors in disease transmission when it warns the physician that
wounds should be dressed to prevent flies from depositing pathogens on the wound.
***

Comprehension questions

1. What strikes you in Suśruta’s description of the preparation of the cadaver to be used
for dissection?

2. How accurate are Suśruta’s explanations for the transmission of communicable

diseases?

3. How does Caraka explain what is now called genetic malformations?

YZ

19
 Aśoka — who called himself ‘Devanampiya Piyadasi’ or ‘Beloved-of-the-Gods,
He Who Looks On [All] With Affection’ — left numerous edicts engraved on
rocks and pillars. This is an extract from his rock edict at Girnar (Saurashtra,
Gujarat), which reflects Aśoka’s concern for the welfare not only of his
subjects, but ultimately of all humans and animals.

‘Everywhere within Beloved‐of‐the‐Gods, King Piyadasi’s domain, and

among the people beyond the borders, the Cholas, the Pāndyas, the
Satiyaputras, the Keralaputras, as far as Tamraparni [Sri Lanka] and where
the Greek king Antiochos rules [in Syria], and among the kings who are
neighbours of Antiochos, everywhere has Beloved‐of‐the‐Gods, King
Piyadasi, made provision for two types of medical treatment: medical
treatment for humans and medical treatment for animals. Wherever
medical herbs suitable for humans or animals are not available, I have had
them imported and grown. Wherever medical roots or fruits are not
available I have had them imported and grown. Along roads I have had
wells dug and trees planted for the benefit of humans and animals.’ (Tr.
Ven. S. Dhammika)

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CENTRAL BOARD OF SECONDARY EDUCATION
Shiksha Kendra, 2, Community Centre, Preet Vihar, Delhi-110 092 India