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Surgery through Ayurvedic Ways

Vedas contain many important subjects of all aspects of life, so that it would be no exaggeration to call it a key to the science, art and religion. In Vedas, Rishis took account of the whole world and whole of humanity in the manifestation of the heavenly power and knowledge. In this respect, medical science (Ayurveda) is an important part of it. The knowledge of 'ayu' revealed according to the need of the time as appreciated by the Rishis in Vedas. With such background we have to consider the importance of Vedic surgical skill in present scenario. At some point of medical evolution we seem to have forgotten the basic contribution that was made by the Vedic literature to make the documentation. After Vedas the Susruta samhita is only available text of Vedic surgical skill. Many more references are also available in other Ayurvedic texts. In different Puranas these examples are quoted in the forms of stories. Vagbhatta samhita is another milestone in this field. Our understanding of the ancient Vedic medical skill is limited due to lack of Vedic textual knowledge. In this consideration, review of the Ayurvedic literature is necessary for the better out come.

A number of examples are available in different texts about the zenith of surgical skill at that time. Susruta has taken the lead in this regard to deal with numerous surgical procedures. From incision and drainage operation of an abscess to reconstructive surgery, Susruta passed a very long way. His command over all the branches of surgery is remarkable. Surgical and para surgical procedures are discussed extensively in the text. Apart from this he described surgical instruments, wound management, importance of blood in surgery and principles of plastic surgery. It can be observed from this sort of description that the Indian surgery is scientific out come of the vast manual experience of the surgical practitioners during thousands of year.

In present context when the modern surgery is on its peak, a part from simple surgical procedure, organ transplantation, surgical and Para surgical procedures on brain and he31i are very common in highly specialized centers of India and abroad. These techniques are boon for the suffering humanity.

Previously impossible operations became common with the high tech instruments and the advent of anesthesia. Transplantation of heart, kidney and liver are the landmarks of modem surgery. Anesthesia plays an important role in these operations. Especially organ transplantation, neuro surgery and plastic surgery are more dependable on anesthesia.

Millions of surgeon, physician, anesthetist, other scientist and research personnel of biosciences contribute the network of modern surgery in India and abroad. The modern surgery is progressing day by day but every science has its limitations and scope. After the invention of LASER, cryosurgery and endoscopic surgery, operations became easier and more fruitful. The governments of the different countries of the world, world Health organization and pharmaceutical business houses patronize this system. In comparison to such a big system, what is the position of Ayurvedic surgery?

And what is the utility of Ayurvedic surgery in present time? Keeping these points in mind one should discuss and reply above-mentioned questions. In reply to these questions it can be announced that Ayurvedic surgery in terms of para-surgical procedures may contribute a lot in surgical lesions. Management of fistula in ano, tumours, urolithisiasis, wound healing and application of leech are the promising features of Ayurvedic surgery.

The history of surgery in India dates back to Vedas in which transplantation of head, amputation of legs and its replacement by iron, legs have been mentioned, performed by divine twin Asvini Kumaras. Susruta Samhita is the oldest available text of surgery in the world. In fact we would know almost nothing about the ancient Indian surgery if Susruta samhita had not been preserved. This book not only represented the embodiment of surgical knowledge of the past millenniums, but also was much ahead of his times in expounding and practicing the surgical principle, the validity of which are realized today. It is very interesting to know that, the study of Vedas, Indian philosophy, epics and Ayurveda was common in Kambuj. In Yasoverma's Lole inscription, it is said that, the king cures the diseases of his subject, and his speech is called Susrodita (originated from susruta). It is important that, apart from other Ayurvedic texts, Susruta-Samhita was also popular in this region.

Kshara Sutra Treatment for Fistula in ANO and Piles

Bhagandara (Fistula in ano) is a disease, which is described, in various ancient medical texts. Bhagandara was recorded as the most notorious disease for the treatment point of view. Fistula in ana is a disease, which takes place in the perineal part and ano-rectum. The fistulae are invariably preceded by ano -rectal abscess.

The treatment of fistula in ano has always been a great problem, both for the patient as well as for the surgeon. This is due to the high recurrence rate. A number of management techniques are described by a number of authors, but all these described techniques are not satisfactory therefore these techniques are discarded. The systemic use of anti- microbial agent is very limited to the earlier stage of peri anal abscess. It is well accepted that fistula in ano is a surgical disease, for that reason, a lot of preference has been given to surgical! Operative approaches. Even despite the fact that it has high recurrence rate. Considering the problems in the management of fistula in ano, postoperative complications and recunence, the para-surgical procedure Kshara-Sutra (medicated thread) is re-practiced for the management of fistula in ano successfully by the Ayurvedic practitioners.

The Kshara sutra therapy is an age old known effective therapy, the efficacy of which has been reputable and acknowledged in the medical world for the treatment of fistula in ano. Every Ayurvedic scholar knows that this therapy is mentioned in Susruta Samhita in the chapter of Visarpa Nadi Stana roga chikitsa. Where it is mentioned as an alternative treatment of Nadi Vrana (sinuses) in emaciated and poor nourished weak persons where surgical procedure is not indicated. The process of Kshara sutra application in the cases of sinuses has also been elaborated which is also applicable in fistula-in ano. Repeated use of Kshara sutra is necessary in the management of sinus, because single application of Kshara sutra was not found sufficient for the complete cure of the disease. So the technique of successive changes of Kshara sutra as often as necessary has also been depicted. In Susruta samhita, a comprehensive procedure including primary application and successive changes of Kshara sutra has been clearly detlned.

Para-Surgical Procedures

Many Surgical and Para surgical measures are practiced in the management of fistula- in ano. Kshara, Agni and Jalauka are three main Para surgical procedures described in Susruta Samhita.

Wound Healing

Wound is the discontinuity of skin and mucous membrane. The healing time of wound depends on the loss of skin and soft tissue. Usually wound heal spontaneously with out any extra effort, but a number of factors are responsible for wound healing. Age site of wound, blood supply, nutritional status, contamination and infection are important factors. In many metabolic disorders and other conditions delayed wound healing is mandatory. Wounds of Traumatic paraplegia, varicose ulcers and other non healing ulcers are problem for a surgeon.

Sixty procedures for the management of wound and ulcerative lesions are discussed in Ayurved. With the help of these procedure wound heals naturally with out any complication.

Blood Leeching and Leech Application

In Susruta Samhita, bloodletting is mentioned for the management of many diseases. Shring, Alabu and Jalauka (Leech) are three main methods of blood letting. Leech application is one important method used to restore the doshic balance of body by removing the impurities from the blood.

Leeches are used to cure numerous medical and surgical conditions. After the popularization of cosmetic or plastic (reconstructive) Surgery, interest in the Lise of Leech application is increased markedly. During skin grafting or other reconstructive surgical operations, blood clotting is the main problem, which hampers the blood supply between the graft and recipient site.

Leeches have been used to maintain blood circulation to grafted tissue. The severed/injured tissue also can be saved by Leech application, Leech application therapy is known as Jalaukavacharaha (hirudotherapy) Leech application is mainly indicated in thromboangitis obliterence, acute or chronic infective or inflammatory local lesions, skin lesions, haemorrhoids etc, other indications are boils, abscess, torisillary abscess, thrombophlebitis, orchitis.

Laser / Kshara Sutra & Kshara Karma

Piles, Fistula, Prolapse Rectum, Pilonidal Sinus, Ano-rectal Abscess, Rectal Polyps, Chronic Fissure

Agni Karma

Skin Diseases (Moles, Warts), Piles, Chronic Fissure-in-ano, Fistula-in-ano, Calcaneal Spur

Raktamokshana & Jalaukavcharan

Thrombosis, Skin Diseases (Psoriasis), Piles, Non Healing Ulcer, Berger's Disease, Raynaud's Disease

Shastra Karma

Piles, Fistula, Fissure, Hernia, Hydrocele , Cyst, Appendix, Abscess, Lipoma & Others