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In the war of 1792 Tipu Sultan's soldiers captured Kawasji (Cowasjee), a Maratha cart driver in the British army, and cut off his nose and an arm. A year later, a kumhara (potter) vaidya of Pune reconstructed Kawasji's nose in the presence of two English doctors, Thomas Cruso and James Trindlay, of the Bombay Presidency.
An illustrated account of this operation,-'not uncommon in India and has been practised for time immemorial'-appeared in the Madras Gazette; the Gentleman's Magazine of London reproduced it in October 1794. The surgical procedure closely corresponded to that mentioned in the ayurvedic text Susruta Samhita (350 AD).
Susruta Samhita is the oldest known work that clearly describes plastic surgery of the nose, ear and lip. Manka, an Indian physician in Baghdad during the reign of the Abbasid Caliph Harun al-Rashid (786-809 AD), translated Susruta Samhita into Arabic under the title of Kitab-Shawasoon al-Hind of Susrud. Persian physician al-Razi (860-925 AD) quotes Sasrad as an authority on surgery.
Susruta Samhita enumerates eight branches of medical knowledge as surgery; treatment of diseases of the eyes, ears, nose, throat and teeth; therapeutics; psychiatry and psychotherapy; paediatrics; toxicology and treatment of poisoning; treatment for longevity and rejuvenation; and treatment for increasing virility. But the text is known more for its extensive chapter on surgery. It mentions 300 different operations employing 42 surgical processes and 121 surgical instruments. These include ophthalmic couching, cutting for stone, removal of arrows and splinters, suturing, examination of dead bodies for anatomy and Caesarean sections.
Surgery, however, fell into disuse in later times. "According to Susruta," says P.C. Ray in his History of Hindu Chemistry, "the dissection of dead bodies is a sine qua non to the student of surgery and this high authority lays particular stress on knowledge gained from experiment and observation. But Manu [law giver] would have none of it. The very touch of a corpse, according to Manu, is enough to bring contamination of the sacred person of Brahmin. Thus we find that shortly after the time of Vagbhata, the handling of a lancet was discouraged and anatomy and surgery fell into disuse and became to all intents and purposes lost sciences to the Hindus."
Whatever be the reasons, the Susruta school did not flourish as much as the Charaka school of therapeutic medicine in India. Chinese sources place Charaka at the court of the 1st century Scythian king Kanishka. Arabs knew him as a medical author whose work was translated from Sanskrit to Persian to Arabic.
The ayurvedic texts contain a vast accumulation of medical and even general information such as the influence of environmental factors. For instance, a chapter in Charaka Samhita 'Janapadodhwamsaniyam', is on epidemics and pollution of air, water and land pollution. There is also a meticulous code of professional ethics and social conduct for the medical profession, much like the Hippocratic oath.
While Susruta Samhita and Charaka Samhita form the cornerstones of ayurveda, there are a number of other classical texts such as the Ashtangahridaya Samhita of Vagbhata, which is popular in the south. The tradition of ayurveda by Ashtavaidya Brahmins is live in Kerala.
Ayurveda has its theoretical foundation in the doctrine of three bodily humours-wind, bile and phlegm (vata, pitta, kapha). "It takes into consideration the whole human being, and not just the phenotype. The tridosha concept takes into consideration the phenotype, genotype and the mind in classifying patients," says Prof. B.M. Hegde, vice-chancellor of the Manipal Academy of Higher Education and a medical doctor. "Consequently, treatment differs even for the same disease from individual to individual, based on the constitutional types."
Ayurvedic medicines are mainly herbal, and therapies include enemas, massage, ointments, douches and surgery. From the end of the first millennium, metallic compounds also came into medical use.
Experts say that many 'modern concepts' were already known in ayurveda. Susruta describes pathogenic microorganisms to be the cause of certain forms of fever, pulmonary consumption, leprosy, smallpox and tuberculosis. Charaka's description of invisible krimis (corpuscles) in blood, that they are unicellular structures, circular or disc-like, without feet and of coppery colour, would marvel even modern accounts. "Even the authentication of Edward Jenner's vaccination came from ayurvedic vaccination's proven track record," says Hegde.
English physician Jenner is credited with discovering vaccination on a scientific basis with his studies on small pox in 1796. A group of Fellows of the Royal Society had earlier studied the method of inoculating people in India and submitted its report in the 1760s. Dr J.Z. Holwell, one of the members who was in the Bengal Province for more than ten years to study the Indian vaccination method, lectured at the London Royal College of Physicians in 1767 "that nearly the same salutary method, now so happily pursued in England,... has the sanction of remotest antiquity (in India), illustrating the propriety of present practice".
The description of the vaccination
methods prevalent then, based on Holwell's lecture, is mentioned in a recent
book Indian Science and Technology in the Eighteenth Century by Prof. Dharmapal,
brought out by Academy of Gandhian Studies in Hyderabad. Holwell talks
about a group of vaccinators inoculating people from home to home with
pus used from the inoculated pustule of the previous year. Following the
inoculation the person had to observe a strict regimen of diet and treatment
for the mild eruptive fever that follows.
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